R688 – Ankle arthroscopy setup
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Ankle arthroscopy setup, includes when rendered debridement, synovectomy, removal of loose body(ies) and/or screw, drilling of defect or microfracture and/or synovial biopsy.
When to Use
- Use R688 as the primary base code for routine ankle arthroscopy involving debridement, synovectomy, or removal of loose bodies.
- Use R688 when performing microfracture or drilling of an osteochondral defect as the primary surgical objective.
- Use R688 in conjunction with E477 when you are performing a separate arthroscopy of the subtalar or intratarsal joints through distinct portals.
Common Pitfalls
- Billing R688 with R689 is a common rejection; these codes are mutually exclusive for the same procedure.
- Attempting to bill E481 or E483 for procedures lasting less than the mandatory 2-hour or 90-minute thresholds will result in audit recovery.
- Billing E478 for pinning an osteochondral fragment is disallowed if you are also billing an F-prefix fracture procedure for the same injury.
Billing Tips
- Ensure your operative report explicitly documents the resection time if claiming E481 or E483, as these are strictly time-dependent add-ons.
- Always check if your additional ankle procedure is a component of R688; if it is, you cannot bill it separately, even if it is listed elsewhere in the Schedule.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
An ankle procedure listed in the Foot and Ankle section of the Schedule performed arthroscopically is eligible for payment in addition to **R688 if that procedure is not described as a component of R688 or described by an E-add-on code to R688**.
Arthroscopic E-add-on codes listed below are not eligible for payment in addition to **R668** when the service described by the E-code is a generally accepted component of a procedure described in Note #1.
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