R689 – Excision of Os Trigonum
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Surgical procedure for the excision of the Os Trigonum when performed as the sole procedure. As a surgical procedure, this service includes all constituent and common elements as defined in the General Preamble (, ). This includes pre-operative evaluation, the surgical procedure itself, and post-operative care. Fee Calculation: - Surgeon (Suffix A): The fee for the surgeon is a flat rate as listed in the Schedule. - Assistant (Suffix B): The fee is calculated based on 6 basic units plus time units. Time unit calculation rules are detailed on . - Anaesthetist (Suffix C): The fee is calculated based on 7 basic units plus time units. Time unit calculation rules are detailed on .
When to Use
- Use R689 specifically for the surgical excision of a symptomatic Os Trigonum when no other related foot or ankle procedures are performed.
- Choose R689 when the procedure is the primary surgical intervention for posterior ankle impingement syndrome caused by the Os Trigonum.
Common Pitfalls
- Billing R688 and R689 together will trigger an automatic rejection as they are mutually exclusive.
- Failing to document the specific clinical necessity for the excision can lead to recovery during a post-payment audit, as the procedure is considered elective.
Billing Tips
- Ensure that the surgical report clearly distinguishes the excision of the Os Trigonum from any concurrent soft tissue debridement, as the latter may be considered inclusive to the primary procedure.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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