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R696
R696 – Midtarsal, single joint
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Arthrodesis of a single midtarsal joint. This service includes any neurovascular exploration and/or protection and tenolysis, when rendered. An additional fee (E512) is applicable for additional midtarsal fusions. As per the note on , R696 is not payable in addition to R695 (Subtalar arthrodesis) for the same patient on the same day.
When to Use
- Use R696 when performing a primary arthrodesis of a single midtarsal joint, such as the talonavicular or calcaneocuboid joint.
- Use R696 in combination with E512 when performing a multi-joint midtarsal fusion procedure to account for each additional joint fused beyond the first.
Common Pitfalls
- Billing R696 alongside R695 for the same foot on the same day will result in an automatic rejection due to the explicit restriction in the Schedule of Benefits.
- Failing to append E512 when multiple midtarsal joints are fused results in significant under-billing, as R696 only covers the base fee for a single joint.
Billing Tips
- Ensure the operative report clearly itemizes each joint fused to justify the number of E512 units claimed in addition to the primary R696 code.
Provider Fee$500.00
Surgical Assistant Fee$75.06
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
Effective: April 1, 2025
Since Sep 2011, this fee has increased 0.0% vs 35.5% CPI inflation
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
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