R950 – Radius and ulna - circular external fixation
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
R950 represents a surgical procedure on the musculoskeletal system (radius and ulna - circular external fixation). As with most surgical services, the fee for R950A includes the major pre-operative visit (consultation or assessment), the surgery itself, and normal post-operative care. This service is eligible for assistant (R950B) and anaesthetist (R950C) fees.
When to Use
- Use R950 for the application of a circular external fixator (e.g., Ilizarov or Taylor Spatial Frame) specifically for fractures or deformity correction involving both the radius and ulna.
- Select R950 when the procedure is performed in a hospital setting as a definitive surgical intervention, distinguishing it from simple splinting or casting codes.
Common Pitfalls
- Billing R950 in addition to a separate fracture reduction code for the same limb is generally considered unbundling; the fixation fee is intended to cover the surgical management of the injury.
- Failing to document the specific 'major pre-operative visit' separately from the surgical claim can lead to audit scrutiny if you attempt to bill a consultation code on the same day as the procedure.
Billing Tips
- If the procedure is performed after hours for a non-elective fracture, ensure you append the appropriate premium (E409 or E410) to the R950 claim to capture the 50% or 75% procedural increase.
- Always verify that the assistant (R950B) and anaesthetist (R950C) codes are submitted on separate claims linked to the same surgical encounter to ensure proper processing of their respective unit-based fees.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Urogenital and Urinary Surgical Procedures
All insured services must be documented in appropriate records to establish that: an insured service was provided, the service submitted is the service rendered, and the service was medically necessary.
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