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R954
R954 – Circular external fixation (greater than 6 cm)
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Circular external fixation (greater than 6 cm)
When to Use
- Use R954 for the application of a circular external fixation device (e.g., Ilizarov or Taylor Spatial Frame) when the construct diameter or frame size exceeds 6 cm.
- Use this code for complex limb reconstruction or deformity correction procedures where a circular frame is the primary method of stabilization, distinguishing it from standard unilateral external fixation.
Common Pitfalls
- Claiming R954 for standard unilateral external fixation devices, which are billed under different codes; ensure the circular nature and size criteria are met.
- Failing to document the specific frame diameter in the operative report, which is essential to justify the 'greater than 6 cm' requirement during an audit.
- Incorrectly appending trauma premiums (E420) without explicitly documenting the Injury Severity Score (ISS) in the patient record as required by GP109.
Billing Tips
- Ensure the operative note clearly describes the circular frame construct, as this is the primary evidence required to support the R954 fee over lower-complexity fixation codes.
- When performing this procedure after hours, verify the start time of the surgery to correctly apply the appropriate after-hours premium (E409 or E410) to the R954 base fee.
Provider Fee$763.80
Surgical Assistant Fee$75.06
Anaesthetist Fee$108.43
Non-Anaesthetist Fee$108.43
Effective: April 1, 2025
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
All insured services must be documented in appropriate records that establish: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary ().
If the trauma premium (E420) is claimed, the medical record must list the Injury Severity Score (ISS) ().
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