R958 – Double level correction - circular external fixation
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
R958 is a fee code for a surgical procedure within the Urogenital and Urinary System section of the OHIP Schedule of Benefits. The specific details of the procedure are not available in the provided context. This service is eligible for billing with suffix A (Surgeon), B (Assistant), or C (Anaesthetist). Assistant and Anaesthetist fees are calculated based on basic and time units as per the General Preamble. The service is eligible for various add-on premiums, including for after-hours service, trauma, and specific patient demographics (e.g., age). See the addOnEligibleCodes section for a detailed list.
When to Use
- Use R958 specifically for the application of a circular external fixation device when performing a double-level correction on a single limb.
- Select this code when the surgical plan necessitates multi-planar correction at two distinct anatomical levels using a circular frame, distinguishing it from single-level procedures.
Common Pitfalls
- Billing R958 for a single-level correction, which should be coded under the appropriate single-level musculoskeletal procedure code rather than this double-level specific fee.
- Failing to document the distinct anatomical levels of the correction, which is a common trigger for audit inquiries regarding the necessity of a double-level procedure.
Billing Tips
- Ensure the operative report explicitly details the two separate levels of osteotomy or correction to justify the higher complexity fee associated with R958 compared to single-level fixation codes.
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. The Act requires that the record establish that: 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.
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