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R961
R961 – Humeral lengthening - circular external fixation (less than or equal to 6 cm)
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This code represents a surgical procedure for humeral lengthening using circular external fixation, specifically for lengths less than or equal to 6 cm, as listed under 'N. Musculoskeletal System Surgical Procedures' on page .
When to Use
- Use R961 for planned humeral lengthening procedures using circular external fixation where the total planned distraction is 6 cm or less.
- Select this code specifically for pediatric or adult patients undergoing limb reconstruction where circular frame application is the primary modality for humeral lengthening.
Common Pitfalls
- Do not bill R961 if the lengthening exceeds 6 cm; this would require a different classification or potentially a manual review/unlisted code if no specific code exists for greater lengths.
- Avoid billing R961 in conjunction with other fracture fixation codes unless the procedures are performed on separate anatomical sites or represent distinct, non-overlapping surgical tasks.
Billing Tips
- Ensure the operative report explicitly documents the length of the lengthening achieved to justify the 6 cm threshold associated with this specific code.
- Always verify if the patient qualifies for age-based premiums, as pediatric patients undergoing this procedure are frequently eligible for the 10% to 30% increases depending on their exact age.
Provider Fee$438.00
Surgical Assistant Fee$75.06
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
Effective: April 1, 2025
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Urogenital and Urinary Surgical Procedures
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