R967 – Pseudoarthrosis - Circular external fixation
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure for the reconstruction of a pseudoarthrosis (false joint) of the femur. This procedure involves the application of a circular external fixation device to stabilize the bone and promote healing. This code is used for the surgeon's fee (suffix A), assistant's fee (suffix B), and anaesthetist's fee (suffix C). The fees for assistant (R967B) and anaesthesia (R967C) are calculated based on basic units plus time-based units as defined in the Schedule of Benefits.
When to Use
- Use R967 specifically for the surgical reconstruction of a femoral pseudoarthrosis where a circular external fixation device is the primary stabilization method.
- Select R967 when the procedure involves the mechanical stabilization of a non-union in the femur, distinguishing it from internal fixation procedures like R328.
Common Pitfalls
- Billing R967 alongside internal fixation codes for the same site is a common audit trigger; ensure the clinical documentation clearly justifies the use of external circular fixation as the primary modality.
- Failing to document the specific Injury Severity Score (ISS) when attempting to claim the E420 trauma premium for this procedure will result in automatic rejection.
Billing Tips
- Ensure that the surgical report explicitly details the application of the circular external fixation device, as this is the defining component for the R967 fee.
- When billing R967B or R967C, ensure the time-based units are calculated strictly according to the Schedule of Benefits to avoid discrepancies with the base unit values.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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