R968 – Lengthening with circular external fixation (less than or equal to 6 cm)
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Reconstructive surgical procedure on the femur for leg length discrepancy. Involves lengthening the femur by 6 centimeters or less using a circular external fixation device. The service includes all common and specific surgical elements, such as pre-operative evaluation, the surgical procedure itself, and post-operative care as defined in the Schedule of Benefits (see , ). The service has 6 base units for an assistant and 6 base units for anaesthesia.
When to Use
- Use R968 specifically for femoral lengthening procedures where the total distraction length is 6 cm or less using a circular external fixator.
- Select R968 when the procedure is limited to the femur; do not use this code for tibial lengthening, which requires different procedural codes.
- Apply R968 for planned reconstructive leg length discrepancy corrections rather than acute fracture management or trauma-related stabilization.
Common Pitfalls
- Billing R968 alongside other musculoskeletal procedures on the same limb may trigger a 'multiple procedure' reduction or rejection; ensure you are not unbundling components included in the global surgical fee.
- Confusing R968 with R969 (which covers lengthening greater than 6 cm) will lead to claims audits; ensure your operative report clearly documents the planned and achieved lengthening distance.
- Failure to document the specific use of a circular external fixation device can lead to denials, as this code is specific to that hardware compared to other fixation methods.
Billing Tips
- Always verify the patient's age at the time of the procedure to apply the appropriate age premium (e.g., 5-16 years), as these add-ons significantly increase the total procedural value.
- Ensure the surgical assistant and anaesthesiologist units are billed correctly based on the 6 base units assigned to R968, and verify that any applicable after-hours or trauma premiums are appended only if the strict eligibility criteria are met.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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