R969 – Lengthening with circular external fixation (greater than 6 cm)
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Lengthening with circular external fixation (greater than 6 cm) is a reconstructive surgical procedure on the femur to correct a leg length discrepancy. The service is eligible for payment to the operating surgeon (suffix A), a surgical assistant (suffix B), and an anaesthetist (suffix C). The fee for this service encompasses all common and specific elements of an insured surgical service as outlined in the Schedule of Benefits (:, :).
When to Use
- Use R969 specifically for femoral lengthening procedures where the planned correction exceeds 6 cm using a circular external fixation device.
- Select R969 when the procedure involves complex reconstruction of the femur, distinguishing it from R968 which covers lengthening of 6 cm or less.
Common Pitfalls
- Billing R969 when the lengthening distance is 6 cm or less, which must be billed under R968 to avoid rejection or audit recovery.
- Failing to document the specific lengthening distance in the operative report, which is required to justify the 'greater than 6 cm' threshold for this higher-valued code.
Billing Tips
- Ensure the operative note explicitly states the planned or achieved lengthening distance to substantiate the use of R969 over R968.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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