R425

PDF page 591 / N11

MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
 HAND AND WRIST
                                                                                                   Asst   Surg     Anae
    EXCISION
    Bone
# R316 Proximal row carpectomy .......................................................              6     451.90    7
# R285 Carpal - bone (one).................................................................         6     214.45    7
# R317 Dorsal exostosis (triquetrum)..................................................              6     189.75    6
# R286 Radial styloid ..........................................................................    6     234.75    7
# R283 Phalanx/metacarpal ................................................................          6     193.00    7
# R272 Bone tumour (see General Preamble GP12)..........................                           I.C     I.C     I.C
    Joint
     Synovectomy/capsulectomy/debridement
# R425 - finger joint...........................................................................    6     261.55    6
# R414 - two or more joints ...............................................................         6     339.65    7
# R407 Synovectomy of extensor or flexor tendons............................                              224.45    6
# R418 Synovectomy/debridement - wrist...........................................                   6     342.55    7
# R492 Radio-ulnar meniscectomy .....................................................               6     231.10    7
    Soft tissue
# R549 Ganglion - Simple or complex.................................................                6     221.80    6
# R551 Excision of fascia for Dupuytrens (palmar fibromatosis), single
           ray, with or without flaps. ....................................................         6     322.15    7
# E832     - excision of fascia for Dupuytrens, additional rays, to R551
             add                                                                                          273.85
# E831     - use of skin grafts, or revision surgery (with or without skin
             grafts), to R549 or R551 ................................... add 30%
         Payment rules:
         1.Excision of fascia for Dupuytren’s (R551, E832) is only insured for patients who demonstrate
           at least one of the following physical signs:
            a.Metacarpophalangeal (MCP) joint flexion contractures of 30 degrees or more.
            b.Interphalangeal (IP) joint flexion contracture of any degree.
            c.Adduction contractures of the interdigital web spaces with significant functional
              impairment.
            d.Recurrence of Dupuytren’s disease, defined as any recurrent flexion contracture of the
              MCP or IP joints following prior interventional treatment (e.g., fasciotomy/fasciectomy).
            e.Significant functional impairment with any degree of contracture at the MCP or IP joints.
         2.R551 is not payable for treatment of Dupuytren’s by aponeurotomy.
         3.A maximum of one R551 is eligible for payment per limb, per day.
         4.A maximum of two E832 are eligible for payment per limb, per day.
         5.Services listed under “Skin Flaps and Grafts” are not eligible for payment with R549 or R551.
         6.R551, E832 and E831 include the palmar and digital components of the Dupuytrens
           procedure, when rendered.
         [Commentary:
         When excision of fascia for Dupuytren’s is performed for one ray, claim R551; when two rays
         on the same hand are treated, claim R551 and E832; when three or more rays on the same
         hand are treated, claim R551 and E832 (2).]

PDF page 635 / N55

MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
 FOOT AND ANKLE
                                                                                                      Asst   Surg     Anae
# R420 Ankle synovectomy.................................................................              6     316.25    7
     Metatarsophalangeal synovectomy/capsulectomy/debridement
# R425 - one .....................................................................................     6     261.55    6
# R414 - two or more ........................................................................          6     339.65    7
    Soft Tissue
# R506 Bursa ...................................................................................... 6        149.45    6
# R549 Ganglion - simple or complex .................................................               6        221.80    6
# R576 Excision of fascia for Dupuytrens (planter fibromatosis), one or
          more rays ...........................................................................     6        322.15    6
# E831    - use of skin grafts, or revision surgery (with or without skin
            grafts), to R549 or R576 ................................... add 30%
      Payment rules:
      1.R576 is not payable for treatment of Dupuytren’s by aponeurotomy.
         2.A maximum of one R576 is eligible for payment per limb, per day.

Master, record 4653. Record Layout PDF, page 1.

R42520260401999999990000261550000000774600000000000000000095760000000957600

Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.