R007 – Other flap
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This code is for 'Other' flaps and is subject to Independent Consideration (IC) as detailed in the General Preamble (). Claims for this service require a supporting letter, operative/consultation report, and a comparison to non-IC procedures in the Schedule. The listing is found on page .
When to Use
- Use R007 for unique reconstructive flaps that do not fit the specific anatomical or technical criteria of defined codes like Z101 or Z102.
- Use R007 when performing complex, non-standard tissue transfers where the complexity of the dissection or reconstruction significantly exceeds standard integumentary surgical procedures.
Common Pitfalls
- Submitting R007 without a detailed letter of explanation comparing the procedure's complexity to a specific, non-IC Schedule code will result in automatic rejection.
- Failing to attach the operative report to the claim submission is a common cause for denial, as the Ministry cannot assess the 'Independent Consideration' without clinical evidence of the work performed.
Billing Tips
- When drafting your supporting letter, explicitly reference a similar non-IC procedure code and justify the fee by highlighting specific technical challenges or increased operative time that distinguishes your case from that benchmark.
No fee information available.
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
Claims for such services must be submitted with a supporting letter explaining the amount of the fee claimed, and must include an appropriate operative or consultation report, and a comparison of the scope and difficulty of the procedure in relation to non-IC procedures in the Schedule.
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