R013 – Free jejunum artery and vein for transplantation
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service is for the transplantation of a free jejunum artery and vein, a complex microvascular surgical procedure. The service may be performed by a single surgeon or multiple surgeons, with specific rules for billing preparation of the recipient site separately (see R014, R016). The service of a second surgical assistant is eligible for payment without special authorization (). As a surgical procedure, it is eligible for various premiums including age-based premiums for patients under 16 (), after-hours premiums (, , ), and the trauma premium (E420) under specific conditions ().
When to Use
- Use R013 specifically for the microvascular transplantation of a free jejunum graft, distinct from the recipient site preparation codes R014 or R016.
- Apply this code when performing the primary vascular anastomosis and graft placement in reconstructive procedures involving free jejunal tissue transfer.
Common Pitfalls
- Failing to document the Injury Severity Score (ISS) in the medical record will result in the automatic rejection of the E420 trauma premium.
- Billing R013 without accounting for the 15% reduction rule when the excision and recipient site preparation are performed by different surgeons is a common audit trigger.
- Attempting to claim the trauma premium (E420) alongside after-hours premiums (E409/E410) is prohibited by the Schedule of Benefits.
Billing Tips
- Ensure the second surgical assistant is billed on the same claim as the primary surgeon to facilitate automatic processing under GP90 guidelines.
- Always verify that the trauma premium (E420) is submitted on the exact same claim as the R013 procedure to ensure the 50% premium is applied correctly.
Effective: April 1, 2025
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Integumentary System Surgical Procedures
For the E420 trauma premium to be payable, the medical record must list the Injury Severity Score (ISS).
When excision of the lesion and preparation of the recipient site are carried out by different surgeons, the preparation fees should be reduced by 15%.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.