R018 – Curettage, electrodesiccation or cryosurgery - single lesion
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Treatment for a single malignant lesion located on the face or neck, performed via curettage, electrodesiccation, or cryosurgery. This fee code applies to a single lesion. Key requirements: - A pathologist's report confirming malignancy must be retained in the patient's record; otherwise, the fee will be adjusted to a lesser amount. - This service is not payable for pre-malignant lesions (). Billing guidance: - If the defect from the procedure is repaired using techniques such as advancement, rotation, transposition, Z-plasty, flap, or graft, the claim should be for the appropriate repair code instead of R018 (). - Assistant Fee: Based on 6 basic units plus time units (, ). - Anaesthesia Fee: Based on 6 basic units plus time units (, ).
When to Use
- Use R018 for the definitive treatment of a biopsy-confirmed basal cell or squamous cell carcinoma on the face or neck using curettage and electrodesiccation.
- Use R018 for cryosurgical destruction of a single malignant lesion on the face or neck when the diagnosis is supported by a prior pathology report.
Common Pitfalls
- Billing R018 for pre-malignant lesions like actinic keratosis, which are excluded from this code and should be billed under the appropriate M5 section codes.
- Failing to retain the pathology report in the patient record, which triggers an automatic audit adjustment to a lower fee.
- Billing R018 when the procedure involves a surgical repair such as a flap or graft, which necessitates using the higher-value repair codes instead.
Billing Tips
- Ensure the pathology report is finalized and filed before submitting the claim to avoid payment clawbacks during post-payment verification.
- If performing the procedure in a hospital setting to achieve tumour-free margins confirmed by frozen section, remember to add code E540 to increase the fee by 25%.
Effective: April 1, 2026
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Integumentary System Surgical Procedures
The amount payable for treatment of a malignant lesion will be adjusted to a lesser fee if the pathologist's report is not retained in the patient's record.
A pre-malignant lesion is not a malignant lesion for the purposes of payment.
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