R021 – Scar revision - face or neck - up to 2.5 cm
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service is for the surgical revision of a scar on the face or neck, with a length of up to 2.5 cm. The fee for R021 includes any method of closure and is claimed by the primary surgeon using suffix 'A'. Services for an assistant (suffix 'B') and an anaesthetist (suffix 'C') are also eligible for payment and are calculated based on basic and time units.
When to Use
- Use R021 for the surgical excision and revision of a facial or neck scar that measures 2.5 cm or less in total length.
- Use this code for elective scar revisions where the primary goal is aesthetic or functional improvement of a mature scar.
Common Pitfalls
- Do not bill R021 for post-infection scarring; these must be claimed as 'I.C.' (Independent Consideration) and are capped at the value of R023.
- Avoid billing R021 if the scar length exceeds 2.5 cm, as you must use the appropriate higher-tier code (e.g., R022) to avoid rejection or audit recovery.
- Do not attempt to unbundle the closure method; the fee for R021 is inclusive of all techniques used to close the site.
Billing Tips
- If performing multiple scar revisions, ensure you are not incorrectly billing R021 multiple times for a single continuous excision; document the length of each distinct scar clearly in the operative report.
- Always verify if the patient qualifies for the age-based premium (under 16 years) to maximize the procedural fee, as this is an eligible surgical procedure under the Schedule of Benefits.
Effective: April 1, 2025
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Integumentary System Surgical Procedures
For trauma cases, the Injury Severity Score (ISS) must be listed in the medical record to claim the E420 trauma premium ().
Authorization is required for all scar revisions in areas other than the face or neck (see Appendix D).
Revision of post-infection scarring of face must be claimed on an “I.C” basis - maximum payable will be as equated to R023.
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