R023 – Scar revision - face or neck - 5.1 cm to 10 cm
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service is for the surgical revision of a scar located on the face or neck, with a length between 5.1 cm and 10.0 cm. The procedure includes any method of closure. For scars resulting from post-infection, the service must be claimed on an Independent Consideration (IC) basis, with the maximum payable amount being equivalent to the fee for R023.
When to Use
- Use for the surgical excision and revision of a symptomatic or disfiguring scar on the face or neck measuring between 5.1 cm and 10.0 cm in total length.
- Use when performing a revision of a scar resulting from a previous infection on the face or neck, ensuring the claim is submitted as Independent Consideration (IC) with R023 as the fee reference.
Common Pitfalls
- Claiming R023 for scars located outside the face or neck without prior authorization, which will result in automatic rejection or audit recovery.
- Incorrectly measuring the scar; if the total length is 5.0 cm or less, you must use R022, and if it exceeds 10.0 cm, you must use R024.
- Failing to provide detailed clinical documentation for post-infection scar revisions, which is mandatory for successful IC processing.
Billing Tips
- Ensure the operative report explicitly states the final measured length of the scar to justify the use of R023 over the smaller R022 or larger R024 codes.
- When billing for post-infection scarring, include a clear note in the 'comments' field of the claim indicating 'IC - Post-infection scar revision, equivalent to R023' to expedite manual review.
Effective: April 1, 2025
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Integumentary System Surgical Procedures
Documentation required for revision of post-infection scarring of face when claimed on an Independent Consideration (IC) basis.
Authorization required for scar revisions in areas other than the face or neck (see Appendix D).
Authorization is required for all scar revisions in areas other than the face or neck (see Appendix D).
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