R026 – Scar revision - other areas
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
R026 is a surgical procedure for the revision of a scar up to 2.5 cm in length, located on areas of the body other than the face or neck. The procedure can be performed using any method of closure. As per the note on page of the Schedule, authorization is required for all scar revisions in areas other than the face or neck (see Appendix D). This service is eligible for surgical assistant and anaesthesia services, each with 6 base units.
When to Use
- Use R026 for the surgical revision of a non-facial, non-cervical scar that is 2.5 cm or less in length.
- Select R026 when performing a revision of a scar on the trunk or extremities that requires formal excision and closure, as opposed to simple debridement.
Common Pitfalls
- Billing R026 without prior authorization as required by Appendix D will result in automatic claim rejection.
- Confusing R026 with facial scar codes like R021 or R022; R026 is strictly for areas other than the face or neck.
- Exceeding the 2.5 cm length limit; if the scar revision exceeds 2.5 cm, you must use a different code or seek manual assessment if no appropriate code exists.
Billing Tips
- Ensure the required authorization is obtained and documented before submission to avoid audit adjustments.
- Remember that R026 is eligible for surgical assistant and anaesthesia base units (6 units each), which can be claimed if the complexity of the procedure warrants their presence.
Effective: April 1, 2025
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Integumentary System Surgical Procedures
Authorization is required for all 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).
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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