R031 – Single lesion
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
R031 is payable for the treatment of a single malignant lesion by means of curettage, electrodesiccation, or cryosurgery. This code is specifically for lesions on areas other than the face or neck. Billing Requirements: - A pathologist's report must be retained in the patient's record, otherwise the fee will be adjusted to a lesser amount. (Source: ) - The lesion must be malignant. According to the Schedule, a pre-malignant lesion is not a malignant lesion for the purposes of payment. (Source: ) - When excision of benign, pre-malignant or malignant skin lesions are corrected by a. Advancement flap including undermining of more than 2.5 cm per side, or b. Rotation, transposition, Z-plasty, or c. Other flap or graft claim the appropriate benefit listed under Skin Flaps and Grafts Section instead of foregoing excision benefits. (Source: )
When to Use
- Use R031 for the definitive treatment of a single confirmed malignant lesion on the trunk or extremities via curettage, electrodesiccation, or cryosurgery.
- Use R031 when the lesion is malignant, as pre-malignant conditions (e.g., actinic keratosis) do not qualify for this specific code.
Common Pitfalls
- Billing R031 for lesions located on the face or neck, which must be billed under R018, R019, or R020 instead.
- Failing to retain the pathology report in the patient record, which triggers an automatic adjustment to a lower fee upon audit.
- Billing R031 for procedures involving flaps or grafts, which are explicitly excluded and must be billed under the Skin Flaps and Grafts section.
Billing Tips
- Ensure the pathology report is finalized and filed before submission to support the malignant diagnosis requirement.
- If treating multiple malignant lesions on the same day, use R032 for two lesions or R033 for three or more to avoid claim rejection for duplicate service.
Effective: April 1, 2026
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Integumentary System Surgical Procedures
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