R037 – Giant cell tumour
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
R037 is a surgical procedure. The fee for the surgeon is payable with suffix A. Assistant services (suffix B) and anaesthesiologist services (suffix C) are calculated based on basic and time units as outlined in the Schedule of Benefits. Various premiums may apply, including those for after-hours services, special visits, trauma, and specific patient factors like age or ASA status for anaesthesia. See the Surgical Assistants' Services (-) and Anaesthesiologists' Services (-) sections of the General Preamble for detailed rules.
When to Use
- Use R037 for the definitive surgical excision of a confirmed giant cell tumour of the bone or soft tissue.
- Use R037 when performing a formal resection that exceeds the scope of a simple biopsy or minor lesion removal.
Common Pitfalls
- Billing R037 alongside a diagnostic biopsy code for the same lesion is considered unbundling; the biopsy is typically included in the definitive surgical fee.
- Attempting to bill a second surgical assistant without prior authorization from a medical consultant will result in an automatic rejection, as R037 is not on the pre-approved list for two assistants.
- Failing to document the specific anatomical site and pathology confirmation in the operative report increases the risk of audit recovery.
Billing Tips
- Ensure the operative report clearly details the extent of the resection, as this documentation is required to justify the R037 fee over lower-valued integumentary or musculoskeletal excision codes.
- If the procedure is performed on a patient under 16 years of age, remember to append the appropriate age-based premium to both the surgeon (suffix A) and assistant (suffix B) claims.
Effective: April 1, 2026
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
See Appendix H of the Schedule of Benefits for a table stating the duration of surgical assisting and corresponding time units.
See Appendix H of the Schedule of Benefits for a table stating the duration of the anaesthesia service and corresponding time units.
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