R047 – Rotations, transpositions, Z-plasties - face, neck or scalp - Defect 5.1 to 10 cm average diameter
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Rotation, transposition, or Z-plasty skin flap for a defect with an average diameter of 5.1 to 10 cm, located on the face, neck, or scalp. This procedure includes undermining. As per the preamble on page , the amount payable will depend on the size and location of the area grafted. Additional procedures other than the skin grafting, such as tendon grafts or inlay grafts, are payable in addition.
When to Use
- Use for a rotation, transposition, or Z-plasty flap on the face, neck, or scalp where the defect size is strictly between 5.1 cm and 10 cm in average diameter.
- Use when the surgical repair requires significant undermining and tissue rearrangement, distinguishing it from simple excision and closure codes like R003 or R004.
Common Pitfalls
- Billing R047 for defects smaller than 5.1 cm; ensure you use R045 or R046 for smaller defects to avoid rejection or audit recovery.
- Failing to document the average diameter of the defect, which is the primary determinant for selecting the correct R-series code.
- Attempting to bill an excision code (e.g., S060) in addition to R047; the flap fee is intended to cover the repair of the defect created by the excision.
Billing Tips
- If performing an excision for a malignant lesion in a hospital setting with frozen section confirmation, remember to add the E540 premium to this base fee.
- Always document the specific dimensions of the defect in the operative report to justify the 5.1 to 10 cm category if audited.
Effective: April 1, 2025
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Integumentary System Surgical Procedures
Includes undermining but will depend on the site and size.
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