R056 – Preparation of microvascular recipient site for innervated free island skin and subcutaneous flap immediately following ablative surgery
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This surgical service covers the preparation of a microvascular recipient site for the transplantation of an innervated free island skin and subcutaneous flap. This code is specifically for when the preparation is performed immediately following ablative surgery and the recipient vessels are located within the site of the ablation. This service is part of a series of procedures for free flap surgery, which may also include elevation of the flap (R067) and transplantation with microvascular anastomosis (R069).
When to Use
- Use R056 when preparing the recipient site for a free flap immediately following an ablative procedure where the recipient vessels are identified within the same surgical field.
- Use R056 in conjunction with R067 (flap elevation) and R069 (microvascular anastomosis) to complete the full billing sequence for a free tissue transfer.
Common Pitfalls
- Failing to apply the 15% reduction to R056 when the ablative surgeon and the reconstructive surgeon are different individuals.
- Billing R056 for recipient site preparation that occurs at a separate anatomical site from the ablation, which may require different coding logic.
- Attempting to bill R056 as a standalone procedure without the associated microvascular anastomosis (R069) or flap elevation (R067) when the clinical intent is a full free flap reconstruction.
Billing Tips
- Ensure the claim includes the associated R067 and R069 codes to accurately reflect the full scope of the reconstructive surgery performed.
- If the procedure is performed after hours or for a trauma patient, verify eligibility for E409, E410, or E420, ensuring the ISS score is documented for E420.
Effective: April 1, 2025
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Integumentary System Surgical Procedures
When excision of the lesion and preparation of the recipient site are carried out by different surgeons, the preparation fees should be reduced by 15%.
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