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R065
R065 – Preparation of microvascular recipient site for free island skin subcutaneous flap
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Preparation of the microvascular recipient site for a free island skin and subcutaneous flap. This involves preparing the blood vessels at the site where a transferred piece of tissue (flap) will be reattached to establish a new blood supply.
When to Use
- Use R065 when performing the specific dissection and isolation of recipient vessels (artery and vein) required to receive a free tissue transfer.
- Use this code for the recipient site preparation phase of a free flap procedure, distinct from the flap harvest (e.g., R064) or the microvascular anastomosis itself.
Common Pitfalls
- Failure to apply the mandatory 15% reduction to the fee when the surgeon performing the excision of the lesion is different from the surgeon preparing the recipient site.
- Attempting to bill R065 in conjunction with other site preparation codes that are considered inclusive of the vascular dissection required for free tissue transfer.
Billing Tips
- Ensure the operative report clearly details the specific vessels identified and prepared to support the free flap, as this justifies the complexity of the procedure.
- If the procedure is performed on a trauma patient, ensure the Injury Severity Score (ISS) is documented in the chart to support the E420 trauma premium.
Provider Fee$925.85
Surgical Assistant Fee$125.10
Anaesthetist Fee$154.90
Non-Anaesthetist Fee$154.90
Effective: April 1, 2025
Category
M. Integumentary System Surgical Procedures
Subcategory
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
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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