How much does R069 pay?

The current OHIP fee for R069 is $961.60, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill R069 to OHIP?

R069 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R069 claims against the Schedule of Benefits rules before submission.

What codes are related to R069?

Codes related to R069 in the Schedule of Benefits include R067, R068, R056.

All codes

R069

R069 – Transplantation of innervated free island skin and subcutaneous flap with microvascular anastomosis(es) and nerve repair

OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

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This surgical procedure involves the transplantation of an innervated free island skin and subcutaneous flap. The procedure includes performing microvascular anastomosis(es) to re-establish blood flow and nerve repair to restore sensation or function. This is a complex reconstructive procedure.

When to Use

Use R069 specifically when the procedure involves a free tissue transfer that includes both microvascular anastomosis and a distinct nerve repair to restore sensation or function to the flap.
Select R069 over R067 or R068 when the complexity of the reconstruction necessitates neurotization of the flap, as R069 is the only code in this series that explicitly accounts for the nerve repair component.

Common Pitfalls

Billing R069 without clear documentation of the nerve repair component will lead to audit scrutiny, as the code specifically requires both microvascular and neural anastomosis.
Failing to document the specific microvascular techniques used can lead to claims being downgraded to simpler flap codes if the Ministry determines the complexity does not meet the R069 threshold.

Billing Tips

Ensure the operative report explicitly details the microvascular anastomosis and the specific nerve repair performed to justify the higher fee compared to standard free flap codes.
If a second assistant is utilized, bill their services alongside R069, as this code is explicitly eligible for a second assistant without prior authorization.

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Provider Fee$961.60

Surgical Assistant Fee$125.10

Anaesthetist Fee$154.90

Non-Anaesthetist Fee$154.90

Effective: April 1, 2025

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