R074 – Defect more than 10 cm average diameter - other areas
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service is for a skin flap procedure, specifically a rotation, transposition, or Z-plasty, to cover a defect with an average diameter exceeding 10 cm. It is applicable for procedures on areas of the body excluding the face, neck, or scalp. The service is classified as a surgical procedure and requires a suffix to denote the role of the physician: R074A for the surgeon, R074B for the assistant, and R074C for the anaesthesiologist. The fee for the surgeon is a set amount, while fees for the assistant and anaesthesiologist are calculated based on basic and time units (see and ). The procedure includes necessary undermining of the skin to facilitate closure, as noted on page of the Schedule (). Additional procedures, such as tendon grafts or inlay grafts, are not included and may be billed separately.
When to Use
- Use R074 for rotation, transposition, or Z-plasty skin flaps on the trunk or extremities where the average diameter of the defect exceeds 10 cm.
- Select R074 when the procedure involves significant undermining of adjacent tissue to facilitate closure of a large defect, distinguishing it from smaller flap codes like R072 or R073.
Common Pitfalls
- Billing R074 for defects on the face, neck, or scalp, which are excluded from this code and require different surgical codes.
- Failing to include the required suffix (A for surgeon, B for assistant, C for anaesthesiologist) which will result in an automatic claim rejection.
- Attempting to bill undermining as a separate procedure, as it is explicitly included in the R074 fee and is not separately payable.
Billing Tips
- If performing an excision for a tumour-free margin in the same session, remember to append the E540 premium to increase the R074 fee by 25%.
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.
The amount payable will depend on the size and location of the area grafted and the type of graft. Additional procedures other than the skin grafting are payable in addition to the skin flap or grafts, e.g. tendon grafts, inlay grafts, etc.
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