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R076
R076 – Defect more than 10 cm average diameter - face, neck or scalp
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
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When to Use
- Use R076 for the repair of a surgical or traumatic defect on the face, neck, or scalp where the average diameter of the defect exceeds 10 cm.
- Select this code when the complexity of the defect size necessitates a major reconstructive effort that exceeds the scope of smaller repair codes like R075.
Common Pitfalls
- Billing R076 for defects smaller than 10 cm; ensure the average diameter is calculated accurately as (length + width) / 2 to avoid rejection or audit recovery.
- Failing to document the specific dimensions of the defect in the operative report, which is the primary evidence required to justify the use of this high-value code.
Billing Tips
- If performing an excision for a tumour-free margin with frozen section, remember to append E540 to the R076 claim to capture the 25% premium.
Provider Fee$709.90
Surgical Assistant Fee$75.06
Anaesthetist Fee$108.43
Non-Anaesthetist Fee$108.43
Effective: April 1, 2025
Category
M. Integumentary System Surgical Procedures
Subcategory
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Integumentary System Surgical Procedures
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