R083 – Full thickness graft - major, over 5 cm
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
R083 is a surgical procedure for which a fee is payable to the surgeon, assistant, and anaesthetist. Fee Calculation: - Surgeon (Suffix A): The fee is the amount listed in the Schedule. - Surgical Assistant (Suffix B): The fee is calculated based on 6 basic units plus time units, as per the rules on and . - Anaesthesiologist (Suffix C): The fee is calculated based on 7 basic units plus time units, as per the rules on and . Second Assistant: Payment for a second surgical assistant for this procedure requires authorization by a medical consultant, as R083 is not listed as an exception on . The second assistant's service is calculated in the same manner as the first.
When to Use
- Use R083 for full-thickness skin grafts where the graft surface area exceeds 5 cm in its greatest dimension, distinguishing it from smaller grafts billed under codes like R008.
- Select R083 when performing a major reconstructive graft following excision of a large lesion or traumatic defect that meets the specific size threshold.
Common Pitfalls
- Billing R083 on the same day as R117 is a common rejection trigger, as skin grafts are explicitly restricted from being claimed alongside this code.
- Failing to document the specific dimensions of the graft in the operative report often leads to audit recovery, as the 'major' designation is strictly size-dependent.
- Assuming a second surgical assistant is automatically payable; R083 is not on the GP90 exception list, meaning you must secure prior approval from a medical consultant.
Billing Tips
- Always verify the graft size in the pathology or operative report to ensure it exceeds 5 cm, as billing R083 for smaller grafts will be downgraded or rejected during audit.
- Ensure the surgical assistant and anaesthetist suffixes (B and C) are calculated using the specific unit values (6 and 7 respectively) to avoid processing errors.
Effective: April 1, 2025
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Integumentary System Surgical Procedures
The medical record must demonstrate the appropriateness of codes claimed relative to size of graft.
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