R084 – Split thickness skin graft - very minor
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
R084 is a surgical procedure listed in the Musculoskeletal System section of the OHIP Schedule of Benefits. As the specific listing from page was not available in the provided context, this entry is based on general rules for surgical procedures found in the General Preamble. This procedure is eligible for payment to the operating surgeon (suffix A) and anaesthesiologist (suffix C). Based on the fee schedule, assistant services (suffix B) are not eligible for payment.
When to Use
- Use R084 for very minor split-thickness skin grafts, such as small donor site closures or tiny defect coverage, where the size does not qualify for more extensive graft codes.
- Use this code when performing a minor graft as a standalone procedure, ensuring it is not billed alongside R117, which is explicitly restricted on the same day.
Common Pitfalls
- Attempting to bill an assistant fee (suffix B) for R084 will result in an automatic rejection, as this procedure is not eligible for assistant services.
- Billing R084 on the same day as R117 will trigger a rejection; ensure you are not double-billing for related integumentary repairs performed in the same session.
Billing Tips
- Always document the specific dimensions of the graft in the operative note to justify the use of the 'very minor' classification over larger, higher-valued graft codes.
- If the procedure is performed after hours, remember to append the appropriate E-code (E409 or E410) to the R084 claim to capture the 50% or 75% premium.
Effective: April 1, 2025
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
All insured services must be documented in appropriate records. The Act requires that the record establish that: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
The medical record must demonstrate the appropriateness of code claimed relative to size.
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