R087 – Major, complex areas skin graft
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
R087 is a major surgical procedure for skin grafting in complex areas such as the face, neck, or hands. As a surgical service, the fee includes the associated pre-operative and post-operative care as defined in the Schedule of Benefits. The service can be performed by a surgeon (suffix A), with assistance (suffix B) and with anaesthesia (suffix C). The medical record must demonstrate the appropriateness of the code claimed relative to the size of the graft.
When to Use
- Use R087 for split-thickness or full-thickness skin grafts specifically involving functional or aesthetic zones like the face, neck, or hands.
- Select R087 when the complexity of the graft site necessitates specialized surgical technique, distinguishing it from simpler excision or closure codes like S061 or S062.
Common Pitfalls
- Billing R087 for simple wound closures or local flaps, which are more appropriately coded under the S-series of the Integumentary section.
- Failing to document the specific dimensions of the graft, which is a mandatory audit requirement to justify the 'major, complex' classification of R087.
- Attempting to bill an assessment code on the same day as R087; remember that the global surgical fee includes all routine post-operative care.
Billing Tips
- If the procedure is performed on an emergency basis after hours, ensure you append the appropriate E-series premium (E409 or E410) to the R087 claim to maximize the procedural fee.
Effective: April 1, 2025
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Urogenital and Urinary Surgical Procedures
All insured services must be documented in the medical record, establishing that the service was provided, medically necessary, and is the same service for which the account is submitted. For surgical procedures, an operative report is required. For services with time-based calculations, the start and stop times must be recorded in the patient's medical record.
The medical record must demonstrate the appropriateness of code claimed relative to size.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.