R088 – Extensive major, very large area(s)
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This billing code is for a surgical procedure within the musculoskeletal system. The fee amount of $641.95 is payable to the surgeon performing the procedure (suffix 'A'). Assistant services (suffix 'B') and anaesthetist services (suffix 'C') are calculated based on basic and time units as outlined in the General Preamble.
When to Use
- Use R088 for extensive, large-area musculoskeletal surgical procedures that do not have a more specific procedural code in the Schedule of Benefits.
- Select R088 when the surgical intervention involves significant tissue involvement or large-scale repair that exceeds the scope of standard minor integumentary or musculoskeletal codes.
Common Pitfalls
- Billing R088 in conjunction with R117 will trigger an automatic rejection as these codes are mutually exclusive.
- Failing to document the specific extent or surface area of the procedure can lead to audit recovery if the claim is challenged for being 'extensive' versus a standard procedure.
- Incorrectly applying after-hours premiums (E409/E410) to the total claim rather than specifically to the surgeon's fee (suffix A) can cause processing errors.
Billing Tips
- Ensure that if a second assistant is required for this extensive procedure, you have pre-authorization or confirm it is on the pre-approved list in GP90 to avoid payment denial.
- Always verify the patient's age and ASA status to maximize eligible add-on units for the anaesthetist (suffix C), as these are frequently missed on high-complexity surgical claims.
Effective: April 1, 2025
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
In the surgical part of the Schedule, the required suffixes are: 'A' if the physician performs the procedure; 'B' if the physician assisted at the surgery; and 'C' if the physician administered the anaesthetic.
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