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R092

R092Minor full thickness graft - less than 1 cm average diameter

OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

Minor - less than 1 cm average diameter

When to Use

  • Use for a full-thickness skin graft where the average diameter of the harvested graft is strictly less than 1 cm.
  • Use when performing a small reconstructive graft following the excision of a minor lesion, provided the graft size meets the <1 cm criteria.

Common Pitfalls

  • Billing R092 on the same day as R117 is prohibited; choose the code that best represents the primary procedure performed.
  • Submitting for a surgical assistant fee (suffix B) will result in an automatic rejection as this code is not eligible for assistant payment.
  • Overestimating the graft size in documentation; if the average diameter is 1 cm or greater, R092 is inappropriate and may trigger an audit.

Billing Tips

  • Ensure the operative report explicitly states the average diameter of the graft to justify the use of R092 over larger graft codes.
  • If performing multiple procedures, remember that R092 is subject to the multiple procedure rule; ensure the primary procedure is billed at 100% and secondary procedures are adjusted accordingly.
Provider Fee$116.65
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

Cardiovascular Surgical Procedures

The medical record must demonstrate the appropriateness of codes claimed relative to size of graft.

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