R102 – Level 1 oncoplastic breast conserving lumpectomy or partial mastectomy for malignancy
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Level 1 oncoplastic breast conserving lumpectomy or partial mastectomy for malignancy. Payment rules: 1. R102 is only eligible for payment when: a. resected breast volume is <= 15% of ipsilateral breast parenchyma, and b. the operative report documents dual plane undermining and lumpectomy defect closure. 2. R102 includes nipple undermining, nipple-areolar complex elevation or centralization, skin resection and glandular advancement if performed.
When to Use
- Use R102 for breast-conserving surgery where the malignancy requires a lumpectomy and the surgeon performs dual plane undermining and glandular advancement to close the defect.
- Use R102 when the resected volume is small (<=15% of breast parenchyma) and the procedure involves oncoplastic techniques like nipple-areolar complex centralization or skin resection.
Common Pitfalls
- Billing R102 without explicitly documenting 'dual plane undermining' and 'lumpectomy defect closure' in the operative report will lead to automatic rejection or recovery upon audit.
- Confusing R102 with standard lumpectomy codes (e.g., R158 or R159) when oncoplastic closure techniques were not actually performed or documented.
Billing Tips
- Ensure the operative note explicitly quantifies the resected volume as <=15% of the ipsilateral breast parenchyma to satisfy the specific eligibility criteria for R102.
- Remember to append E505 or E546 if axillary node management is performed concurrently, as these are distinct add-on codes that do not conflict with the R102 base fee.
Effective: April 1, 2025
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Integumentary System Surgical Procedures
The operative report must document dual plane undermining and lumpectomy defect closure.
R102 includes nipple undermining, nipple-areolar complex elevation or centralization, skin resection and glandular advancement if performed.
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