R106 – Skin flaps and grafts - other than listed above
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Performs a skin flap or graft procedure that is not otherwise listed in the Schedule. This code is billable by the surgeon (suffix <suffix>A</suffix>), assistant (suffix <suffix>B</suffix>), and anaesthetist (suffix <suffix>C</suffix>). All fees are determined by Independent Consideration (I.C.). According to , claims must be submitted with a supporting letter, an operative report, and a comparison of the service's scope and difficulty relative to other listed procedures.
When to Use
- Use R106 when performing a complex skin flap or graft reconstruction that lacks a specific, defined code in the Schedule, such as a unique rotation flap that does not meet the criteria for R128 or R129.
- Use this code for reconstructive procedures involving rare anatomical sites or unconventional tissue transfer techniques where standard integumentary codes are anatomically or procedurally inappropriate.
Common Pitfalls
- Submitting R106 without a detailed operative report and a comparative analysis against existing codes like R123 or R130 will result in an automatic rejection or a significant reduction in the I.C. fee.
- Attempting to use R106 for procedures that are already well-defined in the Schedule (e.g., standard excision and closure) is a common audit trigger and will be denied as the Ministry expects the use of specific codes when available.
Billing Tips
- When submitting your I.C. request, explicitly state the time taken and compare the complexity to a similar listed procedure, such as R134, to justify the requested fee amount.
- Ensure the operative report clearly highlights the unique technical challenges of the flap or graft to support the I.C. valuation, as the Ministry will benchmark your claim against the complexity of standard listed procedures.
No fee information available.
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Integumentary System Surgical Procedures
Claims for Independent Consideration (I.C.) services must be submitted with a supporting letter explaining the amount of the fee claimed.
The submission must include an appropriate operative or consultation report.
The submission must include a comparison of the scope and difficulty of the procedure in relation to non-I.C. procedures in the Schedule.
See General Preamble .
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