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R114

R114Revision of breast mound

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

Revision of a breast mound is a surgical procedure performed to alter, adjust, or correct a previously created breast mound. This procedure is typically performed as a component of post-mastectomy breast reconstruction to refine the aesthetic outcome.

When to Use

  • Use R114 for secondary aesthetic refinements, such as scar revision or contour adjustment, on a breast mound previously reconstructed via mastectomy.
  • Use R114 when performing a minor surgical correction to a breast mound that does not involve the complexity of a flap transfer or major tissue rearrangement.

Common Pitfalls

  • Billing R114 for primary breast reconstruction procedures, which should instead be coded under specific flap reconstruction codes.
  • Confusing R114 with R110 (reduction mammoplasty) or R112 (augmentation mammoplasty); R114 is specifically for post-mastectomy revision, whereas R110/R112 are for non-reconstructive indications.
  • Failing to secure prior authorization from the Ministry, which is a mandatory requirement for this code.

Billing Tips

  • Ensure the operative report clearly distinguishes the revision from the initial reconstruction to justify the use of R114 over primary reconstruction codes.
  • If the revision is performed bilaterally, ensure the claim reflects the appropriate bilateral billing rules to avoid automatic rejection.
Provider Fee$230.30
Surgical Assistant Fee$75.06
Anaesthetist Fee$108.43
Non-Anaesthetist Fee$108.43

Effective: April 1, 2025

Since Oct 2005, this fee has increased 0.0% vs 51.4% CPI inflation
Category

M. Integumentary System Surgical Procedures

Subcategory

INTEGUMENTARY SYSTEM SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Integumentary System Surgical Procedures

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R114 – Revision of breast mound | OHIP Fee Schedule | SnapBill MD