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R123
R123 – Preparation of microvascular recipient site for muscle, tendon and nerve anastomosis(es) immediately following ablative surgery
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service involves the surgical preparation of a microvascular recipient site for a muscle, tendon, and nerve anastomosis. It is specifically performed immediately following ablative surgery (tissue removal), and only when the recipient vessels are located within the site of the ablation. This is a component of a complex reconstructive procedure involving a free island flap.
When to Use
- Use R123 specifically for the preparation of recipient vessels (muscle, tendon, and nerve) within the immediate surgical field following an ablative procedure where a free island flap is being transferred.
- Use this code when the recipient site preparation is a distinct, necessary component of a complex reconstructive surgery that occurs in the same operative session as the tissue ablation.
Common Pitfalls
- Do not bill R123 if the recipient vessels are located outside the primary site of the ablation, as the code explicitly requires the vessels to be within the ablation site.
- Avoid billing R123 as a standalone procedure; it is intended as a component of a larger reconstructive surgery and must be linked to the primary ablative and reconstructive codes to avoid audit scrutiny.
- Failure to document the specific anatomical location of the recipient vessels within the ablation site often leads to claim rejection or recovery during post-payment audits.
Billing Tips
- Ensure the operative report clearly delineates the time and effort spent preparing the recipient site for anastomosis, as this justifies the complexity of the R123 service separate from the flap harvest or ablation.
- If the procedure is performed after hours or on a weekend, ensure the appropriate after-hours premium (e.g., E409 or E410) is applied to the surgeon's fee to maximize the claim value.
Provider Fee$696.40
Surgical Assistant Fee$125.10
Anaesthetist Fee$154.90
Non-Anaesthetist Fee$154.90
Effective: April 1, 2025
Category
M. Integumentary System Surgical Procedures
Subcategory
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Integumentary System Surgical Procedures
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