R138 – Preparation of microvascular recipient site for free toe or finger transplant
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Preparation of a microvascular recipient site for a free toe or finger transplant. This surgical procedure is a component of a multi-stage microvascular reconstruction. This service is often performed in conjunction with other procedures such as R137 (Elevation of free toe or finger and closure of defect) and R139 (Transplantation of free island toe or finger with microvascular anastomosis(es) and tendon nerve and bone repair). A variation, R141, is used when this preparation immediately follows ablative surgery where recipient vessels are in the site of the ablation. Payment for assistant (<suffix>B</suffix>) and anaesthesia (<suffix>C</suffix>) services is based on a unit system as detailed in the General Preamble (see - for assistants, and - for anaesthesia).
When to Use
- Use R138 when preparing a recipient site for a free toe or finger transfer in a staged procedure where the recipient vessels are not being prepared immediately following an ablative surgery.
- Select R138 as the primary code for the recipient site preparation component when performing multi-stage microvascular reconstruction, distinct from the actual transfer (R139) or the elevation of the donor tissue (R137).
Common Pitfalls
- Do not bill R138 if the recipient site preparation occurs immediately following ablative surgery; R141 is the mandatory code for that specific clinical scenario.
- Avoid billing R138 as a standalone procedure if the recipient site preparation is considered an inherent part of the primary microvascular anastomosis (R139) unless the staged nature of the surgery is clearly defined and documented.
Billing Tips
- Ensure the operative report explicitly details the separate stages of the reconstruction to justify billing R138 alongside R137 or R139, as these are frequently audited for unbundling.
Effective: April 1, 2025
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Integumentary System Surgical Procedures
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