R140 – Preparation of microvascular recipient site for free island skin and bone flap immediately following ablative surgery
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Preparation of microvascular recipient site for free island skin and bone flap immediately following ablative surgery and when recipient vessels are in the site of the ablation. This is a surgical procedure and is eligible for surgeon (suffix A), assistant (suffix B), and anaesthetist (suffix C) fees. The assistant and anaesthetist fees are calculated based on a combination of basic and time units. Payment for a second surgical assistant is permitted for this procedure without requiring special authorization as per . This service is eligible for age-based premiums for patients under 16 years of age, as well as after-hours and trauma premiums under specific conditions.
When to Use
- Use R140 specifically for the preparation of recipient vessels located within the immediate site of an ablative surgery for a free flap reconstruction.
- Use this code when the microvascular recipient site preparation is performed as a distinct, necessary step immediately following the primary resection to facilitate the free flap transfer.
Common Pitfalls
- Do not bill R140 if the recipient vessels are located outside the primary ablation site, as this may be considered part of the flap procedure itself rather than the specific preparation defined by R140.
- Avoid billing R140 in conjunction with other general surgical preparation codes if the work is already bundled into the primary ablative procedure code.
- Ensure the documentation clearly distinguishes the recipient site preparation from the flap harvest and inset, as overlapping descriptions can trigger audit flags for unbundling.
Billing Tips
- When a second surgical assistant is required, bill the second assistant's claim using the same code and suffix B; no special authorization is required per GP90.
- Always verify if the trauma premium E420 is applicable, ensuring the ISS score is documented in the chart, as this is a high-value surgical procedure often performed in trauma settings.
Effective: April 1, 2025
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Integumentary System Surgical Procedures
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