R151 – Minor plastic surgery procedure
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A minor plastic surgery procedure, classified by the responsible specialist. The Schedule of Benefits notes that since many plastic surgery procedures are divided into stages, they are classified as very minor, intermediate, major, or extensive major. Claims for these services require descriptive details, such as an operative report, for professional assessment. This surgical procedure includes all common and specific elements as defined in the General Preamble (-, , ), such as pre-operative preparation, the surgical procedure itself, post-operative care, and associated documentation.
When to Use
- Use R151 for minor plastic surgery procedures that do not have a specific, dedicated fee code in the Schedule of Benefits.
- Use this code for staged plastic surgery procedures that a specialist has clinically classified as 'minor' in complexity.
- Use R151 when performing non-laceration integumentary reconstructions that fall outside the scope of standard excision or repair codes.
Common Pitfalls
- Claims for R151 will be rejected if used for the repair of any laceration; these must be billed under the specific laceration repair codes in the Integumentary section.
- Billing R151 without an attached operative report or descriptive clinical details will result in a rejection, as the Ministry requires this for professional assessment of the 'minor' classification.
- General Practitioners (00) and Emergency Medicine physicians (12) are ineligible to claim R151; these codes are restricted to specific surgical specialties.
Billing Tips
- If the procedure is complex and does not fit clearly into the R150-R154 scale, consider using 'I.C.' (Independent Consideration) as the basis for your claim rather than forcing a code that may be undervalued.
- Ensure the operative report clearly justifies the 'minor' classification to prevent the Ministry from reclassifying the service or requesting further documentation.
Effective: April 1, 2025
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Integumentary System Surgical Procedures
Descriptive details of procedure (e.g. operative report) should be submitted with claims for professional assessment.
Descriptive details of procedure (e.g. operative report) should be submitted with claims for codes R150 - R154 for professional assessment.
R150, R151, R152, R153, and R154 are not eligible for payment for the repair of any laceration(s). See repair of laceration services in the Integumentary System Surgical Procedures section of this Schedule.
R150, R151, R152, R153, and R154 are not eligible for payment to physicians in the following specialties: General and Family Practice (00) and Emergency Medicine (12).
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