R155 – Latissimus dorsi or unilateral rectus abdominus
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Code R155 is a surgical procedure: Latissimus dorsi or unilateral rectus abdominus. Payment varies based on the role of the physician, indicated by a suffix: - Suffix 'A' (Surgeon): Paid a flat fee. - Suffix 'B' (Assistant): Fee is calculated based on basic units and time units. See Surgical Assistants' Services section starting on page .. - Suffix 'C' (Anaesthesiologist): Fee is calculated based on basic units and time units. See Anaesthesiologists' Services section starting on page ..
When to Use
- Use R155 for the harvest of a latissimus dorsi muscle flap for reconstructive purposes.
- Use R155 for the harvest of a unilateral rectus abdominis muscle flap, commonly utilized in breast reconstruction or abdominal wall repair.
Common Pitfalls
- Do not bill R155 in addition to the closure of the donor site, as the fee explicitly includes the closure of the donor site defect by any means.
- Avoid billing R155 for bilateral procedures without applying the appropriate multiple procedure rules, as R155 is defined as a unilateral procedure.
Billing Tips
- Ensure the surgical report clearly specifies the muscle harvested, as R155 is restricted to either latissimus dorsi or unilateral rectus abdominis.
Effective: April 1, 2025
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Haematic and Lymphatic Surgical Procedures
The base units for assistant and anaesthetist fees are determined from the 'Anae' column in the Schedule of Benefits. As the specific listing for R155 was not provided, the base units were calculated from the provided master fee record.
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