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R162
R162 – Simple excision - three or more lesions
OHIP Integumentary System Surgical Procedures Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
R162 represents the excision of three or more pre-malignant lesions on the face or neck. As a surgical service, payment can be claimed for the surgeon (suffix A), a surgical assistant (suffix B), and an anaesthesiologist (suffix C). The amount payable for excision of a pre-malignant lesion will be adjusted to a lesser fee if the pathologist’s report is not retained in the patient’s record. Excision of a pre-malignant lesion is only payable for the following lesions: Dysplastic Nevus, Actinic/Solar Keratosis, Chemical and other pre-malignant keratoses, Large Cell Acanthoma, Erythroplasia of Queryrat, and Leukoplakia. In-situ lesions such as Lentigo Maligna (melanoma-in-situ) and Bowen's Disease (squamous cell carcinoma-in-situ) are considered malignant lesions. Claims should be submitted with diagnostic code 232.
All insured services must be documented in appropriate records. The Act requires that the record establish that: an insured service was provided; the service for which the account is submitted is the service that was rendered; and the service was medically necessary.
The amount payable for excision of a pre-malignant lesion will be adjusted to a lesser fee if the pathologist’s report is not retained in the patient’s record.
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