R162 – Excision of three or more pre-malignant lesions - face or neck
OHIP Radiology 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.
When to Use
- Use R162 when performing the excision of three or more distinct pre-malignant lesions, such as actinic keratoses or dysplastic nevi, specifically located on the face or neck.
- Choose R162 instead of multiple units of R160 or R161 when the total count of pre-malignant excisions on the face or neck reaches the three-lesion threshold.
Common Pitfalls
- Billing R162 for in-situ lesions like Bowen's Disease or Lentigo Maligna is incorrect, as these are classified as malignant and require different surgical codes.
- Failure to retain the pathology report in the patient's record will trigger an automatic payment adjustment to a lower fee, as the Ministry requires histological confirmation for pre-malignant claims.
- Submitting R162 with a diagnostic code other than 232 will result in a rejection, as the Ministry specifically mandates this code for pre-malignant lesion excisions.
Billing Tips
- Always append the E542 premium when performing these excisions in your office or an outpatient clinic, as R162 is eligible for this additional fee when performed outside a hospital setting.
Effective: April 1, 2026
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Urogenital and Urinary Surgical Procedures
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.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.