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R164
R164 – Simple excision - two lesions
OHIP Integumentary System Surgical Procedures Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
R164 is simple excision of two lesions under Excision of Pre-Malignant Lesions Including Biopsy of Each Lesion (single or multiple sites), Other Areas, in the Integumentary System section. The single-lesion item is R163 and three or more lesions is R165; face or neck lesions use R160 to R162. E542 is added when performed outside hospital. Excision of a pre-malignant lesion is only payable for: dysplastic nevus, actinic/solar keratosis, chemical and other pre-malignant keratoses, large cell acanthoma, erythroplasia of Queyrat and leukoplakia. In-situ lesions such as lentigo maligna and Bowen's disease are considered malignant lesions. The listing carries 6 assistant units and 6 anaesthesia units.
All insured services must be documented in appropriate medical records to establish that:
1. an insured service was provided;
2. the service for which the account is submitted is the service that was rendered; and
3. 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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