R181 – Excision of nasopharyngeal or oropharyngeal lesion - with palatal split
OHIP Radiology Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
Excision of a nasopharyngeal or oropharyngeal lesion with a palatal split. As a surgical service, the fee includes standard pre-operative and post-operative care as outlined in the Surgical Preamble (). This code is marked with a '#' prefix, indicating that when performed in a hospital or Integrated Community Health Services Centre (ICHSC), the facility costs (premises, equipment, supplies, personnel) are funded by the institution's budget and cannot be billed to the patient ().
When to Use
- Use R181 specifically when the surgical approach requires a palatal split to access and excise a lesion in the nasopharynx or oropharynx.
- Select R181 over R182 when the complexity of the exposure necessitates the palatal split, as R182 covers excision of similar lesions without this specific surgical access requirement.
Common Pitfalls
- Billing R181 when a palatal split was not performed; ensure the operative report explicitly details the palatal split to justify the higher fee compared to standard excision codes.
- Attempting to bill for facility fees or tray sets; as a '#' prefixed code, all facility costs are institutionally funded and cannot be charged to the patient or billed as an extra service.
Billing Tips
- If multiple procedures are performed during the same operative session, ensure the major procedure is billed at 100% and secondary procedures are reduced by 15% per the Surgical Preamble, unless the secondary procedure is non-elective for a new condition.
Effective: April 1, 2025
P. Respiratory Surgical Procedures
RESPIRATORY SURGICAL PROCEDURES
Surgical
Respiratory Surgical Procedures
The '#' prefix indicates this service is subject to special funding rules for premises, equipment, and supplies when performed in a hospital or ICHSC ().
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.