R214 – Malignant tumour with reconstruction
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
An open surgical procedure involving the excision of a malignant tumour from the clavicle or acromion, with subsequent reconstruction. This service is designated with a '#' prefix, indicating that when performed in a hospital or Integrated Community Health Services Centre (ICHSC), the cost of the premises, equipment, supplies, and personnel is funded by the facility and not included in the physician fee (). Payment for surgical assistant (suffix B) and anaesthetist (suffix C) services are calculated based on basic units plus time units, as detailed in the payment adjustment rules.
When to Use
- Use R214 specifically for the excision of a malignant tumour of the clavicle or acromion that requires a formal reconstruction procedure.
- Select R214 over simpler excision codes like R222 or R223 when the surgical plan necessitates complex tissue rearrangement or structural reconstruction post-excision.
Common Pitfalls
- Billing R214 without documenting the specific reconstruction technique, which is a mandatory requirement for this code's definition.
- Failing to recognize the '#' prefix, which prohibits billing for facility-related costs when the procedure is performed in a hospital or ICHSC.
Billing Tips
- Ensure the operative report explicitly details the reconstruction component to justify the use of R214 over a standard excision code.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.