All codes
R319
R319 – Graft to nose - autologous, bone or cartilage
OHIP Respiratory Surgical Procedures Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure involving a graft to the nose. In addition to the common elements outlined in the Schedule of Benefits (see , ), this service includes all specific elements of a surgical procedure (), such as:
• Supervising the preparation of and/or preparing the patient for the procedure(s).
• Performing the procedure(s), by any method, or assisting another physician in the performance of the procedure and carrying out appropriate recovery room procedures, being responsible for the transfer of the patient to the recovery room, ongoing monitoring and detention during the immediate post-operative and recovery period.
• Making arrangements for any related assessments or procedures, including obtaining any specimens from the patient and interpreting the results where appropriate.
• Where indicated, making or supervising the making of arrangements for follow-up care, and post-procedure monitoring of the patient’s condition, including intervening, until the first post-operative visit.
• Discussion with, providing any advice and information, including prescribing therapy, to the patient or patient’s representative, whether by telephone or otherwise, on matters related to the service.
• Providing premises, equipment, supplies and personnel for the specific elements.
Pre-authorization required
All insured services must be documented in appropriate medical records to establish that the service was provided, medically necessary, and is the service for which the account is submitted, as per .
For the trauma premium `E420` to be payable, the medical record must list the Injury Severity Score (ISS) as per .
Written prior authorization by a Ministry of Health medical consultant is required.
Sex
Male
Usage limits
Requires written prior authorization by a Ministry of Health medical consultant (see Surgical Preamble, paragraph 17).
When a second surgical assistant is required, the service is only eligible for payment following authorization by a medical consultant and requires submission of a letter from the surgeon outlining the reason the second assistant was required. See .
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