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R335

R335Reconstruction mandible - complete

OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

A surgical procedure for the complete, unilateral reconstruction of the mandible with bone grafts* and/or a plate or prosthesis. This procedure is listed under the Orthognathic Surgery section for the Skull and Mandible.

When to Use

  • Use R335 for complete, unilateral mandibular reconstruction involving bone grafting, rigid fixation plates, or custom prostheses.
  • Select R335 when the procedure involves a full segment replacement, distinguishing it from R334 which is typically reserved for partial or less extensive mandibular repairs.

Common Pitfalls

  • Billing R335 alongside other mandibular surgical codes (e.g., R645 or R646) without clear documentation of separate, distinct procedures will trigger a rejection for unbundling.
  • Failure to document the specific use of bone grafts or prosthetic hardware in the operative report is a frequent cause for audit recovery, as the code definition explicitly requires these components.

Billing Tips

  • Ensure the operative report explicitly details the 'complete' nature of the reconstruction to justify the use of R335 over lower-valued partial reconstruction codes.
  • If the procedure is performed as a trauma case, ensure the Injury Severity Score (ISS) is documented in the chart to support the E420 trauma premium.
Provider Fee$819.15
Surgical Assistant Fee$75.06
Anaesthetist Fee$232.35
Non-Anaesthetist Fee$232.35

Effective: April 1, 2025

Category

N. Musculoskeletal System Surgical Procedures

Subcategory

MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Musculoskeletal System Surgical Procedures

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