R347 – Bicoronal flaps
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
According to the note on page of the Schedule, R347 requires the elevation of bicoronal flaps with exposure of the upper half facial skeleton and subsequent closure and re-suspension of soft tissues. This service is listed under the heading 'Surgery for Correction of Down's Syndrome Facial Stigmata'.
When to Use
- Use R347 specifically for the surgical correction of facial stigmata associated with Down's syndrome where a bicoronal approach is required to expose the upper facial skeleton.
- Apply this code when the operative procedure necessitates the full elevation of bicoronal flaps and the subsequent re-suspension of soft tissues, rather than limited or localized incisions.
Common Pitfalls
- Billing R347 for routine cosmetic or reconstructive procedures that do not involve the specific clinical indication of Down's syndrome facial stigmata will lead to claim rejection.
- Failure to explicitly document the 're-suspension of soft tissues' in the operative report is a common audit trigger, as this is a mandatory component of the code definition.
- Attempting to bill R347 alongside other facial skeletal procedures without clear evidence of distinct, separate operative sites may result in claims being flagged for unbundling.
Billing Tips
- Ensure the operative report clearly details the extent of the exposure of the upper half facial skeleton to satisfy the specific requirements listed on page N34 of the Schedule.
- If the procedure is performed on a pediatric patient, remember to apply the appropriate age-based surgical premium (e.g., AGE_PREMIUM_UNDER_16_YEARS) to the base fee.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
The operative report should document the elevation of bicoronal flaps with exposure of the upper half facial skeleton and subsequent closure and re-suspension of soft tissues.
R347 requires elevation of bicoronal flaps with exposure of the upper half facial skeleton and subsequent closure and re-suspension of soft tissues.
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