R384 – Mandibular osteotomies for prognathism - vertical ramus
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
R384 is a surgical procedure for a vertical ramus osteotomy, a type of mandibular osteotomy performed for prognathism. This service is a form of orthognathic surgery on the mandible.
When to Use
- Use R384 specifically for a vertical ramus osteotomy performed to correct mandibular prognathism.
- Select R384 when the surgical approach is limited to the vertical ramus, distinguishing it from R529 (sagittal split osteotomy) or other mandibular procedures.
Common Pitfalls
- Billing R384 alongside other mandibular osteotomies without documenting the distinct surgical sites, which may trigger a review for unbundling.
- Failing to document the Injury Severity Score (ISS) in the chart when attempting to claim the E420 trauma premium for emergency cases.
- Assuming automatic payment for a second surgical assistant; R384 requires prior authorization from a medical consultant for a second assistant to be eligible.
Billing Tips
- Ensure the operative report explicitly describes the vertical ramus osteotomy technique to support the use of R384 over more generic mandibular surgical codes.
- When performing bilateral procedures, ensure the claim reflects the correct number of units, noting that assistant and anaesthesia basic units are governed by the major procedure only.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
For time-based components (assistant, anaesthesia), the medical record must document the start and end times for the service.
If claiming the trauma premium (E420), the medical record must list the Injury Severity Score (ISS).
Listed under 'Mandibular osteotomies for prognathism'.
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