R391 – Orbital dystopia - intracranial approach
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure for the correction of orbital dystopia, which is a malposition of the entire orbit, performed via an intracranial approach. Note: The asterisk () indicates that the fee for this service includes the harvesting and grafting of bone or cartilage grafts. Therefore, separate codes for bone grafts such as Z263, Z264, E975, Z265, E976, or Z266 are not to be billed in addition.
When to Use
- Use R391 for the surgical correction of orbital dystopia specifically when the procedure necessitates an intracranial approach for orbital repositioning.
- Use this code for complex craniofacial reconstructions where the orbital malposition is secondary to congenital syndromes or severe trauma requiring intracranial access.
Common Pitfalls
- Do not bill bone or cartilage graft harvesting codes (Z263, Z264, E975, Z265, E976, or Z266) in addition to R391, as these are explicitly included in the fee.
- Avoid billing R391 for orbital procedures that do not involve an intracranial approach; ensure the operative report clearly details the intracranial access to support the claim during audit.
Billing Tips
- If a second surgical assistant is required, you must obtain prior authorization from a medical consultant and submit a formal letter from the surgeon justifying the necessity of the additional assistant.
- Ensure the appropriate age premium (e.g., AGE_PREMIUM_5_TO_16_YEARS) is applied if the patient meets the specific age criteria, as this is a surgical procedure eligible for these percentage increases.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
* Includes harvesting and grafting of bone or cartilage grafts.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.