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R399
R399 – Lateral canthoplasty, unilateral
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
R399 is for a unilateral lateral canthoplasty. As a surgical procedure, its fee includes all inherent components such as pre-operative, intra-operative, and post-operative care typically associated with the surgery. When this procedure is performed in conjunction with another procedure, E930 may be added.
When to Use
- Use R399 for a standalone unilateral lateral canthoplasty procedure.
- Use R399 in conjunction with E930 when performing a lateral canthoplasty alongside another primary surgical procedure on the same day.
Common Pitfalls
- Attempting to bill R399 bilaterally; it is strictly a unilateral code, and you must use the appropriate bilateral indicator or claim twice if permitted by the Schedule of Benefits.
- Failing to document the necessity of the second procedure when claiming E930, which can lead to claim rejection during manual audits.
- Incorrectly applying after-hours premiums (E409/E410) to elective cases, as R399 only qualifies for these when the procedure is non-elective or delayed due to a surgical emergency.
Billing Tips
- Always verify the patient's age at the time of the procedure to ensure the correct age premium (e.g., AGE_PREMIUM_UNDER_16Y) is applied to the R399 fee.
- Ensure E930 is submitted on the same claim as the primary procedure to trigger the additional flat fee payment correctly.
Provider Fee$204.80
Surgical Assistant Fee$75.06
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
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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