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R531

R531Static slings for facial paralysis

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

A reconstructive surgical procedure for facial paralysis using static slings. This procedure is listed in the of the Musculoskeletal System Surgical Procedures section. It includes allowances for surgical assistance and anaesthesia.

When to Use

  • Use R531 when performing a static facial sling procedure to address facial paralysis, specifically when the intervention is limited to static support rather than dynamic reanimation.
  • Select R531 for reconstructive procedures involving fascial or synthetic slings to provide static suspension of the paralyzed face, distinguishing it from the more complex dynamic procedures like R532 or R533.

Common Pitfalls

  • Billing R531 alongside R532 or R533 for the same anatomical site is considered unbundling and will result in claim rejection or audit recovery.
  • Failure to document the specific material used for the static sling can lead to claims being flagged, as OHIP requires clear evidence of the reconstructive nature of the procedure.

Billing Tips

  • Ensure that if a surgical assistant is required, the assistant's claim is submitted with the appropriate suffix to the R531 base code to ensure correct payment of the assistant's premium.
Provider Fee$307.15
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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