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R568
R568 – Trapezius/sternomastoid transplant
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Trapezius/sternomastoid transplant
When to Use
- Use R568 specifically for the surgical transfer of the trapezius or sternomastoid muscle for reconstructive purposes.
- Select this code when the procedure involves the transposition of these specific muscles to restore function or provide tissue coverage in the head and neck region.
Common Pitfalls
- Billing R568 in conjunction with other reconstructive flap codes that already include the muscle harvest/transfer component, which may trigger a duplicate service rejection.
- Failure to document the specific muscle transferred, as generic 'muscle flap' descriptions may lead to audit inquiries regarding the appropriateness of the R568 fee.
Billing Tips
- Ensure that if a second assistant is utilized, the claim includes the appropriate indicator for the second assistant, as R568 is explicitly eligible for this without prior authorization.
Provider Fee$338.65
Surgical Assistant Fee$75.06
Anaesthetist Fee$108.43
Non-Anaesthetist Fee$108.43
Effective: April 1, 2025
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Endocrine Surgical Procedures
Per , a second assistant's services are payable for R568 and authorization is not required.
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