What is OHIP billing code R604?

R604 is "Revision of R602, R603", an OHIP Musculoskeletal System Surgical Procedures code from the Ontario Schedule of Benefits (Physician Services).

How do I bill R604 to OHIP?

R604 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R604 claims against the Schedule of Benefits rules before submission.

What codes are related to R604?

Codes related to R604 in the Schedule of Benefits include R602, R603.

All codes

R604

R604 – Revision of R602, R603

OHIP Musculoskeletal System Surgical Procedures Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

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R604 is a surgical procedure code within the Musculoskeletal System section. It is listed as 'I.C.' (Independent Consideration) for Assistant, Surgical, and Anaesthesia fees. This code is for the revision of Pollicization (R602) or Digital Reimplantation (R603). Claims for I.C. services must be submitted with a supporting letter explaining the fee claimed, an operative or consultation report, and a comparison of the scope and difficulty of the procedure to non-I.C. procedures in the Schedule. For surgical procedures not listed but similar to a listed service, R990 should be used.

Supporting letter explaining the amount of the fee claimed

Appropriate operative or consultation report

Comparison of the scope and difficulty of the procedure in relation to non-IC procedures in the Schedule

R602 R603

Information regarding this code's fees and specific billing instructions are based on its 'I.C.' (Independent Consideration) status as detailed in the General Preamble .

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