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R609
R609 – Combined LeFort I and LeFort III osteotomy in hemifacial microsomia
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Combined LeFort I and LeFort III osteotomy is a surgical procedure performed for hemifacial microsomia.
When to Use
- Use R609 when performing a combined LeFort I and LeFort III osteotomy specifically for the correction of hemifacial microsomia.
- Do not use R609 for isolated LeFort I or LeFort III procedures, as these require their own specific surgical codes.
Common Pitfalls
- Billing R609 without explicit documentation of the hemifacial microsomia diagnosis will lead to automatic claim rejection.
- Attempting to bill for a second surgical assistant without prior authorization from a medical consultant will result in a payment denial, as R609 is not on the pre-approved list for second assistants.
Billing Tips
- Ensure the age-based premium is applied to both the surgeon (suffix A) and the surgical assistant (suffix B) claims if the patient is under 16 years of age.
- If the procedure is performed after hours, ensure you select the correct premium code (E409/E410 for surgeons, E400B/E401B for assistants) to avoid underpayment.
Provider Fee$1,586.20
Surgical Assistant Fee$125.10
Anaesthetist Fee$309.80
Non-Anaesthetist Fee$309.80
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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