R647 – Oral vestibuloplasty - with secondary epithelization
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Oral vestibuloplasty with secondary epithelization. This is a surgical procedure listed under the Musculoskeletal System section of the Schedule. The service includes all common and specific elements applicable to surgical procedures as outlined in the General Preamble. This typically involves pre-operative evaluation, the surgical procedure itself, and normal post-operative care until the first post-operative visit. - Assistant Fee Calculation: The fee for an assistant (suffix 'B') is calculated using 6 base units plus time units as per the rules in the Surgical Assistants' Services section (, ). The assistant unit fee is $12.51. - Anaesthesia Fee Calculation: The fee for an anaesthetist (suffix 'C') is calculated using 6 base units plus time units as per the rules in the Anaesthesiologists' Services section (, ). The anaesthesiologist unit fee is $15.49.
When to Use
- Use R647 for surgical deepening of the labial or lingual sulcus where the raw surface is left to heal by secondary epithelization.
- Select R647 when the procedure is limited to the vestibuloplasty itself, as opposed to R648 which involves more complex grafting or reconstruction.
Common Pitfalls
- Billing R647 in conjunction with other oral surgical procedures without verifying if the General Preamble considers them inclusive, leading to automatic claim rejection.
- Failing to document the specific surgical technique used, which is critical if the claim is audited to distinguish it from minor soft tissue revisions.
Billing Tips
- Ensure the surgical report clearly indicates that secondary epithelization was the intended method of healing to justify the use of R647 over other potential soft tissue codes.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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