R648 – Oral vestibuloplasty - with skin graft
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service is for an oral vestibuloplasty procedure that includes a skin graft. The fee for this surgical procedure (suffix 'A') covers the surgeon's work, including the pre-operative assessment where the decision to operate is made, the surgery itself, and normal post-operative care in hospital. This service is eligible for assistant (suffix 'B') and anaesthetist (suffix 'C') services, which are calculated based on basic units plus time units as defined in the Schedule of Benefits. See the Surgical Assistants' Services (-) and Anaesthesiologists' Services (-) sections for detailed calculation rules.
When to Use
- Use R648 when performing a formal vestibuloplasty that specifically requires a skin graft for mucosal coverage, distinguishing it from R647 which covers vestibuloplasty without a graft.
- Select this code for surgical procedures aimed at deepening the labial or buccal sulcus to improve denture stability where the raw surface created requires a split-thickness or full-thickness skin graft for healing.
Common Pitfalls
- Billing R648 when only a mucosal advancement flap is performed; if no skin graft is utilized, the service must be billed under R647.
- Attempting to bill a separate consultation fee on the same day as the procedure; the R648 fee is comprehensive and includes the pre-operative assessment where the decision to operate is finalized.
Billing Tips
- Ensure the operative report explicitly documents the harvesting and placement of the skin graft, as this is the defining clinical requirement for the R648 code over R647.
- Apply the appropriate age premium (e.g., for patients under 16) to the surgical fee (suffix A) and assistant fee (suffix B) to ensure full capture of eligible procedural increases.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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