R655 – Pericranial flap to orbit or face - bilateral
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Pericranial flap to orbit or face, performed bilaterally. This surgical procedure is eligible for surgeon (suffix A), assistant (suffix B), and anaesthetist (suffix C) services. - When performed in conjunction with a coronal approach for the main operation, add-on code E974 may also be claimed. - Anaesthesia services (claimed as R655C) are calculated based on 7 base units plus time units as per rules on (). - Surgical assistant services (claimed as R655B) are calculated based on 7 base units plus time units. As per rules on (), when assistant units are not specified for a procedure, the anaesthesia base units are used.
When to Use
- Use R655 when harvesting and transposing a pericranial flap bilaterally to reconstruct defects in the orbit or facial region.
- Use R655 specifically for bilateral procedures; for unilateral harvesting, refer to R654.
Common Pitfalls
- Failing to include the add-on code E974 when the pericranial flap is harvested via a coronal approach, which is a common oversight for this procedure.
- Attempting to bill a second surgical assistant without prior authorization, as R655 is not on the pre-approved list for multiple assistants and requires a formal letter of justification.
- Incorrectly assuming the assistant fee is zero; you must claim the assistant service (R655B) using the 7 base units derived from the anaesthesia schedule.
Billing Tips
- Always ensure the coronal approach is clearly documented in the operative report to support the mandatory eligibility requirement for the E974 add-on.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
The anaesthesia service (suffix C) includes 7 base units plus applicable time units (, ).
The surgical assistant service (suffix B) includes 7 base units plus applicable time units. The base units are derived from the anaesthesia units as per , since no assistant units are explicitly listed for this code.
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