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R659
R659 – Upper LeFort III advancement without occlusal change - unilateral
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A unilateral surgical procedure for the upper LeFort III advancement without occlusal change. This service is a type of orbito-cranial surgery. The fee for this service is inclusive of harvesting and grafting of any necessary bone or cartilage grafts, as noted in the of the Schedule of Benefits.
When to Use
- Use R659 for unilateral LeFort III advancement procedures where the primary goal is skeletal repositioning without altering the patient's dental occlusion.
- Select this code when the surgical plan involves orbito-cranial advancement that necessitates the harvesting and integration of autogenous bone or cartilage grafts.
Common Pitfalls
- Attempting to bill separately for bone or cartilage harvesting is a common error, as these components are explicitly inclusive in the R659 fee.
- Billing R659 for bilateral procedures is incorrect; ensure you are using the appropriate bilateral code if both sides are addressed in the same operative session.
Billing Tips
- Ensure the operative report clearly details the unilateral nature of the advancement to prevent claim rejection or audit queries regarding the scope of the procedure.
- Verify that the patient's age is accurately reflected in the claim to automatically trigger the correct age-based fee premium, as these are significant additions to the base fee.
Provider Fee$932.10
Surgical Assistant Fee$75.06
Anaesthetist Fee$154.90
Non-Anaesthetist Fee$154.90
Effective: April 1, 2025
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
Includes harvesting and grafting of bone or cartilage grafts.
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