R678 – Hypertelorism correction - medial orbital wall osteotomies
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure for the correction of hypertelorism (abnormally increased distance between the orbits) involving osteotomies of the medial orbital walls. As noted on page of the Schedule of Benefits, this service includes the harvesting and grafting of bone or cartilage grafts.
When to Use
- Use for the surgical correction of hypertelorism specifically involving medial orbital wall osteotomies.
- Use when the procedure includes the harvesting and grafting of bone or cartilage, as these components are bundled into the fee.
Common Pitfalls
- Do not bill separately for bone or cartilage harvesting using codes such as Z263, Z264, E975, Z265, E976, or Z266, as these are included in the R678 fee.
- Avoid unbundling the procedure; the Schedule of Benefits explicitly states that the harvesting and grafting are inclusive of the R678 service.
Billing Tips
- Ensure the surgical report clearly documents the performance of the medial orbital wall osteotomies to support the use of this specific code over other craniofacial procedures.
- Apply the appropriate age-based premium (e.g., under 30 days, under 1 year, etc.) to the base fee to maximize the claim value based on the patient's age at the time of surgery.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
All insured services must be documented in appropriate records that establish: an insured service was provided, the service claimed is the service that was rendered, and the service was medically necessary.
* Includes harvesting and grafting of bone or cartilage grafts.
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