R679 – Hypertelorism correction - medial and lateral orbital wall osteotomies
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Surgical correction of hypertelorism involving osteotomies of the medial and lateral orbital wall. This is a major surgical procedure. - Note: The fee for this service includes the harvesting and grafting of any necessary bone or cartilage grafts, as per the note on page . - As a surgical procedure, it is eligible for separate payment for surgical assistant (suffix B) and anaesthetist (suffix C) services, which are calculated based on units: - Surgical Assistant (B): Based on 10 basic units (from page ) plus time units (as per rules on ). - Anaesthetist (C): Based on 20 basic units (from page ) plus time units (as per rules on ).
When to Use
- Use R679 for the definitive surgical correction of hypertelorism requiring both medial and lateral orbital wall osteotomies.
- Select this code when the procedure involves complex craniofacial reconstruction where bone or cartilage grafting is required as an integral component of the orbital wall repositioning.
Common Pitfalls
- Do not bill separate bone or cartilage graft harvesting codes (e.g., Z263, Z264, E975, Z265, E976, Z266) as these are explicitly included in the R679 fee.
- Avoid billing R679 in conjunction with restricted codes listed in the Schedule; ensure the claim reflects the comprehensive nature of the procedure to avoid automated rejections.
Billing Tips
- Ensure surgical assistant and anaesthetist units are calculated using the specific basic unit values (10 and 20 respectively) defined for R679 in the Schedule, rather than standard surgical defaults.
- Apply age-based surgical premiums (e.g., for patients under 16 years) to the surgeon, assistant, and anaesthetist fees to ensure accurate total reimbursement.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
* Includes harvesting and grafting of bone or cartilage grafts.
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