R681 – Late correction traumatic enophthalmos, Tessier Technique - extracranial
OHIP Radiology Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Late correction traumatic enophthalmos using the Tessier Technique - this involves total periorbital stripping and bone grafts. This service represents the extracranial approach. As this code is not marked with an asterisk, the harvesting of bone or cartilage grafts is not an included component and may be billed separately. See related codes for graft harvesting.
When to Use
- Use R681 for the late-stage surgical correction of traumatic enophthalmos via an extracranial approach when total periorbital stripping and bone grafting are required.
- Select R681 specifically for extracranial Tessier Technique procedures; do not use for intracranial approaches, which are covered under different procedural codes.
Common Pitfalls
- Failing to bill for graft harvesting separately; because R681 is not marked with an asterisk, the harvesting of bone or cartilage is not included in the primary fee.
- Incorrectly assuming graft harvesting is bundled; unlike codes such as R376 or R678, R681 requires separate submission of Z263, Z264, Z265, or Z266 to be compensated for the harvest.
Billing Tips
- Always append the appropriate graft harvesting code (e.g., Z264 for rib or Z266 for cranial) to your R681 claim to ensure full reimbursement for the additional operative time and effort.
- If multiple rib grafts are required, ensure you bill Z264 for the first rib and E975 for each subsequent rib to maximize the claim accuracy.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures, Surgical Assistants' Services, Anaesthesiologists' Services
All insured services must be documented in appropriate records that establish: 1) an insured service was provided; 2) the service for which the account is submitted is the service that was rendered; and 3) the service was medically necessary.
Tessier Technique - total periorbital stripping and bone grafts.
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