R692 – Moderate burn
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Debridement, excision, fasciotomy, and/or grafting for a moderate burn, payable per unit. A unit is defined as a quarter-hour (15 minutes) or a major part thereof. Time unit calculation begins when the physician is first in attendance with the patient in the operating room and concludes when the physician's attendance is no longer required. Per , start and stop times must be recorded in the patient's medical record for the service to be eligible for payment.
When to Use
- Use R692 for debridement or excision of moderate burns where the procedure duration is clearly documented in 15-minute increments.
- Select R692 when the clinical severity of the burn does not meet the criteria for R691 (minor) or R693 (major), ensuring the surgical intervention is appropriately categorized by depth and surface area.
Common Pitfalls
- Failure to document exact start and stop times in the operative note will result in automatic rejection, as this is a time-based unit code.
- Billing R692 in conjunction with R691 or R693 for the same patient encounter is prohibited and will trigger a claim rejection.
- Rounding up time units incorrectly; ensure you only bill for 15-minute blocks or major parts thereof as defined in GP7.
Billing Tips
- Always explicitly state the start and stop times in the surgical report to satisfy the mandatory documentation requirement under GP7.
- If the procedure qualifies as non-elective and occurs after hours, ensure the appropriate E409 or E410 premium is appended to the R692 claim to maximize the procedural fee.
Effective: April 1, 2025
M. Integumentary System Surgical Procedures
INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
Surgical
Integumentary System Surgical Procedures
Start and stop times must be recorded in the patient's permanent medical record or the service is not eligible for payment.
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