R698 – Debridement, excision, fasciotomy and flap and/or graft closure for necrotizing fasciitis
OHIP Radiology Code — INTEGUMENTARY SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Debridement, excision, fasciotomy and flap and/or graft closure for necrotizing fasciitis. This service is calculated in units, where one unit equals 1/4 hour or a major part thereof. Time units are calculated based on the time spent by the physician in direct contact with the patient in the operating room.
When to Use
- Use R698 for the surgical management of necrotizing fasciitis requiring formal debridement, excision, or fasciotomy with subsequent flap or graft closure.
- Use this code when the patient is admitted to an Intensive Care Unit (ICU) on the same day the procedure is performed, as this is a mandatory condition for eligibility.
Common Pitfalls
- Failure to document exact start and stop times in the operative report will result in automatic rejection of the claim.
- Billing R698 without explicit documentation of the patient's ICU status on the day of surgery will trigger an audit or rejection.
- Attempting to bill R698 alongside R495 is prohibited as they are restricted codes.
Billing Tips
- Ensure the operative report clearly details the extent of the debridement or excision to justify the total time units claimed, as each unit represents 1/4 hour.
- Always verify if the patient meets the criteria for the E420 trauma premium if the necrotizing fasciitis resulted from a qualifying traumatic injury with an appropriate Injury Severity Score (ISS).
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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