R907 – Cystic hygroma - unilateral
OHIP Radiology Code — HAEMATIC AND LYMPHATIC SURGICAL PROCEDURES · Schedule of Benefits
This procedure involves the unilateral excision of a cystic hygroma. This service is listed under the Haematic and Lymphatic Surgical Procedures section.
When to Use
- Use R907 for the definitive surgical excision of a unilateral cystic hygroma (lymphangioma) in the neck or axillary region.
- Select R907 when the procedure involves the complete removal of the cystic mass, distinguishing it from simple aspiration or drainage procedures.
Common Pitfalls
- Billing R907 bilaterally is incorrect; the code description explicitly specifies unilateral, and bilateral claims will be rejected or adjusted.
- Attempting to bill R907 in conjunction with other excision codes for the same anatomical site may trigger a 'multiple procedure' rule reduction, requiring careful use of the M-code modifiers if applicable.
- Failure to document the specific anatomical location and the unilateral nature of the excision can lead to audit recovery if the claim is flagged for review.
Billing Tips
- Ensure that age-based premiums are applied correctly, as R907 is frequently performed on pediatric patients and these premiums significantly increase the total claim value.
- If the procedure is performed on an emergency basis after hours, ensure the correct E-code (E409 or E410) is linked to the R907 claim to capture the 50% or 75% procedural uplift.
Effective: April 1, 2025
R. Haematic and Lymphatic Surgical Procedures
HAEMATIC AND LYMPHATIC SURGICAL PROCEDURES
Surgical
Haematic and Lymphatic Surgical Procedures
All insured services must be documented in appropriate records to establish that the service was provided, is the service submitted for payment, and was medically necessary.
For anaesthesia services, start and finish times must be documented in the medical record, particularly if a replacement anaesthetist is used.
For surgical assistant services, start and stop times must be documented in the patient's permanent medical record if a replacement assistant is used.
Anaesthesia (Anae) and Assistant (Asst) fees are calculated based on a combination of basic units listed with the surgical procedure and time units. The unit fee for anaesthesia is $15.49 and for an assistant is $12.51. Please refer to the Anaesthesiologists' Services () and Surgical Assistants' Services () sections of the Schedule of Benefits for detailed calculation rules.
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