R092

PDF page 563 / M13

INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
 SKIN AND SUBCUTANEOUS TISSUE
                                                                                               Asst   Surg    Anae
    Debridement, excision, fasciotomy, escharotomy, and/or grafting - in Operating Room
# R691 Minor burn................................................................... per unit  75.00
# R692 Moderate burn ............................................................ per unit     87.50
# R693 Major burn................................................................... per unit 100.00
     Payment rules:
     1.R691, R692 and R693 are eligible for payment only when rendered in an Operating Room.
         2.Unit means ¼ hour or major part thereof.
         3.Time units are calculated based on the time spent by the physician in direct contact with the
           patient and commence when the physician is first in attendance with the patient in the
           operating room and end when the physician is no longer in attendance with that patient in the
           operating room.
         4.Only one of R691, R692 or R693 is eligible for payment for the same patient during the same
           encounter.
         5.R083, R084, R085, R086, R087, R088, R091, R092, R093, R495 are not eligible for payment
           in addition to R691, R692 or R693.
         [Commentary:
         See General Preamble GP7 for definitions and time-keeping requirements. As noted on GP7,
         start and stop times must be recorded in the patient's permanent medical record or the service
         is not eligible for payment.]

PDF page 569 / M19

B. Full thickness grafts
# R092 Minor - less than 1 cm average diameter ...............................                 116.65 7
# R093 Intermediate - 1 cm to 5 cm average diameter .......................                  6 178.90 7
# R083 Major - over 5 cm.................................................................... 6 280.15 7
# R091 Complex - eyelid, nose, lip, face.............................................        6 263.95 7
     Note:
     1.R092, R093, R083, R091 - The medical record must demonstrate the appropriateness of
        codes claimed relative to size of graft.
     2.Skin grafts are not eligible for payment in addition to R117.
# R057 Appendage or tissue re-vascularization involving
         microanastomosis with or without micro neuroanastomosis
         (see General Preamble GP12)...........................................                     I.C    I.C      I.C
# R058 Revision of above (see General Preamble GP12)..................                              I.C    I.C      I.C

Master, record 4348. Record Layout PDF, page 1.

R09220260401999999990000116650000000000000000000000000000111720000001117200

Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.