E679 – Vein graft harvest remote from site of by-pass
OHIP Surgical Assists Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
E679 is an add-on fee payable for the harvest of a vein graft from a remote site. This code is only eligible for payment when the patient's saphenous vein is unavailable for use as a graft. It is claimed in addition to the primary vascular surgical procedure being performed.
When to Use
- Use E679 when the saphenous vein is absent, previously stripped, or unsuitable for harvesting due to varicosities, requiring an alternative site like the cephalic or basilic vein.
- Claim this code when performing a bypass procedure where the primary graft source is unavailable, necessitating a secondary, remote harvest site.
Common Pitfalls
- Billing E679 when the saphenous vein is simply difficult to access or harvest; the code strictly requires the vein to be unavailable for use as a graft.
- Submitting E679 as a standalone claim, which will result in an automatic rejection as it is an add-on code requiring a primary vascular procedure code.
- Failing to explicitly document the clinical justification for the remote harvest, which is a mandatory requirement for audit compliance.
Billing Tips
- Ensure the primary vascular procedure code is submitted on the same claim to trigger the add-on payment for E679.
- Clearly note the specific anatomical reason for the saphenous vein's unavailability in the operative report to satisfy the documentation requirement.
Effective: April 1, 2025
Q. Cardiovascular Surgical Procedures
CARDIOVASCULAR SURGICAL PROCEDURES
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Cardiovascular Surgical Procedures
The medical record should document the reason the saphenous vein was unavailable.
1. Common femoral artery repair (e.g. R784, R785) includes repair to the profunda femoris artery as far as the first major branch. 2. If the repair extends beyond the first major branch of the profunda femoris artery, R815 may be claimed in addition. 3. If the repair extends beyond the second major branch of the profunda femoris artery, R856 instead of R815 may be claimed in addition. 4. For procedures involving the application of a complete aortic cross clamp, the anaesthetic basic fee will depend on: a. the level of application of the cross clamp; and b. the surgical exposure and extent of the aortic repair
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