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E768
E768 – Nephrectomy with repair of vena cava for thrombus - above the hepatic vein
OHIP Surgical Assists Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
This service is an add-on fee payable in addition to `S416` (thoraco-abdominal or radical nephrectomy) when the procedure includes the repair of the vena cava for a thrombus located above the hepatic vein.
When to Use
- Use E768 specifically when performing a radical nephrectomy (S416) where the tumor thrombus extends into the suprahepatic vena cava, requiring complex vascular reconstruction.
- Apply this code when the thrombus location necessitates an approach above the hepatic veins, distinguishing it from E766 (infrahepatic) or E767 (retrohepatic) thrombus involvement.
Common Pitfalls
- Billing E768 without an associated S416 claim will result in an automatic rejection, as it is strictly an add-on procedure.
- Claiming E768 for thrombus removal below the hepatic veins is a common audit trigger; ensure the operative report explicitly documents the thrombus level as suprahepatic.
Billing Tips
- Ensure the operative report clearly describes the vascular repair technique used for the suprahepatic vena cava to justify the complexity associated with this specific add-on fee.
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