R708 – Internal iliac artery (unilateral or bilateral)
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
Ligation of the internal iliac artery, which can be performed on one or both sides (unilateral or bilateral). As a surgical procedure, this service includes a pre-anaesthetic evaluation, the anaesthetic procedure itself, post-anaesthetic follow-up, preparation of the patient, the surgical procedure by any method or assistance in its performance, and all related post-operative care and monitoring. For full details on included elements, refer to the General Preamble, particularly , , (Surgical Assistant Specific Elements), and (Anaesthesiologist Specific Elements).
When to Use
- Use R708 for the ligation of the internal iliac artery during obstetric hemorrhage to control life-threatening postpartum bleeding when conservative measures have failed.
- Use R708 for surgical management of pelvic trauma or intractable pelvic hemorrhage where internal iliac artery ligation is the definitive procedure.
Common Pitfalls
- Do not attempt to bill R708 as a bilateral procedure by adding a second unit or modifier; the fee is inclusive of both unilateral and bilateral ligation.
- Avoid billing R708 in conjunction with other major pelvic vascular procedures unless they represent distinct, non-overlapping surgical sites, as the General Preamble prohibits unbundling inclusive services.
Billing Tips
- Ensure the operative report explicitly details the ligation of the internal iliac artery to support the claim, as this is a high-value surgical code subject to audit.
Effective: April 1, 2025
Q. Cardiovascular Surgical Procedures
CARDIOVASCULAR SURGICAL PROCEDURES
Surgical
Cardiovascular Surgical Procedures
The description specifies this service is for 'unilateral or bilateral' ligation of the internal iliac artery, indicating the fee is the same whether one or both sides are treated.
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