R778 – Cannulation for infusion chemotherapy - carotid artery
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
R778 is a surgical procedure for the cannulation of the carotid artery, typically performed for infusion chemotherapy. This service includes all common and specific elements of a surgical procedure as defined in the Schedule of Benefits. The listed fee is for the surgeon (suffix A). Assistant (suffix B) and Anaesthetist (suffix C) services are billed separately and are calculated on a time and basic unit basis. The basic units for an assistant are 6, and for an anaesthetist are 6. See .
When to Use
- Use R778 specifically for the surgical cannulation of the carotid artery for the purpose of delivering infusion chemotherapy.
- Use this code when the procedure is performed as a distinct surgical intervention, ensuring it is not bundled into a more comprehensive vascular reconstruction or bypass procedure.
Common Pitfalls
- Billing R778 as a percutaneous line placement; this code is intended for a surgical procedure and requires appropriate operative documentation.
- Failing to bill the assistant (suffix B) or anaesthetist (suffix C) services separately, as these are not included in the $148.50 surgeon fee.
- Attempting to claim R778 with other vascular procedures without ensuring the services are not considered 'incidental' or 'included' under the Schedule of Benefits rules.
Billing Tips
- Always verify if the patient qualifies for age premiums (e.g., AGE_PREMIUM_U16Y) or after-hours premiums (E409/E410) to maximize the claim value beyond the base fee.
- Ensure the anaesthetist includes the appropriate basic units (6) and any applicable patient-specific or procedure-specific add-ons (e.g., E022C for ASA III) to accurately reflect the complexity of the case.
Effective: April 1, 2025
Q. Cardiovascular Surgical Procedures
CARDIOVASCULAR SURGICAL PROCEDURES
Surgical
Cardiovascular Surgical Procedures
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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