R791 – Femoro-popliteal bypass with saphenous vein
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
Femoro-popliteal bypass graft with saphenous vein is a cardiovascular surgical procedure. - The service may be performed 'with or without endarterectomy' (:). - The fee for the surgeon (suffix A) is a set amount. - The fee for the surgical assistant (suffix B) is calculated based on 10 base units plus time units as defined in :-:. - The fee for the anaesthetist (suffix C) is calculated based on 10 base units plus time units as defined in :-:. - This service is not payable on the same day as R878 (:).
When to Use
- Use R791 for a standard femoro-popliteal bypass procedure utilizing the patient's own saphenous vein as the graft material.
- Use R791 when the procedure includes an endarterectomy at the inflow or outflow site, as the code is inclusive of this step.
Common Pitfalls
- Billing R791 and R878 on the same day will result in a rejection, as these procedures are mutually exclusive in the Schedule of Benefits.
- Failure to document exact start and stop times in the patient record will lead to a clawback of the surgical assistant and anaesthetist time units during an audit.
- Forgetting to append the E672 composite graft fee when using a combination of vein and synthetic material (e.g., Dacron) results in lost revenue.
Billing Tips
- Always verify if the procedure qualifies for the E672 composite graft add-on, as this is a common oversight when synthetic components are integrated into the saphenous vein graft.
- Ensure the anaesthetist and surgical assistant claims are submitted with the same start/stop times as documented in the operative report to avoid discrepancies that trigger manual review.
Effective: April 1, 2025
Q. Cardiovascular Surgical Procedures
CARDIOVASCULAR SURGICAL PROCEDURES
Surgical
Cardiovascular Surgical Procedures
Surgical Assistant Services: The start and stop times must be documented in the patient's permanent medical record for time unit calculation.
Anaesthesiologist Services: The time anaesthesia starts and ends must be documented in the patient's permanent medical record for time unit calculation.
If claiming the E420 trauma premium, the Injury Severity Score (ISS) must be listed in the medical record.
R791 ... with or without endarterectomy.
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