All codes
R818
R818 – Lacerated major vein - including patch
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
Repair of a lacerated major vein such as a femoral, popliteal, vena cava, axillary, sub-clavian, brachial, or microscopic repair of a digital vein, which includes the use of a patch. This service is a variation of R820.
When to Use
- Use R818 when performing a repair of a major vein (e.g., femoral, vena cava) specifically requiring the application of a patch to close the defect.
- Use R818 for microscopic repair of a digital vein where the complexity of the repair necessitates a patch or graft material.
- Choose R818 over R820 when the repair is specifically for a laceration involving a major vein that requires patch augmentation, whereas R820 is typically reserved for other vascular repairs.
Common Pitfalls
- Billing R818 without documenting the use of a patch in the operative report, which is a mandatory requirement for this specific code.
- Attempting to bill R818 in conjunction with other vascular repair codes for the same vessel, which will trigger a rejection for duplicate or overlapping services.
- Failure to include the Injury Severity Score (ISS) in the medical record when attempting to claim the E420 trauma premium alongside this procedure.
Billing Tips
- Ensure the operative note explicitly describes the vein repaired and the specific material used for the patch to satisfy audit requirements for the 'including patch' component.
- When performing this procedure on a trauma patient, ensure the ISS score is clearly documented in the chart to support the E420 premium, as this is a common point of audit failure.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.