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R819
R819 – Lacerated major vein - by vein graft
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure for the repair of a lacerated major vein by means of a vein graft. Examples of applicable veins include femoral, popliteal, vena cava, axillary, sub-clavian, brachial, or microscopic repair of a digital vein. As a surgical service, this includes all common and specific elements as defined in the Schedule of Benefits, such as the pre-operative assessment where the decision to operate is made, the surgical procedure itself, and normal post-operative care.
When to Use
- Use R819 when performing a formal vein graft repair for a lacerated major vein, such as the femoral, popliteal, or axillary vein, where a graft is required to restore continuity.
- Use R819 for the microscopic repair of a digital vein when the complexity of the procedure meets the criteria for a formal vein graft repair.
Common Pitfalls
- Billing R819 for simple primary venous repair or ligation, which should be coded under alternative vascular repair codes like R818, as R819 specifically requires a vein graft.
- Failing to include the Injury Severity Score (ISS) in the medical record when attempting to claim the E420 trauma premium for R819, leading to automatic rejection.
Billing Tips
- Ensure the operative report explicitly details the use of a vein graft, as this is the defining clinical requirement that distinguishes R819 from simpler venous repair codes.
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