All codes
R821
R821 – Spleno-renal - transthoracic approach
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
R821 is a surgical procedure for creating a spleno-renal anastomosis, a shunt between the splenic vein and the left renal vein, performed via a transthoracic approach. This procedure is typically used to decompress the portal venous system in cases of portal hypertension. The fee schedule listing specifies the base units for both surgical assistance (suffix B) and anaesthesia (suffix C).
When to Use
- Use R821 specifically for a transthoracic approach to create a spleno-renal shunt in patients with portal hypertension.
- Select R821 when the surgical plan necessitates thoracic access to the splenic and left renal veins, distinguishing it from abdominal approaches covered by other R-series codes.
Common Pitfalls
- Billing R821 when an abdominal approach was actually performed, which would require a different code from the R822-R824 series.
- Failing to document the specific transthoracic approach, which is a primary audit trigger for this high-value surgical code.
Billing Tips
- Ensure the surgical report explicitly describes the transthoracic entry, as this is the defining clinical requirement for the R821 fee.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.