R824 – Meso-caval
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
Meso-caval anastomosis is a cardiovascular surgical procedure listed under 'Anastomosis' of veins. It is a procedure to create a shunt, typically between the superior mesenteric vein and the inferior vena cava. This service has 10 basic units for a surgical assistant and 10 basic units for an anaesthesiologist.
When to Use
- Use R824 specifically for the creation of a meso-caval shunt between the superior mesenteric vein and the inferior vena cava.
- Select R824 when performing a direct venous anastomosis for portal decompression, distinguishing it from portacaval shunts coded under R820 or R821.
Common Pitfalls
- Failing to document the Injury Severity Score (ISS) in the medical record when claiming the E420 trauma premium, which leads to automatic rejection.
- Incorrectly calculating time units for R824B or R824C by failing to account for the specific tiered unit structure that changes after the first hour or 1.75 hours.
Billing Tips
- Ensure that the surgical assistant (R824B) and anaesthesiologist (R824C) claims are submitted with the correct basic units (10) and accurate time-based unit increments to avoid payment delays.
- If a second surgical assistant is required, you must obtain prior authorization from a medical consultant and submit a formal letter from the surgeon justifying the necessity, as R824 is not on the pre-approved list for multiple assistants.
Effective: April 1, 2025
Q. Cardiovascular Surgical Procedures
CARDIOVASCULAR SURGICAL PROCEDURES
Surgical
Cardiovascular Surgical Procedures
All insured services must be documented in appropriate medical records, establishing that the service was provided, is the service submitted for claims, and was medically necessary.
The medical record requirements as found in the Act are listed in Appendix G of the Schedule.
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