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R842
R842 – Extra fascial and sub-fascial incompetent perforators by full fascial technique
OHIP Cardiovascular Surgical Procedures Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
Extra fascial and sub-fascial incompetent perforators by full fascial technique is a surgical procedure for varicose veins. This service is insured only when specific medical criteria are met.
Insurance Conditions for Varicose Vein Surgery
As outlined on page of the Schedule, surgical services for varicose veins are insured only when all of the following conditions are met:
1. Documented Incompetence: There must be incompetence (reflux) at the saphenofemoral junction or saphenopopliteal junction, documented by Doppler or duplex ultrasound scanning.
2. Failed Conservative Management: The patient must have failed a trial of conservative management lasting at least three months. Conservative management includes analgesics and prescription gradient support compression stockings.
3. Specific Clinical Conditions: The patient must have at least one of the conditions described in either category (a) or (b) below:
• a. One or more signs of chronic venous insufficiency: Eczema, Pigmentation, Lipodermatosclerosis, or Ulceration.
• b. Varicosities that result in one or more of the following:
• Ulceration secondary to venous stasis.
• One or more significant hemorrhages from a ruptured superficial varicosity (defined as a hemorrhage requiring iron therapy or transfusion).
• Two or more episodes of minor hemorrhage from a ruptured superficial varicosity.
• Recurrent superficial thrombophlebitis.
• Stasis dermatitis.
• Varicose eczema.
• Lipodermosclerosis.
• Unremitting edema or intractable pain interfering with activities of daily living and requiring chronic analgesic medication.
This procedure has an anaesthesia value of 7 base units and a surgical assistant value of 6 base units, plus applicable time units for both.
Incompetence (i.e. reflux) at the saphenofemoral junction or saphenopopliteal junction must be documented by Doppler or duplex ultrasound scanning.
Documentation of a failed trial of conservative management of at least three months duration.
The patient has at least one of the conditions described in either a. or b. (One or more signs of chronic venous insufficiency: Eczema, Pigmentation, Lipodermatosclerosis, or Ulceration; OR Varicosities that result in one or more of the following: Ulceration secondary to venous stasis, One or more significant hemorrhages from a ruptured superficial varicosity, Two or more episodes of minor hemorrhage from a ruptured superficial varicosity, Recurrent superficial thrombophlebitis, Stasis dermatitis, Varicose eczema, Lipodermosclerosis, Unremitting edema or intractable pain interfering with activities of daily living and requiring chronic analgesic medication.)
1. Conservative management includes analgesics and prescription gradient support compression stockings.
2. Significant hemorrhage refers to a hemorrhage related to varicose veins that requires iron therapy or transfusion.
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