R860 – Per-obturator ilio-femoral graft - with saphenous vein
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
A per-obturator ilio-femoral graft is a surgical procedure to bypass a blocked iliac artery. This is achieved by using a segment of the patient's saphenous vein, which is routed through the obturator foramen to connect the iliac and femoral arteries, thereby restoring blood flow to the leg.
When to Use
- Use R860 when performing a bypass of an iliac artery occlusion using an autologous saphenous vein graft routed through the obturator foramen.
- Select R860 specifically for extra-anatomical bypass procedures where standard aorto-bifemoral or ilio-femoral routing is contraindicated or anatomically impossible.
Common Pitfalls
- Billing R860 alongside R861 (the contralateral procedure) without applying the appropriate multiple procedure reduction rules for the assistant and anaesthetist.
- Attempting to claim for a second surgical assistant without prior medical consultant authorization, as R860 does not carry automatic eligibility for a second assistant.
- Failure to explicitly document the use of the saphenous vein in the operative report, which is a mandatory requirement for this specific code.
Billing Tips
- Ensure the operative report clearly details the graft path through the obturator foramen to justify the use of R860 over other vascular bypass codes.
- When performing bilateral procedures, remember that the anaesthetist and assistant basic units are calculated based on the major procedure only.
Effective: April 1, 2025
Q. Cardiovascular Surgical Procedures
CARDIOVASCULAR SURGICAL PROCEDURES
Surgical
Cardiovascular Surgical Procedures
All insured services must be documented in appropriate records to establish that the service was provided, medically necessary, and is the service for which the account is submitted. See for general requirements.
An operative report is required.
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