R865 – Distal spleno-renal shunt
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
This service is for the surgical creation of a distal spleno-renal shunt, an anastomosis procedure. The fee is for the surgeon's work (suffix A). Assistant (suffix B) and anaesthesia (suffix C) services are also payable based on unit calculations. The assistant service has 10 base units, and the anaesthesia service has 10 base units, with additional time units calculated as per the Schedule of Benefits. See , , , and for unit calculation rules.
When to Use
- Use R865 for the specific creation of a distal spleno-renal shunt (Warren shunt) to manage portal hypertension.
- Select this code when performing a selective shunt procedure to decompress the gastroesophageal varices while maintaining portal perfusion to the liver, as opposed to non-selective shunts like R825.
Common Pitfalls
- Billing R865 in conjunction with other major vascular shunt procedures without prior approval, as this may be flagged as unbundling.
- Failing to document the specific anatomical approach, which can lead to audit scrutiny regarding the complexity of the anastomosis compared to simpler venous bypass procedures.
Billing Tips
- Ensure the surgical assistant and anaesthesia units are calculated strictly according to the base units (10 each) plus time units as defined in GP85-GP93, as these are frequently audited for over-calculation.
Effective: April 1, 2025
Q. Cardiovascular Surgical Procedures
CARDIOVASCULAR SURGICAL PROCEDURES
Surgical
Cardiovascular Surgical Procedures
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