R878 – Subintimal dissection for recanalization of femoral/popiteal/tibial arterial occlusive disease
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
Subintimal dissection for recanalization of femoral, popliteal, or tibial arterial occlusive disease. Payment for this procedure includes catheter placement, angiography, and any associated image guidance. The fees for obtaining and interpreting any images in conjunction with R878 are not eligible for payment to any physician. Payment for assistant (R878B) and anaesthesia (R878C) services are calculated based on basic units plus time-based units as per the Schedule of Benefits. For R878B (Assistant), the service has 10 base units. For R878C (Anaesthesia), the service has 10 base units.
When to Use
- Use R878 for subintimal recanalization of chronic total occlusions in the femoral, popliteal, or tibial arteries when the procedure is the primary intervention.
- Use R878 when the subintimal technique is specifically required to navigate through or around a long-segment arterial occlusion that cannot be crossed intraluminally.
Common Pitfalls
- Do not bill separately for diagnostic angiography or image guidance, as these are explicitly included in the R878 fee.
- Avoid billing R878 alongside restricted codes like R809 or R791, as these are mutually exclusive and will trigger automatic rejections.
- Do not attempt to claim professional fees for image interpretation, as the Schedule of Benefits prohibits payment for this to any physician when performed with R878.
Billing Tips
- If you perform angioplasty at a site remote from the subintimal dissection, ensure you add E815 to the claim to capture the additional work, as this includes any necessary stenting.
- For bilateral procedures, you may only bill R878 as separate services if you utilize distinct, separate bilateral incisions for each side.
Effective: April 1, 2025
Q. Cardiovascular Surgical Procedures
CARDIOVASCULAR SURGICAL PROCEDURES
Surgical
Cardiovascular Surgical Procedures
Bilateral procedures for R878 are payable only as separate services when subintimal dissection is performed using separate bilateral incisions.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.