R868

PDF page 677 / Q19

CARDIOVASCULAR SURGICAL PROCEDURES
 VEINS
                                                                               Asst        Surg        Anae
       Varicose veins involving the long and/or short saphenous vein(s)
        Surgical services (ligation/stripping) for the treatment of varicose veins involving the long
        saphenous and/or short saphenous vein(s) are only insured when all of the following conditions
        are met:
        1.There is incompetence (i.e. reflux) at the saphenofemoral junction or saphenopopliteal
          junction that is documented by Doppler or duplex ultrasound scanning;
        2.The patient has failed a trial of conservative management of at least three months duration;
          and
        3.The patient has at least one of the conditions described in either a. or b. below:
            a.One or more of the following signs of chronic venous insufficiency:
              i. Eczema;
              ii. Pigmentation;
              iii. Lipodermatosclerosis;
              iv. Ulceration
            b.Varicosities that result in one or more of the following:
              i. Ulceration secondary to venous stasis;
              ii. One or more significant hemorrhages from a ruptured superficial varicosity;
              iii. Two or more episodes of minor hemorrhage from a ruptured superficial varicosity;
              iv. Recurrent superficial thrombophlebitis;
              v. Stasis dermatitis;
              vi. Varicose eczema;
              vii. Lipodermosclerosis;
              viii. 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.
       LIGATION/STRIPPING
# Z745 Saphenous..............................................................................             53.20   6
# R868 High ligation and stripping of long saphenous vein with groin
          dissection ...........................................................................      6   200.00   7
# R869 Stripping of short saphenous vein with popliteal dissection....                                6   107.50   7
# R837 Multiple ligation and avulsion..................................................               6   200.00   7
# R844 Recurrent varicose veins - multiple ligation and/or stripping ..                               6   353.80   7
# R842 Extra fascial and sub-fascial incompetent perforators by full
          fascial technique.................................................................          6   384.75   7
# E653    - plus stripping.............................................................. add              127.15
# Z746 Femoral...................................................................................     6    74.25   7
# Z747 Popliteal ..................................................................................   6    74.25   7
# Z748 Internal jugular ........................................................................      6   148.60   7
# R839 Internal iliac.............................................................................    6   394.85   10
# R834 I.V.C. - transabdominal ...........................................................            6   446.50   10

Master, record 5089. Record Layout PDF, page 1.

R86820260401999999990000200000000000774600000000000000000111720000001117200

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