R825 – Resection of AV aneurysm or fistula with or without major graft - major aneurysm
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
Resection of a major arteriovenous (AV) aneurysm or fistula, with or without a major graft. This service is designated for major aneurysms and is not payable for the revision or repair of an AV fistula or graft required for haemodialysis. For haemodialysis access revision, refer to procedures on page of the Diagnostic and Therapeutic Procedures section of this Schedule.
When to Use
- Use R825 for the surgical resection of a primary or secondary arteriovenous aneurysm that is not related to dialysis access.
- Use this code for the resection of a congenital or traumatic AV fistula that requires major vascular reconstruction or graft placement.
Common Pitfalls
- Do not bill R825 for the revision, thrombectomy, or repair of a haemodialysis AV fistula or graft; these must be billed using the specific J-codes found in the Diagnostic and Therapeutic Procedures section.
- Submitting R825 for routine maintenance or minor revisions of dialysis access will result in automatic rejection or recovery during audit.
Billing Tips
- Ensure the operative report explicitly describes the 'major' nature of the aneurysm or fistula to justify the use of R825 over minor vascular repair codes.
- If the procedure is performed on an emergency basis for a trauma patient, ensure the Injury Severity Score (ISS) is documented in the chart to support the E420 trauma premium.
Effective: April 1, 2025
Q. Cardiovascular Surgical Procedures
CARDIOVASCULAR SURGICAL PROCEDURES
Surgical
Cardiovascular Surgical Procedures
All insured services must be documented in appropriate records that establish: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
Assistant basic units: 10.
Anaesthesia basic units: 17.
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