R836 – Pulmonary embolectomy
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
Pulmonary embolectomy is a surgical procedure to remove a blockage, such as a blood clot (embolus), from the pulmonary arteries. This is performed to treat a pulmonary embolism, a serious and potentially life-threatening condition. Payment for this service is based on a fee for the surgeon (R836A). Associated assistant services (R836B) are calculated with 18 base units plus time units. Associated anaesthesia services (R836C) are calculated with 20 base units plus time units.
When to Use
- Use R836A for the surgical removal of a pulmonary embolus when the procedure is performed via open pulmonary embolectomy.
- Use this code for life-saving surgical intervention in patients with massive pulmonary embolism who are hemodynamically unstable and refractory to thrombolysis or where thrombolysis is contraindicated.
Common Pitfalls
- Do not bill R836A alongside R818, R819, R820, or R828, as these represent distinct cardiac or vascular procedures that are generally considered mutually exclusive or bundled depending on the surgical approach.
- Failure to document the Injury Severity Score (ISS) in the medical record will result in the rejection of the E420 trauma premium, even if the patient meets the clinical criteria for trauma.
- Attempting to bill for a second surgical assistant without prior authorization will result in an automatic rejection, as R836 is not on the pre-approved list for multiple assistants.
Billing Tips
- Ensure the start time of the procedure is accurately recorded to determine eligibility for after-hours premiums (E409/E410 for surgeons, E400C/E401C for anaesthesia) and to correctly calculate time units for assistants and anaesthesiologists.
- When the procedure is cancelled after anaesthesia induction but before the incision, switch to billing E006B for the assistant and E006C for the anaesthesiologist to ensure appropriate compensation for the standby time.
Effective: April 1, 2025
Q. Cardiovascular Surgical Procedures
CARDIOVASCULAR SURGICAL PROCEDURES
Surgical
Cardiovascular Surgical Procedures
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