R932 – Axillo-bilfemoral graft
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
This procedure involves placing a graft from the axillary artery to both femoral arteries to bypass blockages in the aorta and iliac arteries. The fee includes the surgical procedure itself (suffix A), as well as services for an assistant (suffix B) and anaesthetist (suffix C), which are calculated based on basic and time units.
When to Use
- Use R932 when performing a bypass graft specifically from the axillary artery to both femoral arteries for aortoiliac occlusive disease.
- Select R932 over R933 when the graft configuration involves a bilateral femoral connection, as R933 is restricted to unilateral axillo-femoral bypass.
Common Pitfalls
- Attempting to bill a second assistant without prior authorization; R932 is not on the pre-approved list, and claims will be rejected without a supporting letter to a medical consultant.
- Failing to document the exact start and end times for anaesthesia and assistant services, which are mandatory for calculating time-based units beyond the base fee.
- Incorrectly stacking E409 or E410 with E420; the Trauma Premium is mutually exclusive with after-hours and night procedure premiums.
Billing Tips
- Ensure the Injury Severity Score (ISS) is explicitly recorded in the chart if claiming the E420 Trauma Premium, as this is a frequent audit trigger for major vascular procedures.
- When performing multiple procedures during the same anaesthetic, remember that the basic units for the assistant and anaesthetist are derived solely from the major procedure code.
Effective: April 1, 2025
Q. Cardiovascular Surgical Procedures
CARDIOVASCULAR SURGICAL PROCEDURES
Surgical
Cardiovascular Surgical Procedures
For time-based services (anaesthesia, assistant), the start and end times must be recorded in the patient's medical record.
If claiming the E420 Trauma Premium, the Injury Severity Score (ISS) must be listed in the medical record.
If claiming anaesthesia extra unit E010C for obesity, the patient's Body Mass Index (BMI) must be documented, calculated from height and weight.
If claiming anaesthesia extra unit E025C for unanticipated massive transfusion, the volume of red blood cells transfused must be documented.
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