R937 – Ilio-femoral bypass graft
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
This service involves the surgical creation of a bypass graft from the iliac artery to the femoral artery. The procedure is designed to circumvent a blockage or diseased segment in the ilio-femoral arterial system, thereby restoring adequate blood flow to the lower limb. This may involve the use of an autologous vein or a synthetic graft.
When to Use
- Use R937 when performing a primary bypass graft specifically from the iliac artery to the femoral artery to address symptomatic peripheral arterial disease.
- Select R937 for elective or urgent revascularization procedures where the inflow source is the iliac artery and the outflow target is the femoral artery, distinguishing it from femoral-femoral (R934) or aorto-femoral bypass procedures.
Common Pitfalls
- Billing R937 in conjunction with other vascular procedures on the same vessel segment without proper documentation of separate incisions or distinct anatomical sites, which may trigger audit flags for unbundling.
- Failure to document the specific graft material (autologous vein vs. synthetic) in the operative report, which is a mandatory requirement for substantiating the procedure during a post-payment review.
Billing Tips
- Ensure that the surgical assistant (R937B) and anaesthesiologist (R937C) units are calculated precisely based on the start and end times documented in the anaesthesia record to avoid claim rejections.
- If the procedure is performed on an emergency basis after hours, append the appropriate E-series premium (E409 or E410) to the primary procedure code, ensuring the start time of the surgery is clearly noted in the hospital record.
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 the service was provided, is the service for which the account is submitted, and was medically necessary.
The operative report must be included in the patient's medical record.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.