R946 – Brachio-basilic vein AV fistula transposition for haemodialysis
OHIP Radiology Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Brachio-basilic vein AV fistula transposition for haemodialysis. From the Schedule: - Note: R946 includes placement, venography and any image guidance. Obtaining and interpreting any images in conjunction with R946 are not eligible for payment to any physician. - Note: R946 includes any revision and/or re-anastomosis, when rendered.
When to Use
- Use R946 specifically for the surgical transposition of the basilic vein to the brachial artery to create a functional haemodialysis fistula.
- Select this code when the procedure involves the mobilization and superficialization of the deep basilic vein to facilitate cannulation for dialysis.
Common Pitfalls
- Billing for intraoperative venography or image guidance separately is a common error; these are explicitly included in the R946 fee.
- Attempting to bill for a revision or re-anastomosis on the same day as the primary transposition will result in a rejection, as these are bundled into the R946 global fee.
- Submitting R946 alongside other vascular access codes like R941 or R945 for the same patient on the same day will trigger an automatic rejection due to the daily limit restriction.
Billing Tips
- Ensure your operative report clearly documents the transposition of the basilic vein to support the use of R946 over simpler fistula creation codes.
- If the procedure is performed after hours or on weekends, ensure you append the appropriate E409 or E410 premium to the R946 claim to maximize the procedural fee.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Surgical
Cardiovascular Surgical Procedures, Diagnostic and Therapeutic Procedures
Only one of R941, R942, R943, R944, R945 or R946 is eligible for payment per patient per day, any physician.
R946 includes placement, venography and any image guidance. Obtaining and interpreting any images in conjunction with R946 are not eligible for payment to any physician.
R946 includes any revision and/or re-anastomosis, when rendered.
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