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E521
E521 – Left atrial appendage occlusion/excision - when done in conjunction with another procedure
OHIP Surgical Assists Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
This service is for the occlusion or excision of the left atrial appendage by suture or device, performed as an add-on in conjunction with another primary surgical procedure. This service is not eligible for payment for the same patient on the same day as R709.
When to Use
- Use E521 when performing a left atrial appendage occlusion or excision as a secondary, incidental procedure during a primary cardiac surgery such as mitral valve repair or coronary artery bypass grafting.
- Use this code when the LAA is addressed via suture or device specifically as an add-on to a primary procedure, provided the primary procedure is not R709.
Common Pitfalls
- Billing E521 on the same day as R709 will result in an automatic rejection, as R709 is explicitly restricted by the Schedule of Benefits for this code.
- Attempting to bill E521 as a stand-alone procedure is incorrect; it is defined as an add-on code and requires a primary surgical procedure to be present on the claim.
Billing Tips
- Ensure E521 is submitted on the same claim as the primary surgical procedure to maintain the correct billing relationship and avoid processing delays.
- If E521 is performed during an after-hours or emergency setting, ensure the appropriate premium (E409 or E410) is applied to the procedural fee to maximize the claim value.
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