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E521

E521Left 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.
Provider Fee$200.00

Effective: April 1, 2025

Category

Q. Cardiovascular Surgical Procedures

Subcategory

CARDIOVASCULAR SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Cardiovascular Surgical Procedures

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