E654 – Coronary artery repair - each additional
OHIP Surgical Assists Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
This code represents the fee for each additional coronary artery repair performed during a bypass procedure. It is intended to be billed in addition to the primary procedure codes `R742 or R743`.
Note: Where a single segment of vein is used for more than two anastomoses, the second and subsequent anastomoses are to be claimed at 50% of the E654 fee.
When to Use
- Use for each additional coronary artery bypass graft (CABG) performed beyond the initial vessel covered by the primary procedure code R742 or R743.
- Apply for each distal anastomosis performed on a sequential graft after the first two anastomoses on a single vein segment, billed at 50% of the E654 fee.
Common Pitfalls
- Billing E654 for the primary vessel, which is already included in the base fee for R742 or R743.
- Failing to reduce the fee to 50% when a single vein segment is used for more than two anastomoses, leading to potential audit recovery.
- Attempting to bill assistant or anaesthesia services separately for this code, as these are strictly included in the primary procedure fee.
Billing Tips
- Ensure the total number of E654 units claimed matches the number of additional distal anastomoses performed beyond the primary vessel.
- Clearly document the number of anastomoses per vein segment in the operative report to justify the 50% fee reduction for sequential grafts.
Effective: April 1, 2025
Q. Cardiovascular Surgical Procedures
CARDIOVASCULAR SURGICAL PROCEDURES
Procedure
Cardiovascular Surgical Procedures
Where a single segment of vein is used for more than 2 anastomoses, the second and subsequent anastomoses are to be claimed at 50% of the E654 fee.
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