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R704

R704 – Implantable ventricular assist device

OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits

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Surgical implantation of a ventricular assist device. This is a cardiovascular surgical procedure for the heart and pericardium. Payment rules differentiate this from paracorporeal devices and ECMO. This service may be billed with R701 if a right ventricular assist device is also inserted to support the left ventricular assist device. If replacing a device, both the removal and insertion fees are payable. A second assistant is payable without special authorization.

When to Use

  • Use R704 for the primary surgical implantation of an implantable ventricular assist device (VAD).
  • Use R704 in conjunction with R701 when a right ventricular assist device is inserted to support the primary left ventricular assist device.
  • Use R704 in combination with R705 or Z744 when performing a device replacement, as both the removal and insertion are separately payable.

Common Pitfalls

  • Do not bill R704 for extracorporeal membrane oxygenator (ECMO) procedures; these must be billed under Z788.
  • Failure to document the Injury Severity Score (ISS) in the medical record will result in the rejection of the E420 trauma premium if claimed alongside R704.
  • Attempting to claim R701 for a paracorporeal device inserted for less than 14 days is incorrect when billed with R704; the R701 payment rule is specifically expanded for R704 support.

Billing Tips

  • A second surgical assistant is payable for R704 without requiring prior authorization, and their fee is calculated identically to the first assistant.
  • Ensure that if you are claiming the E420 trauma premium, the procedure is rendered within 24 hours of the trauma event and the ISS meets the age-specific thresholds (ISS > 15 for age 16+, ISS > 12 for under 16).
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Provider Fee$2,163.35
Surgical Assistant Fee$225.18
Anaesthetist Fee$433.72
Non-Anaesthetist Fee$433.72

Effective: April 1, 2025

Since Oct 2009, this fee has increased 0.0% vs 42.6% CPI inflation
Category

Q. Cardiovascular Surgical Procedures

Subcategory

CARDIOVASCULAR SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Cardiovascular Surgical Procedures

When the E420 trauma premium is claimed, the medical record must list the Injury Severity Score (ISS).

R701R702R703R705Z744Z788

Extracorporeal membrane oxygenator procedures do not constitute R701, R702, R703 or R704.

Extracorporeal membrane oxygenator procedures are eligible for payment as Z788.

Z744 or R705 are eligible for payment when rendered with cardiac transplantation.

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R704 – Implantable ventricular assist device | OHIP Fee Schedule | SnapBill MD