R709 – Left atrial ablative procedure for surgical treatment of atrial arrhythmia
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
Left atrial ablative procedure for surgical treatment of atrial arrhythmia (either Cox-Maze procedure or performed using an energy source). Note: R709 includes all left atrial ablation sites, internal exclusion or external excision of the left atrial appendage, and the ablation procedure involving the pulmonary veins. Commentary: Examples of energy sources used for ablation may include cryoablation, microwave, or radiofrequency (unipolar or bipolar) ablation.
When to Use
- Use R709 for a standalone or concomitant surgical Cox-Maze procedure performed for the treatment of atrial fibrillation.
- Use R709 when performing surgical left atrial ablation using energy sources such as cryoablation, microwave, or radiofrequency to target pulmonary veins.
- Use R709 for surgical procedures that include the internal exclusion or external excision of the left atrial appendage as part of the arrhythmia treatment.
Common Pitfalls
- Do not bill R709 in addition to other atrial ablation or appendage exclusion codes, as the fee is inclusive of all left atrial sites and pulmonary vein isolation.
- Avoid unbundling the left atrial appendage management; it is explicitly included in the R709 fee and cannot be claimed separately.
- Ensure the procedure is documented as a surgical treatment for arrhythmia; do not use R709 for catheter-based electrophysiology procedures which fall under different fee schedules.
Billing Tips
- R709 is a comprehensive procedural code; ensure your operative report clearly details the energy source used and the specific anatomical sites ablated to support the claim during audit.
- Verify if the procedure qualifies for age-based premiums or after-hours premiums (E409/E410) if the surgical start time meets the specific OHIP criteria.
Effective: April 1, 2025
Q. Cardiovascular Surgical Procedures
CARDIOVASCULAR SURGICAL PROCEDURES
Surgical
Cardiovascular Surgical Procedures
R709 includes all left atrial ablation sites, internal exclusion or external excision of the left atrial appendage, and the ablation procedure involving the pulmonary veins.
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