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R715
R715 – Closure of atrial septal defect - secundum
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
R715 is a cardiovascular surgical procedure for the closure of a secundum atrial septal defect. This service is eligible for surgeon, assistant, and anaesthesiologist billing. The fee for the surgical assistant (suffix B) is calculated based on 18 basic units plus time units. The fee for the anaesthesiologist (suffix C) is calculated based on 20 basic units plus time units. As per , a second assistant's service is eligible for payment for R715 without requiring special authorization from a medical consultant.
When to Use
- Use R715 specifically for the surgical closure of a secundum-type atrial septal defect, distinguishing it from R716 or R717 which involve different defect types or repair methods.
- Select this code when the procedure is performed as an open surgical repair, as opposed to percutaneous device closure which is billed under different interventional cardiology codes.
Common Pitfalls
- Failing to document the specific type of ASD (secundum) in the operative report, which can lead to audit discrepancies if the procedure is later reviewed against R716 or R717.
- Incorrectly applying after-hours premiums (E409/E410) to elective cases; ensure the procedure meets the non-elective criteria or was delayed by an intervening emergency to qualify.
Billing Tips
- When a second assistant is utilized, bill the service directly without seeking prior authorization, as R715 is explicitly exempt from this requirement under GP90.
- Ensure that age-based premiums are calculated on the base fee and applied correctly based on the patient's exact age at the time of the procedure to avoid claim rejections.
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