R717 – Closure of atrial septal defect with anamalous pulmonary venous drainage
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
This is a major cardiac surgical procedure involving the repair of a hole in the atrial septum (atrial septal defect) along with the rerouting of pulmonary veins that are abnormally connected. This service is performed via open-heart surgery.
When to Use
- Use R717 specifically for the surgical repair of an atrial septal defect (ASD) that is anatomically complicated by anomalous pulmonary venous drainage.
- Do not use R717 for a simple secundum ASD closure; use R715 for standard ASD repairs without anomalous venous return.
Common Pitfalls
- Billing R717 alongside a standard hospital admission assessment is a common rejection; only the 'major pre-operative visit' is eligible for payment.
- Failure to document the specific anatomical complexity of the anomalous pulmonary venous drainage can lead to audit scrutiny regarding the necessity of the more complex R717 procedure versus a standard R715.
Billing Tips
- Ensure that if the procedure is performed on a pediatric patient, you append the appropriate age-based premium (e.g., AGE_PREMIUM_UNDER_1Y or AGE_PREMIUM_UNDER_16Y) to maximize the procedural fee.
- If the procedure is non-elective and commences during after-hours, ensure you select the correct premium (E409 or E410) as these cannot be combined with the E420 trauma premium.
Effective: April 1, 2025
Q. Cardiovascular Surgical Procedures
CARDIOVASCULAR SURGICAL PROCEDURES
Surgical
Cardiovascular Surgical Procedures
The medical record must list the Injury Severity Score (ISS) to claim the E420 trauma premium.
For services rendered by a Medical Trainee, the medical record must identify the Supervising Physician, the Medical Trainee and level of training, the service performed, patient consent, and be signed off by the Supervising Physician.
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