R746 – Ventricular aneurysm
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
R746 is a major cardiovascular surgical procedure for the excision of a ventricular aneurysm. The service is eligible for surgeon (A), assistant (B), and anaesthetist (C) fees. The surgeon's fee is a set amount, while the assistant and anaesthetist fees are calculated based on a combination of basic and time units as outlined in the Schedule of Benefits. - Surgical Assistant (suffix B): The fee is based on 18 basic units plus time units. See - for detailed calculation rules. - Anaesthesiologist (suffix C): The fee is based on 28 basic units plus time units. See - for detailed calculation rules.
When to Use
- Use R746 as the primary code for the surgical excision of a ventricular aneurysm performed in a hospital operating room.
- Use R746 in conjunction with E648 when the procedure specifically involves the excision of an extensive endocardial scar during the aneurysm repair.
Common Pitfalls
- Failure to document the Injury Severity Score (ISS) in the medical record will result in the rejection of the E420 trauma premium claim.
- Attempting to bill E648 as a standalone procedure; it is strictly an add-on code and must be submitted on the same claim as the primary R746 procedure.
- Incorrectly applying after-hours premiums (E400 series or E401 series) to elective cases that were not delayed by an intervening surgical emergency.
Billing Tips
- Ensure the surgical assistant and anaesthesiologist include the appropriate time units in their claims, as the base fee for R746 only covers the surgeon's portion.
- When a second surgical assistant is medically necessary for R746, bill the second assistant's service using the same calculation rules as the first, as this is permitted without prior authorization.
Effective: April 1, 2026
Q. Cardiovascular Surgical Procedures
CARDIOVASCULAR SURGICAL PROCEDURES
Surgical
Cardiovascular Surgical Procedures
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