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R749
R749 – Pericardiectomy - both sides open or sternal split
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
Pericardiectomy, both sides open or sternal split. This is a major surgical procedure. Payment for this service is typically claimed with a suffix to denote the role of the physician: 'A' for the surgeon, 'B' for the assistant, and 'C' for the anaesthesiologist. The service includes all common elements of insured services as described in - of the Schedule, as well as the specific elements for surgical, assistant, and anaesthesia services.
When to Use
- Use R749 for a formal pericardiectomy performed via a sternal split (sternotomy) or bilateral thoracotomy approach.
- Select R749 over R748 when the procedure involves a full sternal split or both sides open, as R748 is typically reserved for more limited approaches.
Common Pitfalls
- Failing to append the correct suffix (A for surgeon, B for assistant, C for anaesthesiologist) will result in immediate claim rejection.
- Attempting to bill for additional minor procedures that are considered bundled into the 'common elements' of this major surgical fee will lead to audit recovery.
Billing Tips
- If a second surgical assistant is medically necessary, you may bill for them without prior authorization; use the same calculation method as the first assistant.
- Ensure that any applicable age-based premiums or non-elective surgical premiums (E409A/E410A) are submitted on the same claim as the primary R749 code to ensure automatic processing.
Provider Fee$1,097.90
Surgical Assistant Fee$167.83
Anaesthetist Fee$319.20
Non-Anaesthetist Fee$319.20
Effective: April 1, 2026
Category
Q. Cardiovascular Surgical Procedures
Subcategory
CARDIOVASCULAR SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Cardiovascular Surgical Procedures
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