R754 – Ligation or division patent ductus - infant or child
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
This code represents the surgical procedure for the ligation or division of a patent ductus arteriosus, specifically for patients who are infants or children. Per the Schedule of Benefits, an infant is defined as a person from 29 days up to, but less than, 2 years of age, and a child is a person from 2 years to and including 15 years of age (). The service is eligible for payment to the surgeon (suffix A), surgical assistant (suffix B), and anaesthesiologist (suffix C).
When to Use
- Use R754 for the surgical ligation or division of a patent ductus arteriosus in patients aged 29 days up to 15 years inclusive.
- Select R754 over R755 when the procedure is performed on an infant or child; R755 is reserved for patients 16 years of age and older.
Common Pitfalls
- Billing R754 for a patient 16 years of age or older will result in a rejection; ensure the patient's age at the time of service is 15 or younger.
- Failing to include the appropriate age-based anaesthesia unit modifiers (E009C, E019C) in addition to the base anaesthetic fee will result in underpayment for the anaesthesiologist.
- Attempting to claim the trauma premium (E420) without explicit documentation of an Injury Severity Score (ISS) greater than 12 in the medical record will lead to claim rejection.
Billing Tips
- Always append the correct suffix (A for surgeon, B for assistant, C for anaesthesiologist) to ensure the claim processes against the correct fee schedule.
- If a second surgical assistant is required, you must submit a letter from the surgeon justifying the necessity to the Ministry for manual authorization to avoid automatic denial.
Effective: April 1, 2025
Q. Cardiovascular Surgical Procedures
CARDIOVASCULAR SURGICAL PROCEDURES
Surgical
Cardiovascular Surgical Procedures
newborn, infant or child
The fee for the surgeon (suffix A) is a flat rate. The fees for the surgical assistant (suffix B) and anaesthesiologist (suffix C) are calculated based on a combination of basic units and time units.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.