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R831

R831Subclavian aortic arch reconstruction

OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits

Represents the primary surgical procedure for total hip replacement, including options for acetabular or femoral component replacement. The fee listed is for the primary surgeon (suffix A). Associated services for surgical assistance (suffix B) and anaesthesia (suffix C) are billed using this code with the respective suffix. - The amount payable for the surgical assistant service is calculated based on 11 basic units plus time units (see :). - The amount payable for the anaesthesia service is calculated based on 11 basic units plus time units (see :).

When to Use

  • Use R831 for primary subclavian aortic arch reconstruction procedures where the surgical approach involves the subclavian artery segment.
  • Select R831 over R830 or R832 when the reconstruction is specifically localized to the subclavian arch, ensuring the clinical documentation matches the anatomical site.

Common Pitfalls

  • Failing to append the mandatory E659 add-on code when the procedure is performed via thoracotomy, which is a common clinical requirement for this surgery.
  • Omitting the E667 'Ruptured' add-on code when the procedure is performed on an emergency basis for a ruptured arch, resulting in significant under-billing.
  • Attempting to bill a second surgical assistant without prior authorization, which will lead to automatic rejection unless a letter of medical necessity is submitted to a consultant.

Billing Tips

  • Always verify if the patient meets the criteria for the E420 trauma premium by ensuring the Injury Severity Score (ISS) is documented in the chart, as this applies to both the surgeon and the assistant/anaesthesia units.
  • Ensure that the surgical assistant (R831B) and anaesthesiologist (R831C) units are calculated correctly using the specific unit values ($12.51 and $15.49 respectively) rather than the base procedural fee.
Provider Fee$910.70
Surgical Assistant Fee$125.10
Anaesthetist Fee$154.90
Non-Anaesthetist Fee$154.90

Effective: April 1, 2025

Category

Q. Cardiovascular Surgical Procedures

Subcategory

CARDIOVASCULAR SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Musculoskeletal System Surgical Procedures

The fee for the surgical assistant service (R831B) is calculated by adding 10 basic units and applicable time units, multiplied by the assistant unit fee of $12.51.

The fee for the anaesthesiologist's service (R831C) is calculated by adding 10 basic units and applicable time units, multiplied by the anaesthesiologist unit fee of $15.49.

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