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R874
R874 – Cardiopulmonary transplantation
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
Cardiopulmonary transplantation is a major surgical procedure involving the replacement of a patient's diseased heart and lungs with organs from a donor. This service is listed in the Cardiovascular Surgical Procedures section of the Schedule of Benefits and is eligible for surgeon (suffix A), assistant (suffix B), and anaesthetist (suffix C) fees. Payment for a second surgical assistant is permitted without special authorization.
When to Use
- Use R874 for the definitive en-bloc or sequential replacement of both the heart and lungs in a single surgical session.
- Select R874 when the procedure involves the complete excision of the recipient's cardiopulmonary block and implantation of donor organs, distinguishing it from isolated heart (R870) or lung (R872) transplant codes.
Common Pitfalls
- Billing R874 in conjunction with other major thoracic procedures that are considered integral to the transplant process, which may lead to claim rejection as 'included in the procedure'.
- Failing to explicitly document the presence and role of a second surgical assistant when claiming for two assistants, which is permitted for R874 but requires clear identification of both providers on the claim.
Billing Tips
- Ensure that after-hours premiums (E409 or E410) are applied to the base fee of R874 when the procedure meets the non-elective criteria, as these premiums are calculated on the surgical fee.
- When claiming for a second surgical assistant, ensure the second assistant's claim is submitted with the same service date and diagnostic code to avoid automated processing errors.
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