R920 – Ventricular tumour
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
Excision of a ventricular tumour. The fee for the surgeon is a flat rate. The fees for the anaesthetist and surgical assistant are calculated based on a combination of basic units and time units. For the anaesthetist (suffix C), the service includes a pre-anaesthetic evaluation, the anaesthetic procedure, and post-anaesthetic follow-up. For the surgical assistant (suffix B), the service includes preparation, assistance, and post-procedure monitoring. This procedure is eligible for a second surgical assistant without prior authorization.
When to Use
- Use R920 for the definitive surgical excision of a tumor located within the ventricular chambers of the heart.
- Use this code for primary ventricular tumor resections where the procedure is performed as a standalone surgical event.
Common Pitfalls
- Do not bill R920 with E003B, as it is explicitly restricted and will result in an automatic claim rejection.
- Failure to document the Injury Severity Score (ISS) in the medical record will lead to the clawback of the E420 trauma premium if audited.
- Attempting to bill R920 alongside other cardiovascular procedures may trigger 'major procedure' rules; ensure the primary procedure is clearly identified to avoid payment reduction.
Billing Tips
- Ensure the surgical start time is accurately recorded to determine eligibility for after-hours premiums (E400B/E401B for assistants, E400C/E401C for anaesthetists).
- When a second surgical assistant is utilized, bill the second assistant's claim separately; no prior authorization is required for this specific procedure.
Effective: April 1, 2026
Q. Cardiovascular Surgical Procedures
CARDIOVASCULAR SURGICAL PROCEDURES
Surgical
Cardiovascular Surgical Procedures
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