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R927
R927 – Aorto-pulmonary window
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
R927 is a surgical procedure to repair an aorto-pulmonary window, which is a congenital cardiovascular anomaly characterized by an abnormal communication between the ascending aorta and the main pulmonary artery. This service is listed under the Heart and Pericardium repair section of the Cardiovascular Surgical Procedures.
When to Use
- Use R927 specifically for the surgical repair of a congenital aorto-pulmonary window (AP window) where there is a direct communication between the ascending aorta and the main pulmonary artery.
- Do not use R927 for patent ductus arteriosus (PDA) ligation, which is billed under distinct codes; R927 is reserved for the window defect itself.
Common Pitfalls
- Billing R927 in conjunction with other major cardiac repairs without ensuring the secondary procedures are eligible for multiple procedure rules, as this can trigger automatic rejections.
- Failing to apply the mandatory age-based premiums for pediatric patients under 16, which are essential for accurate reimbursement given the congenital nature of this procedure.
Billing Tips
- Always verify the start time of the procedure to ensure correct application of E409 or E410 premiums, as these significantly impact the total claim value for this high-complexity surgery.
Provider Fee$960.40
Surgical Assistant Fee$225.18
Anaesthetist Fee$433.72
Non-Anaesthetist Fee$433.72
Effective: April 1, 2025
Since Apr 2004, this fee has increased 1.2% vs 57.0% CPI inflation
Category
Q. Cardiovascular Surgical Procedures
Subcategory
CARDIOVASCULAR SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Cardiovascular Surgical Procedures
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