R930 – Aortic valvoloplasty
OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits
Aortic valvoloplasty is a surgical procedure to repair a dysfunctional aortic valve. The fee for this service varies based on the role of the physician. The surgeon's fee (suffix A) is a set amount. The fees for the surgical assistant (suffix B) and the anaesthetist (suffix C) are calculated based on a combination of basic units and time-based units as detailed in the Schedule of Benefits.
When to Use
- Use R930 for surgical repair of a dysfunctional aortic valve where the primary intent is valvuloplasty rather than full valve replacement.
- Select R930 when the procedure is performed as a standalone aortic valve repair, distinguishing it from more extensive procedures like R726 (Aortic valve replacement).
Common Pitfalls
- Billing R930 in conjunction with other valve procedures without applying the multivalvular adjustment rule, which requires the secondary procedure to be billed at 85% of its fee.
- Failing to document the specific surgical approach or the necessity of the repair, which can lead to audit scrutiny if the claim is flagged for review against replacement codes.
- Incorrectly applying trauma premiums (E420) without explicitly listing the Injury Severity Score (ISS) in the medical record, which is a mandatory requirement for this code.
Billing Tips
- Ensure that if a second surgical assistant is utilized, it is billed appropriately as R930 does not require special authorization for a second assistant.
- Always verify the case commencement time against the Schedule of Benefits to maximize after-hours premiums (E409/E410) if the procedure is non-elective or delayed by an emergency.
Effective: April 1, 2025
Q. Cardiovascular Surgical Procedures
CARDIOVASCULAR SURGICAL PROCEDURES
Surgical
Cardiovascular Surgical Procedures
Multivalvular replacement - the fee will be that for the major valve replaced plus 85% of the fee for the additional valve or valves.
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