All codes
P018
P018 – Caesarean section
OHIP Plastic Surgery Code — OBSTETRICS · Schedule of Benefits
Caesarean section is a surgical procedure for delivering a fetus. This service is eligible for surgeon, assistant, and anaesthetist fees. The fee includes routine post-operative care. For multiple births, this code may be billed with additional codes such as E499 for a second infant delivered by caesarean section or E500 for a third and subsequent infant. Special payment rules apply for mixed delivery types (vaginal followed by caesarean), multiple deliveries by caesarean section only, deliveries between 20-23 weeks gestation, and stillbirths. See payment adjustment rules for details.
When to Use
- Use P018 as the primary surgical code for a caesarean section delivery, including cases where a trial of labour was attempted but failed.
- Use P018 in combination with E499 for the second infant in a multiple birth delivered entirely by caesarean section.
- Use P018 in combination with E500 for the third and subsequent infants in a multiple birth delivered by caesarean section.
Common Pitfalls
- Billing E500 for a third infant when the delivery occurs between 20-23 weeks gestation via caesarean section; E500 is explicitly excluded in this specific gestational window.
- Attempting to bill multiple delivery codes when all fetuses are stillborn; only the primary delivery code (P018) is payable in this scenario.
- Failing to account for the 85% rule when billing a mixed delivery (vaginal delivery followed by a caesarean section), where the vaginal component must be reduced.
Billing Tips
- Always ensure the primary code (P018) is billed first to establish the base surgical fee before adding premiums like E499 or E500.
- Apply after-hours premiums (E409 or E410) to the primary P018 fee based on the exact start time of the procedure to maximize reimbursement.
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