P031 – Prophylactic cervical cerclage
OHIP Plastic Surgery Code — OBSTETRICS · Schedule of Benefits
Prophylactic cervical cerclage is a surgical procedure involving the placement of a suture around the cervix to provide mechanical support and prevent premature dilation. This service is intended for non-emergency, prophylactic cases. According to the commentary on page , if the criteria for an emergency cerclage (P032) are not met, this code should be used. The service includes all constituent and common elements of an insured surgical service as described in the Schedule of Benefits on pages -. This procedure is eligible for assistant (P031B) and anaesthesia (P031C) services, which are calculated based on basic and time units.
When to Use
- Use P031 for elective, prophylactic cervical cerclage placement in patients with a history of cervical insufficiency or other non-acute indications.
- Use P031 when the clinical criteria for emergency cerclage defined under P032 (such as advanced cervical dilation or prolapsed membranes) are not present.
Common Pitfalls
- Billing P031 for an emergency procedure; if the patient presents with acute cervical changes requiring immediate intervention, P032 is the correct code.
- Attempting to bill P031 in conjunction with other surgical procedures that are considered part of the global surgical package without proper documentation of separate, distinct services.
Billing Tips
- Ensure the procedure is clearly documented as prophylactic to avoid rejection or audit inquiries regarding the necessity of P032 versus P031.
- Always apply the appropriate after-hours or weekend premiums (E409/E410) if the elective procedure is delayed by an intervening emergency and commences outside of standard hours.
Effective: April 1, 2025
K. Obstetrics
OBSTETRICS
Surgical
Obstetrics, Female Genital Surgical Procedures
Female
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