What is OHIP billing code S014?

S014 is "Reconstruction with lip switch flap", an OHIP Urology code from the Ontario Schedule of Benefits (Physician Services).

How much does S014 pay?

The current OHIP fee for S014 is $444.40, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill S014 to OHIP?

S014 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates S014 claims against the Schedule of Benefits rules before submission.

What codes are related to S014?

Codes related to S014 in the Schedule of Benefits include S013, S015, M030, M031, M032.

All codes

S014

S014 – Reconstruction with lip switch flap

OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

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Reconstruction with lip switch flap is a surgical procedure for the lip, categorized under Cleft lip reconstruction. This service is not eligible for payment when billed with M030, M031, or M032.

When to Use

Use S014 specifically for the surgical reconstruction of a cleft lip utilizing a lip switch flap (Abbe or Stein-Estlander flap) technique.
Select this code when performing secondary cleft lip revision or complex primary reconstruction where a tissue transfer from the opposing lip is required to restore anatomy.

Common Pitfalls

Billing S014 concurrently with M030, M031, or M032 will result in automatic claim rejection due to explicit OHIP restriction rules.
Failure to document the specific flap technique (e.g., Abbe flap) in the operative report creates an audit risk, as S014 is specific to the lip switch procedure rather than general cleft repair (S013).

Billing Tips

Ensure all applicable age-based premiums (e.g., AGE_PREMIUM_UNDER_1_YEAR) are appended to the claim, as these significantly increase the base fee for pediatric cleft patients.
If the procedure is performed on a trauma patient, ensure the Injury Severity Score (ISS) is documented in the chart to support the E420 trauma premium.

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Provider Fee$444.40

Surgical Assistant Fee$75.06

Anaesthetist Fee$123.92

Non-Anaesthetist Fee$123.92

Effective: April 1, 2025

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