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S020

S020Glossoplasty

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

Glossoplasty is the surgical repair or reconstruction of the tongue. The surgeon's fee is for the procedure itself. Payment for a surgical assistant (suffix B) and an anaesthetist (suffix C) are calculated based on a base unit value of 6 units each, plus time units as per the rules in the General Preamble (see - for assistant and - for anaesthetist). This procedure is marked with a '#', indicating facility costs are covered by the hospital or ICHSC budget.

When to Use

  • Use S020 for formal surgical reconstruction or repair of the tongue, such as following trauma or resection, rather than simple suturing of a minor laceration.
  • Use this code for tongue-tie release (frenuloplasty) if the procedure involves more complex tissue rearrangement than a simple frenotomy.

Common Pitfalls

  • Billing S020 for minor tongue lacerations that are more appropriately coded as simple suturing (e.g., S001) will lead to claim rejections or audit adjustments.
  • Failing to document the complexity of the reconstruction can lead to denials, as the Ministry may view the procedure as a minor repair rather than a formal glossoplasty.

Billing Tips

  • Ensure the anaesthetist and assistant claims are submitted with the correct suffixes (C and B respectively) and include the base units plus time-based units as per the General Preamble.
  • If the procedure is performed on a pediatric patient, verify the age-based premium (e.g., AGE_PREMIUM_UNDER_30D) is applied to both the surgical fee and the assistant's fee to maximize the claim value.
Provider Fee$197.45
Surgical Assistant Fee$75.06
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94

Effective: April 1, 2025

Category

S. Digestive System Surgical Procedures

Subcategory

DIGESTIVE SYSTEM SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Digestive System Surgical Procedures

This procedure is listed under the section for Oral Cavity and Pharynx, which is noted to include nasopharynx, oropharynx, and hypopharynx except where otherwise specified.

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