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S036
S036 – Uvulopalatopharyngoplasty (includes tonsillectomy)
OHIP Digestive System Surgical Procedures Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Uvulopalatopharyngoplasty (includes tonsillectomy). S036 is an insured service only: a. for the treatment of obstructive sleep apnea that is unresponsive to or intolerant of continuous positive airway pressure (CPAP); and b. when the procedure is rendered to correct an identified site of airway obstruction causing the obstructive sleep apnea. It is not an insured service when rendered solely for the treatment of snoring. No assistant units are listed; anaesthesia is 6 basic units plus time units ().
The medical record must document the diagnosis of obstructive sleep apnea, that the patient's condition is unresponsive to or the patient is intolerant of continuous positive airway pressure (CPAP), and the identified site of airway obstruction that the procedure is intended to correct.
As per , the medical record must establish that the service was medically necessary.
Note: S036 Uvulopalatopharyngoplasty is an insured service only under the following conditions: - For the treatment of obstructive sleep apnea that is unresponsive to continuous positive airway pressure (CPAP) or intolerant of continuous positive airway pressure (CPAP) and; - the procedure is rendered to correct an identified site of airway obstruction causing the obstructive sleep apnea.
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