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S045
S045 – Parotid gland - subtotal (with preservation of facial nerve)
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure for the subtotal excision of the parotid gland while preserving the facial nerve. This procedure is categorized under Digestive System Surgical Procedures.
When to Use
- Use S045 for a formal subtotal parotidectomy where the facial nerve is identified and preserved, distinguishing it from S043 (parotidectomy, superficial) or S044 (parotidectomy, total).
- Select S045 when the surgical intent and operative report confirm the removal of the majority of the gland while explicitly documenting the preservation of the facial nerve branches.
Common Pitfalls
- Billing S045 alongside S043 or S044 for the same gland is a common audit trigger for unbundling; only one parotidectomy code is payable per gland.
- Failure to document the preservation of the facial nerve can lead to claims being downgraded to a lower-valued procedure code during a post-payment audit.
- Attempting to bill a second surgical assistant without prior authorization is a frequent rejection; S045 does not carry automatic eligibility for a second assistant.
Billing Tips
- Ensure the operative report explicitly states 'subtotal excision' and 'facial nerve preservation' to support the S045 fee over the lower-valued S043.
- If performing bilateral procedures, bill the major procedure at 100% and the second procedure at 85% with the appropriate bilateral indicator to ensure correct processing.
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