S069 – Pharyngoplasty
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Pharyngoplasty is a surgical procedure for the reconstruction or plastic repair of the pharynx. The listed fee is for the surgeon's professional service (suffix A). The fee for an assistant (suffix B) is calculated using 8 basic units plus time units. The fee for an anaesthetist (suffix C) is calculated using 8 basic units plus time units. See the Surgical Assistants' Services () and Anaesthesiologists' Services () sections of the General Preamble for unit calculation rules.
When to Use
- Use S069 for reconstructive pharyngeal surgery, such as uvulopalatopharyngoplasty (UPPP) or similar plastic repairs of the pharyngeal wall.
- Select S069 when the procedure is specifically focused on the structural reconstruction of the pharynx, rather than simple excision or biopsy codes like S067 or S068.
Common Pitfalls
- Billing S069 in conjunction with other pharyngeal procedures without checking for 'major procedure' rules, which may result in the assistant or anaesthetist units being incorrectly calculated.
- Failing to document the specific surgical technique used, which can lead to audit scrutiny if the claim is flagged for review against less intensive procedures.
Billing Tips
- Ensure that if an assistant or anaesthetist is involved, their units are calculated based on the 8 basic units defined for S069, plus the appropriate time units as per the General Preamble.
Effective: April 1, 2025
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
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