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S088

S088Cricopharyngeal diverticulum

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

This service involves the surgical removal (excision) of a cricopharyngeal diverticulum. It is classified under the Oesophagus - Excision section of the Schedule of Benefits.

When to Use

  • Use S088 when performing the formal excision of a Zenker's diverticulum (cricopharyngeal diverticulum).
  • Use this code for the definitive surgical removal of the pouch, as opposed to a simple myotomy.

Common Pitfalls

  • Do not bill S088 in conjunction with S086 (cricopharyngeal myotomy), as these are mutually exclusive and restricted by the Schedule of Benefits.
  • Avoid billing S088 if the procedure performed was solely a myotomy without the excision of the diverticulum, as S088 specifically requires the excision component.

Billing Tips

  • If an assistant is required for this procedure, you must submit a letter to the Ministry outlining the clinical necessity and claim the assistant fee using M400B for manual review.
Provider Fee$390.05

Effective: April 1, 2025

Category

S. Digestive System Surgical Procedures

Subcategory

DIGESTIVE SYSTEM SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Digestive System Surgical Procedures

Note: S086 is not eligible for payment with S088.

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