S090 – Total thoracic oesophageal resection
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Total thoracic oesophageal resection is a surgical procedure involving the complete removal of the oesophagus located within the thoracic cavity. This service includes all common and constituent elements of a surgical procedure as defined in the Schedule of Benefits (see -, , ). The fee is for the surgeon's service (suffix 'A'). Assistant (suffix 'B') and anaesthetist (suffix 'C') services are claimed separately based on basic and time units. This procedure may be performed in conjunction with add-on services such as reconstruction (E730), diaphragm repair (E847), or radical node dissection (E644). A percentage-based premium (E683) applies if performed using minimally invasive techniques.
When to Use
- Use S090 for the complete surgical excision of the thoracic oesophagus, distinct from partial resections or oesophagectomies that do not involve the entire thoracic segment.
- Apply S090 when performing an oesophagectomy that requires concurrent add-on procedures such as reconstruction (E730) or radical mediastinal node dissection (E644) following neoadjuvant therapy.
Common Pitfalls
- Failing to document the specific surgical approach (e.g., VATS, robotic-assisted) prevents the successful application of the 35% E683 premium, which is not automatically triggered.
- Attempting to bill E644 without explicit documentation of preoperative chemotherapy or radiotherapy in the patient record will lead to claim rejection.
- Incorrectly assuming E730 is included in the base fee; it must be claimed as a separate line item to receive the additional flat fee.
Billing Tips
- Always append the appropriate age-based premium (e.g., AGE_PREMIUM_5Y_TO_16Y) to both the surgeon (S090A) and the assistant (S090B) claims to ensure the full percentage increase is applied to both services.
- When performing non-elective procedures after hours, ensure the start time is clearly documented to support the application of E409 or E410, as these are time-sensitive and subject to audit.
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