All codes
S091
S091 – Oesophageal hiatus hernia - abdominal or transthoracic approach with fundal plication
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Repair of an oesophageal hiatus hernia performed with an abdominal or transthoracic approach, which includes fundal plication. This procedure can be performed laparoscopically or thoracoscopically (E793). It may be performed with additional procedures such as gastroplasty (E744), reconstruction of the diaphragm with mesh (E847), or in conjunction with cholecystectomy and/or vagotomy (E742).
When to Use
- Use S091 for the primary repair of an oesophageal hiatus hernia that includes a fundal plication, regardless of whether the approach is abdominal or transthoracic.
- Use S091 in combination with E793 when the procedure is performed via a laparoscopic or thoracoscopic approach to capture the 25% premium.
Common Pitfalls
- Failing to append E742 for each additional procedure when performing a cholecystectomy or vagotomy alongside S091, as these are not automatically included in the base fee.
- Omitting E847 when mesh is used for diaphragmatic reconstruction, which is a common oversight that results in under-billing for the materials and complexity involved.
- Incorrectly assuming S091 covers all concurrent abdominal surgeries; for procedures other than those specified in the billing interactions, you must refer to the Surgical Preamble SP3 for appropriate multi-procedure billing rules.
Billing Tips
- Always verify if the patient qualifies for the age-based premium (under 16 years) or the trauma premium (E420) to ensure the base fee is correctly adjusted for high-acuity or pediatric cases.
- Ensure E744 is added as a separate line item if a gastroplasty is performed, as it is a flat-fee add-on that does not automatically trigger with the base S091 code.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.