S093 – Enucleation of benign oesophageal tumour
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Enucleation of benign oesophageal tumour is a surgical procedure for the removal of a non-cancerous growth from the oesophagus. The surgeon carefully shells out the tumour from the esophageal wall. This procedure can be performed using various techniques, including traditional open surgery or minimally invasive methods such as thoracoscopy, video-assisted thoracic surgery (VATS), or robotic-assisted surgery. When a minimally invasive approach is used, the service may be eligible for a 35% premium using add-on code E683.
When to Use
- Use S093 for the surgical enucleation of benign esophageal leiomyomas or other non-malignant esophageal tumors.
- Select S093 when performing the procedure via traditional open thoracotomy or laparotomy approaches.
Common Pitfalls
- Failing to append E683 when the procedure is performed via VATS, robotic, or uniportal approaches, which results in a 35% loss of potential revenue.
- Attempting to bill for a second surgical assistant without prior medical consultant authorization, as this will result in automatic rejection.
- Assuming standard anesthesia units apply; S093 requires Independent Consideration (IC) for anesthesia, which must be calculated based on time units.
Billing Tips
- Always document the specific minimally invasive technique used (e.g., VATS or robotic) in the operative report to substantiate the E683 premium claim.
- If a surgical assistant is required, ensure the request for M400B is submitted with a formal letter of justification to the medical consultant before or alongside the claim to avoid payment delays.
Effective: April 1, 2025
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
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