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S095
S095 – Oesophageal stricture (Thal)
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Oesophageal stricture (Thal) - may include oesophageal hiatus hernia repair with or without gastroplasty.
When to Use
- Use S095 specifically for the surgical correction of an oesophageal stricture using the Thal technique, which inherently includes the repair of an associated hiatus hernia.
- Select S095 when performing a gastroplasty in conjunction with the stricture repair, as the code description explicitly encompasses this combination.
Common Pitfalls
- Do not bill S095 alongside other hiatus hernia repair codes like S091 or S092, as the inclusion of the hernia repair in S095 makes these redundant and subject to rejection.
- Failure to append the E683 premium when performing the procedure thoracoscopically or robotically will result in significant under-billing, as this is a 35% add-on.
Billing Tips
- Ensure the E683 premium is submitted on the same claim as S095 to capture the 35% increase for minimally invasive approaches.
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