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S097
S097 – Oesophago-gastrostomy for bypass
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Oesophago-gastrostomy for bypass is a surgical procedure to create an anastomosis between the esophagus and the stomach. This is performed as a sole procedure to bypass a diseased or obstructed segment. As a surgical service, it includes the common elements outlined in - and specific elements for surgical procedures.
When to Use
- Use S097 when performing a palliative bypass for unresectable esophageal malignancy where no resection is attempted.
- Use this code for benign strictures or anatomical obstructions where a bypass anastomosis is the singular surgical objective.
Common Pitfalls
- Billing S097 alongside a resection code like S095 or S096 will trigger a rejection, as S097 is strictly defined as a sole procedure.
- Attempting to bill for a second assistant without prior approval from the Ministry will result in automatic denial, as S097 is excluded from the GP90 pre-approved list.
Billing Tips
- If a second assistant is medically necessary, obtain written authorization from a medical consultant before submission to ensure the claim is not rejected under GP90 rules.
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