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S118
S118 – Gastrostomy
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
S118 represents the surgical procedure for creating a gastrostomy, which is an artificial external opening into the stomach. This procedure can be performed in conjunction with other services, such as repair of a Mallory-Weiss laceration (add-on code E697) or when performed with another intra-abdominal procedure (add-on code E707).
When to Use
- Use S118 as the primary procedure code when performing an open or laparoscopic gastrostomy for enteral feeding access.
- Use S118 in combination with E697 when a gastrostomy is performed specifically to address a Mallory-Weiss laceration.
- Use S118 with add-on E707 when the gastrostomy is performed concurrently with another distinct intra-abdominal surgical procedure.
Common Pitfalls
- Failing to document the specific intra-abdominal procedure performed alongside S118 will result in the rejection of the E707 add-on fee.
- Attempting to claim E420 (Trauma Premium) alongside after-hours premiums (E409/E410) will lead to automatic rejection, as these are mutually exclusive.
- Submitting a claim for a second surgical assistant without prior authorization from a medical consultant will result in non-payment for that assistant.
Billing Tips
- Always verify the patient's age at the time of the procedure to ensure the appropriate age-based surgical premium (e.g., AGE_PREMIUM_5Y_TO_16Y) is applied to the S118 base fee.
- Ensure the Injury Severity Score (ISS) is explicitly documented in the operative report if claiming the E420 trauma premium to avoid audit clawbacks.
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