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S129
S129 – Conversion of previous gastrectomy to Roux-en-y
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Conversion of previous gastrectomy to Roux-en-y. As per the Schedule of Benefits on page , payment for a second surgical assistant is allowed without special authorization.
When to Use
- Use S129 for the conversion of a prior gastrectomy to a Roux-en-Y reconstruction when the primary intent is the revision of the previous surgical anatomy.
- Use S129 when performing a Roux-en-Y reconstruction specifically following a failed or complicated previous gastrectomy, distinguishing it from a primary gastrectomy procedure.
Common Pitfalls
- Billing S129 alongside other major abdominal procedures without ensuring the Multiple Procedure Rule (50% reduction for the second procedure) is applied correctly to the lower-valued code.
- Failing to document the necessity of a second surgical assistant, despite S129 being pre-authorized for one, which can lead to recovery during a focused audit of assistant claims.
Billing Tips
- Since S129 is explicitly listed as eligible for a second surgical assistant without special authorization, ensure the assistant's claim is submitted with the appropriate modifier to avoid manual review delays.
- If the procedure is performed after hours, ensure the E409 or E410 premium is applied to the S129 base fee, but note that these cannot be combined with the E420 trauma premium.
Provider Fee$910.00
Surgical Assistant Fee$87.57
Anaesthetist Fee$139.41
Non-Anaesthetist Fee$139.41
Effective: April 1, 2025
Category
S. Digestive System Surgical Procedures
Subcategory
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
Services where a second assistant's services are payable and authorization is not required include: S129.
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