S131 – Vagotomy - truncal or selective
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Truncal or selective vagotomy. This is a surgical procedure listed in the Digestive System section of the Schedule. The fee for the surgeon (suffix 'A') is a set amount. The fees for the surgical assistant (suffix 'B') and anaesthetist (suffix 'C') are calculated using a unit-based system. Both assistant and anaesthetist services for S131 are assigned 7 base units. Time units are added based on the duration of the service, as detailed in the General Preamble (, ). Note: For suture of duodenal ulcer, see S139.
When to Use
- Use S131 for a definitive truncal or selective vagotomy performed as a standalone procedure for refractory peptic ulcer disease.
- Use S131 when the procedure is performed in conjunction with other gastric surgeries, ensuring you check the Schedule for potential 'multiple procedure' reduction rules if applicable.
Common Pitfalls
- Do not bill S131 for a simple suture of a duodenal ulcer; that procedure is specifically covered under S139.
- Failure to document the specific type of vagotomy (truncal vs. selective) can lead to audit scrutiny regarding the complexity of the procedure performed.
- Incorrectly billing S131 as an add-on procedure when it is intended as a primary surgical code can result in automatic claim rejection.
Billing Tips
- Ensure the surgical assistant and anaesthetist correctly apply the 7 base units plus the appropriate time units as defined in the General Preamble.
- If the procedure is performed after hours, ensure the correct E-series premium (E400/E401 series) is appended to the surgeon, assistant, and anaesthetist claims respectively to capture the full eligible premium.
Effective: April 1, 2025
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
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