S149 – Ileostomy
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
S149 is the billing code for an ileostomy, a surgical procedure that creates a stoma by routing the ileum (the final section of the small intestine) through the abdominal wall. This service is compensable for the surgeon, surgical assistant, and anaesthesiologist, with fees calculated based on basic and time units for the assistant and anaesthesiologist.
When to Use
- Use S149 for the creation of an ileostomy as a standalone procedure or as the primary component of a bowel resection where the ileostomy is the definitive surgical outcome.
- Select S149 when the procedure involves routing the terminal ileum through the abdominal wall to create a stoma, distinguishing it from colostomy procedures like S150 or S151.
Common Pitfalls
- Billing S149 in conjunction with other major bowel resections without verifying if the ileostomy is considered an inclusive component of the more comprehensive procedure code.
- Failing to document the specific anatomical site of the stoma, which can lead to audit discrepancies when distinguishing between ileostomy and colostomy claims.
- Incorrectly applying after-hours premiums (E409/E410) to elective, non-urgent cases that do not meet the criteria of non-elective or emergency-delayed procedures.
Billing Tips
- Ensure that if the ileostomy is performed as part of a multi-procedure surgery, you are not double-billing components that are already bundled into the primary surgical code.
- Always append the appropriate age-based premium (e.g., AGE_PREMIUM_UNDER_16_YEARS) if the patient qualifies, as these are percentage-based increases that apply directly to the surgeon's fee for S149.
Effective: April 1, 2026
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
All insured services must be documented in appropriate records to establish that: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
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