S156 – Exteriorization of intestine (Mickulicz)
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
S156 represents a surgical procedure for the exteriorization of the intestine (Mickulicz). The fee for the surgeon is for the procedure itself, submitted with suffix A. Fees for a surgical assistant (suffix B) and an anaesthesiologist (suffix C) are calculated based on basic units and time units as outlined in the Schedule of Benefits.
When to Use
- Use S156 specifically for the creation of a loop stoma or exteriorization of a bowel segment (Mickulicz procedure) as a distinct surgical event.
- Select S156 when performing the exteriorization of the intestine in cases of obstruction or perforation where primary anastomosis is not feasible, distinguishing it from simple resection codes like S154 or S155.
Common Pitfalls
- Billing S156 in conjunction with a bowel resection code (e.g., S154) without verifying if the resection is considered inclusive of the exteriorization under the Schedule of Benefits rules.
- Failing to document the specific 'Mickulicz' technique, which can lead to audit scrutiny if the procedure is later reclassified as a standard colostomy or ileostomy (e.g., S157 or S158).
Billing Tips
- Ensure the surgical assistant and anaesthesiologist claims utilize the correct 6 basic units as defined in the payment adjustment rules to avoid manual claim adjustments.
- If the procedure is performed on an emergency basis after hours, ensure the non-elective status is clearly documented to support the application of E409 or E410 premiums.
Effective: April 1, 2025
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
The medical record must establish that an insured service was provided, the service for which the account is submitted is the service that was rendered, and the service was medically necessary.
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