What is OHIP billing code S159?

S159 is "Meckel’s diverticulum excision - with small bowel resection", an OHIP Urology code from the Ontario Schedule of Benefits (Physician Services).

How much does S159 pay?

The current OHIP fee for S159 is $406.85, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill S159 to OHIP?

S159 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates S159 claims against the Schedule of Benefits rules before submission.

What codes are related to S159?

Codes related to S159 in the Schedule of Benefits include S194.

All codes

S159

S159 – Meckel’s diverticulum excision - with small bowel resection

OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

Ask AI Bill This Code — Sign Up Free

Excision of a Meckel's diverticulum combined with a resection of the small intestine. This is a major surgical procedure listed under the Digestive System section of the Schedule of Benefits. This procedure is an extension of S194, which is the excision without bowel resection. The service is eligible for surgeon (A), assistant (B), and anaesthetist (C) fees.

When to Use

Use S159 when the Meckel’s diverticulum is complicated by pathology requiring a formal small bowel resection and anastomosis, rather than a simple diverticulectomy.
Use S159 for cases involving bowel obstruction or perforation secondary to the Meckel’s, where the segment of the ileum containing the diverticulum must be excised to ensure healthy margins.

Common Pitfalls

Billing S159 when only a simple excision of the diverticulum was performed; this should be billed under S194 to avoid audit scrutiny for upcoding.
Failing to document the necessity of the bowel resection in the operative report, which is essential to justify the higher fee of S159 over S194.
Attempting to bill S159 in addition to other small bowel procedures performed during the same operative session, which is generally considered bundled under the primary procedure rule.

Billing Tips

Ensure the operative note explicitly describes the resection of the small bowel segment and the subsequent anastomosis to support the use of S159.
If the procedure is performed on a trauma patient, ensure the Injury Severity Score (ISS) is clearly documented in the chart to support the E420A trauma premium.

Have a specific question? Ask our billing assistant

Provider Fee$406.85

Surgical Assistant Fee$75.06

Anaesthetist Fee$108.43

Non-Anaesthetist Fee$108.43

Effective: April 1, 2025

Ready to bill this code?

SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.

Get Started Free Already have an account? Sign in