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S161
S161 – Oesophageal myotomy, partial (below aortic arch)
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Performs a partial oesophageal myotomy, which is an incision into the muscle of the oesophagus, specifically in the portion below the aortic arch. This procedure can be billed with the add-on code E758 if an oesophageal hiatus hernia repair is also performed. Additionally, a 35% fee increase is applicable to S161 when the procedure is performed thorascopically, by video-assisted thoracic surgery (VATS), by robotic-assisted surgery, or by uniportal approach, claimed with add-on code E683.
When to Use
- Use S161 for a partial oesophageal myotomy performed below the aortic arch, typically for the treatment of achalasia or diffuse oesophageal spasm.
- Use S161 in conjunction with E758 when a concurrent oesophageal hiatus hernia repair is performed during the same operative session.
Common Pitfalls
- Failure to append the E683 add-on code when performing the procedure via VATS, robotic-assisted, or uniportal approaches, which results in a 35% underpayment.
- Attempting to bill a surgical assistant fee without prior authorization, as S161 does not have pre-assigned basic units and requires a letter to the medical consultant for approval.
Billing Tips
- Always verify the surgical approach and ensure E683 is included on the claim to trigger the 35% fee increase for minimally invasive techniques.
- If a surgical assistant is required, submit the claim using M400B accompanied by a letter from the surgeon to justify the necessity and secure authorization from the medical consultant.
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