S168 – Subtotal colectomy
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Ileostomy, subtotal colectomy. This procedure involves the surgical removal of most of the large intestine, followed by bringing the end of the small intestine (ileum) through the abdominal wall to create a stoma. This service is eligible for add-on codes for specific circumstances, such as E793 for laparoscopic assistance or E738 for the creation of a continent ileostomy. Payment for assistant and anaesthetist services is based on a unit system (see Unit-Based Information).
When to Use
- Use S168 for a subtotal colectomy with end ileostomy when the rectum is left in situ, distinguishing it from a total proctocolectomy (S170).
- Apply S168 when performing an urgent subtotal colectomy for fulminant colitis where the rectal stump is managed separately.
Common Pitfalls
- Billing S168 in conjunction with S170 is a common error; these are mutually exclusive procedures based on the extent of the resection.
- Failing to document the specific anatomical extent of the resection can lead to recovery during audits if the claim is flagged as an unbundled total proctocolectomy.
Billing Tips
- Always append E793 if the procedure is performed laparoscopically to ensure the appropriate premium is captured alongside the base S168 fee.
- If the patient has a history of prior bowel resection, verify if E718 is applicable, provided it does not conflict with the specific exclusions listed for S168.
Effective: April 1, 2026
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
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