What is OHIP billing code S188?

S188 is "Bowel resection without anastomosis (colostomy and mucous fistula)", an OHIP Urology code from the Ontario Schedule of Benefits (Physician Services).

How much does S188 pay?

The current OHIP fee for S188 is $877.40, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill S188 to OHIP?

S188 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates S188 claims against the Schedule of Benefits rules before submission.

What codes are related to S188?

Codes related to S188 in the Schedule of Benefits include S189, E793, S175, S176, S177, S180, S178, S179.

All codes

S188

S188 – Bowel resection without anastomosis (colostomy and mucous fistula)

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

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S188 describes a bowel resection where anastomosis (re-connection) is not performed. Instead, the two ends of the resected bowel are brought to the skin surface to create stomas: a colostomy for fecal diversion and a mucous fistula for drainage from the non-functional part of the bowel. This service is eligible for billing by the surgeon (suffix A), assistant (suffix B), and anaesthesiologist (suffix C).

When to Use

Use S188 for emergency bowel resection where the patient's clinical instability precludes safe primary anastomosis, necessitating a colostomy and a separate mucous fistula.
Use S188 when performing a Hartmann's procedure or similar diversion surgery where the distal bowel segment is brought to the skin as a mucous fistula rather than being oversewn in the abdomen.

Common Pitfalls

Billing S188 alongside codes for primary anastomosis (e.g., S175-S184) is a duplicate billing error, as S188 specifically defines the absence of anastomosis.
Failing to document the creation of both the colostomy and the mucous fistula can lead to audit scrutiny, as the code specifically covers the creation of both stomas.

Billing Tips

Ensure the operative report explicitly details the creation of the mucous fistula, as this distinguishes S188 from simpler stoma procedures that may carry lower values.
If the procedure is performed after hours, ensure the start time is clearly documented to support the application of E409 or E410 premiums, as these are frequently audited for surgical procedures.

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Provider Fee$877.40

Surgical Assistant Fee$77.46

Anaesthetist Fee$95.76

Non-Anaesthetist Fee$95.76

Effective: April 1, 2026

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