S189 – Intestinal bypass for morbid obesity
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Intestinal bypass for morbid obesity. - The fee for this service is for the surgeon (suffix A). - The amount payable for a surgical assistant (suffix B) is calculated based on 7 base units plus time units. See for full calculation rules. - The amount payable for an anaesthesiologist (suffix C) is calculated based on 10 base units plus time units. See for full calculation rules. Note: - S189 is an insured service only when all of the conditions set out in the Surgical Preamble are satisfied. - Mini-gastric bypass (loop gastric bypass) does not constitute intestinal bypass for the purpose of S189.
When to Use
- Use S189 for traditional intestinal bypass procedures performed for morbid obesity that meet all Surgical Preamble requirements.
- Use S189 in conjunction with E793 when the procedure is performed laparoscopically or laparoscopically assisted.
Common Pitfalls
- Billing S189 for mini-gastric or loop gastric bypass procedures, which are explicitly excluded from this code definition.
- Failing to satisfy the Surgical Preamble conditions, which renders the entire service ineligible for payment regardless of the procedure performed.
- Attempting to claim E793 for loop gastric bypass procedures, which will result in rejection as they do not qualify as intestinal bypass under S189.
Billing Tips
- Always append E793 to your S189 claim if the procedure is laparoscopic to secure the 25% fee increase.
- Ensure the second surgical assistant is billed using the standard 15% calculation, as this is permitted for S189 without requiring prior medical consultant authorization.
Effective: April 1, 2025
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
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