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S196
S196 – Multivisceral transplant - donor
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
When to Use
- Use S196 when performing a multivisceral transplant donor procedure that includes the mandatory removal of both the small bowel and the liver.
- Use this code when the procedure involves the small bowel and liver, regardless of whether additional organs like the duodenum, stomach, pancreas, or large bowel are also removed.
Common Pitfalls
- Billing S196 without explicit documentation in the medical record confirming the removal of both the small bowel and the liver will lead to audit rejection.
- Attempting to bill for a second surgical assistant automatically is a common error, as S196 is not on the pre-approved list and requires prior authorization and a letter of justification.
Billing Tips
- Ensure the surgical report clearly lists all organs harvested to satisfy the specific documentation requirement for S196.
- If the procedure is performed after hours, ensure the claim includes the correct E-code (E409 or E410) to apply the appropriate percentage increase to the surgeon's fee.
Provider Fee$3,129.95
Surgical Assistant Fee$77.46
Anaesthetist Fee$127.68
Non-Anaesthetist Fee$127.68
Effective: April 1, 2026
Category
S. Digestive System Surgical Procedures
Subcategory
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Digestive System Surgical Procedures
The medical record must specify the organs removed to confirm the service meets the definition of multivisceral transplant (small bowel and liver, with or without duodenum, stomach, pancreas and large bowel).
S196 must include removal of the small bowel and liver, with or without removal of the duodenum, stomach, pancreas and large bowel.
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