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S213
S213 – Anterior resection or proctosigmoidectomy
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Anterior resection or proctosigmoidectomy (anastomosis below peritoneal reflection) is a surgical procedure involving the removal of the sigmoid colon and rectum, with the re-connection (anastomosis) made below the peritoneal reflection.
When to Use
- Use S213 for a standard anterior resection or proctosigmoidectomy where the anastomosis is definitively placed below the peritoneal reflection.
- Use S213 when performing a low anterior resection for rectal cancer, ensuring the surgical report explicitly confirms the anastomosis level to justify the code over higher-level resections.
Common Pitfalls
- Failing to append the E793 premium for laparoscopic-assisted procedures, which is a common oversight that results in a 25% underpayment.
- Incorrectly billing S213 for procedures where the anastomosis remains above the peritoneal reflection, which may be audited as an upcoding error compared to other bowel resection codes.
- Forgetting to include the E810 add-on when a coloanal anastomosis is performed, as this is a distinct surgical step that warrants a 25% increase.
Billing Tips
- Always verify if the procedure qualifies for the E808 flat fee for neo-rectal pouch formation, as this is an independent add-on that must be submitted on the same claim as S213.
- If performing the procedure for trauma, ensure the Injury Severity Score (ISS) is clearly documented in the chart to support the E420 50% trauma premium, as this is a high-scrutiny billing item.
Provider Fee$1,377.95
Surgical Assistant Fee$103.28
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
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