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S216
S216 – Perineal surgeon
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
S216 represents the service provided by the perineal surgeon during an abdomino-perineal resection or pull-through procedure when performed by a two-surgeon team. The abdominal surgeon's component is billed separately using S215. This two-surgeon team approach is an alternative to the single-surgeon procedure, S214.
When to Use
- Use S216 specifically when performing the perineal portion of an abdomino-perineal resection or pull-through procedure as part of a formal two-surgeon team.
- Select S216 when the abdominal surgeon is simultaneously billing S215 to ensure the two-surgeon team requirement is met for the same patient and date.
Common Pitfalls
- Billing S216 as a solo surgeon is a common error; if you perform the entire procedure alone, you must use S214 instead.
- Failure to coordinate with the abdominal surgeon to ensure both S215 and S216 are submitted for the same operative session will trigger automatic rejections.
- Attempting to bill S216 in conjunction with surgical assistant codes is generally disallowed, as the two-surgeon team structure replaces standard assistant billing.
Billing Tips
- Ensure your operative report clearly delineates your role as the perineal surgeon to justify the use of the two-surgeon team code over the single-surgeon S214.
- Verify that the abdominal surgeon has successfully submitted S215, as the Ministry often cross-references these claims to validate the two-surgeon team requirement.
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