S218 – Colon reconstruction following Hartmann procedure
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
S218 is a surgical procedure for colon reconstruction after a Hartmann procedure. This major abdominal surgery involves taking down a colostomy and re-anastomosing the bowel to restore intestinal continuity. The fee for the surgeon (suffix A) is a flat rate. Assistant Services (Suffix B): Payment for a surgical assistant is based on 8 base units plus time units as per the rules in -. Anaesthesia Services (Suffix C): Payment for an anaesthesiologist is based on 8 base units plus time units as per the rules in -.
When to Use
- Use S218 specifically for the elective takedown of a colostomy and colorectal or colo-anal anastomosis following a previous Hartmann procedure.
- Select S218 when the procedure involves the mobilization of the splenic flexure and the restoration of intestinal continuity, distinguishing it from simpler stoma closures like S217.
Common Pitfalls
- Billing S218 in conjunction with S217 is a common rejection error, as S218 is inclusive of the stoma closure and bowel reconstruction.
- Failing to document the complexity of the adhesiolysis encountered during the takedown can lead to audit scrutiny if the procedure time significantly exceeds the expected duration for a standard S218.
Billing Tips
- Ensure the operative report clearly details the anastomosis technique to support the use of S218 over lower-valued bowel repair codes.
- Apply the appropriate after-hours premiums (E400 series) if the procedure is performed on an emergency basis outside of standard operating room hours.
Effective: April 1, 2026
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
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