S222 – Presacral or trans-sacral proctotomy and excision of lesion
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Presacral or trans-sacral proctotomy and excision of lesion.
When to Use
- Use S222 for the surgical excision of presacral tumors or cysts via a Kraske or posterior trans-sacral approach.
- Select S222 when performing a formal proctotomy to gain access to the retrorectal space for lesion removal, distinguishing it from simple transanal excisions coded under S221.
Common Pitfalls
- Billing S222 in conjunction with transanal excision codes (e.g., S221) is often flagged as unbundling; ensure the surgical approach is distinct and documented as a separate anatomical access.
- Failure to document the specific posterior approach (e.g., sacrococcygeal incision) can lead to audit reclassification to lower-valued rectal procedures.
Billing Tips
- If the patient meets the criteria for morbid obesity (BMI > 40), ensure you append E676A to the S222 claim to receive the 25% premium for this major pelvic surgery.
Effective: April 1, 2026
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures, Surgical Assistants' Services, Anaesthesiologists' Services
All insured services must be documented in appropriate records. The Act requires that the record establish that: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
This is a surgical procedure. The fee for the surgeon (suffix A) is a flat rate. Fees for the assistant (suffix B) and anaesthetist (suffix C) are calculated based on basic units plus time units.
Basic units for assistant (suffix B): 6
Basic units for anaesthetist (suffix C): 7
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.