S228 – Insertion of Thiersh wire
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
S228 is listed under the 'Rectum - Repair' and 'Rectal prolapse' sub-headings. The procedure involves the insertion of a Thiersh wire for the treatment of rectal prolapse. As a surgical procedure, it is claimable with suffix 'A' by the surgeon. Assistant services (suffix 'B') and anaesthesia services (suffix 'C') are also eligible for payment, with fees calculated based on basic and time units as outlined in the Schedule of Benefits.
When to Use
- Use S228 specifically for the insertion of a Thiersch wire to manage rectal prolapse when non-surgical management has failed.
- Use this code for patients requiring a mechanical sphincter reinforcement procedure, distinguishing it from more complex rectal repairs like S225 or S226.
Common Pitfalls
- Billing S228 in conjunction with other major rectal repairs without ensuring the procedure is distinct, as the Schedule of Benefits limits assistant and anaesthesia basic units to the major procedure only.
- Failing to document the specific indication of rectal prolapse, which is a mandatory clinical condition for this code to be valid.
Billing Tips
- Ensure the surgical assistant and anaesthesiologist are aware that if multiple procedures are performed, only the major procedure's basic units are claimable to avoid rejection.
Effective: April 1, 2026
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures, Surgical Assistants' Services, Anaesthesiologists' Services
The medical record must establish that an insured service was provided, the service claimed is the service rendered, and the service was medically necessary.
For assistant services, time spent must be documented, including direct contact with the patient in the operating room prior to scrub time and time spent assisting at surgery from scrub time until no longer required.
For anaesthesia services, time units are calculated based on time spent by the anaesthesiologist from initiating anaesthesia until the patient may be safely placed under customary post-operative supervision.
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