S231 – Rectovaginal fistula repair
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service covers the surgical repair of a rectovaginal fistula. The procedure fee includes all common surgical elements as defined in the Schedule of Benefits (e.g., preparation, post-operative care planning, record keeping). The fee is applicable when the surgeon performs the procedure (suffix A). Separate fees apply for surgical assistance (suffix B) and anaesthesia (suffix C), which are calculated based on basic and time units.
When to Use
- Use S231 when performing a formal surgical repair of a confirmed rectovaginal fistula in a female patient.
- Select S231 for primary or secondary repairs where the procedure is distinct from a simple closure or minor debridement.
Common Pitfalls
- Do not attempt to bill a second surgical assistant for S231, as it is not on the pre-approved list and requires prior authorization from a medical consultant.
- Avoid billing S231 in conjunction with other minor anorectal procedures unless the work performed is distinct and documented as a separate operative event.
Billing Tips
- Ensure the operative report clearly details the complexity of the fistula tract to justify the use of S231 over less invasive procedural codes.
- If the procedure is performed after hours, ensure the start time is documented in the operative report to support the application of E409 or E410 premiums.
Effective: April 1, 2025
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Urogenital and Urinary Surgical Procedures
Female
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