S253 – Low imperforate anus repair
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service is for the surgical repair of a low imperforate anus. The fee includes the surgical procedure and is eligible for assistant and anaesthesia services based on unit calculations. The '#' prefix indicates that facility costs (premises, equipment, supplies, and personnel) are funded through the hospital or ICHSC budget when performed in those settings, as per .
When to Use
- Use S253 for the definitive surgical repair of a low imperforate anus where the rectal pouch is at or below the level of the puborectalis sling.
- Select S253 when performing a perineal anoplasty or similar low-level reconstruction, distinguishing it from more complex high-anorectal malformation repairs like S256 or S257.
Common Pitfalls
- Billing S253 for high or intermediate anorectal malformations will lead to audit discrepancies; ensure the anatomical level of the pouch is clearly documented in the operative report.
- Failure to apply the mandatory age-based premium (GP64) for pediatric patients under 16 results in significant underpayment, as this code is almost exclusively used in the pediatric population.
Billing Tips
- Always append the appropriate age premium suffix to the surgeon's fee (S253A) to ensure the percentage increase is applied correctly based on the patient's exact age in days or years.
Effective: April 1, 2025
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
This service is marked with a '#' prefix, indicating that facility costs for services in a hospital or ICHSC are funded through their respective budgets.
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