S257 – Anoplasty, for stenosis
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Anoplasty for stenosis is a surgical procedure to repair a narrowing of the anus. This procedure is listed under the Digestive System Surgical Procedures section. The '#' prefix on this code indicates that when the procedure is performed in a hospital, the cost of premises, equipment, supplies, and personnel is covered by the hospital's global budget and not billed separately by the physician (see ). The fee for the surgeon is a set amount, while the fees for the surgical assistant and anaesthetist are calculated based on basic units and time units. This service is eligible for an assistant (6 basic units) and anaesthesia (6 basic units).
When to Use
- Use S257 specifically for the surgical repair of symptomatic anal stenosis, distinct from simple anal dilation (S253) or more extensive procedures like sphincterotomy (S260).
- Select this code when performing a formal anoplasty (e.g., Y-V or diamond flap) to reconstruct the anal canal diameter, rather than a minor revision or excision of skin tags.
Common Pitfalls
- Billing S257 in conjunction with S253 (anal dilation) is a common error; the dilation is considered an integral component of the anoplasty procedure and is not separately billable.
- Failure to recognize that the '#' prefix prohibits billing for tray fees or facility-related supplies when performed in a hospital setting, leading to automatic rejections or audit flags.
Billing Tips
- Ensure the operative report explicitly documents the technique used for the stenosis repair to justify the use of S257 over lower-valued minor anorectal codes.
- When performing bilateral procedures or multiple anorectal surgeries during the same session, remember that assistant and anaesthesia basic units are restricted to the major procedure only.
Effective: April 1, 2026
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
The '#' prefix indicates that when this procedure is performed in a hospital, the premises, equipment, supplies, and personnel are funded by the hospital's global budget.
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