S258B – Repair of Anal Sphincter - Assistant
OHIP Urology Code — Digestive System Surgical Procedures · Schedule of Benefits
Surgical assistance for the repair of the anal sphincter. The amount payable for this service is calculated by adding together the number of basic and time units and multiplying that total by the unit fee. See pages - for detailed rules on calculation, after hours premiums, and special visit premiums for surgical assistants.
When to Use
- Use S258B when acting as the surgical assistant for a formal repair of the anal sphincter (S258A) performed by the primary surgeon.
- Apply this code for assistance during complex obstetric-related sphincter repairs where the primary surgeon has billed S258A for the procedure.
Common Pitfalls
- Billing S258B without the primary surgeon having billed S258A, which will result in an automatic rejection.
- Failing to document the exact start and end times of the surgery, which is required to calculate the time units correctly for the assistant fee.
- Attempting to bill a second assistant for this procedure without prior authorization from a medical consultant, as S258B is intended for a single assistant.
Billing Tips
- Ensure the total fee is calculated by adding the basic units (defined by the S258A fee) and the time units, then multiplying by the unit fee as per the General Preamble.
- Verify if the case qualifies for the Trauma Premium (E420) or Age-Based Premiums, as these are calculated as a percentage of the total assistant fee including time units.
Effective: January 1, 2025
Surgical Assistants' Services
Digestive System Surgical Procedures
Surgical
Surgical Assistants' Services
A second assistant's service for S258 is not listed as payable without prior authorization by a medical consultant. See .
The '#' prefix indicates that for services performed in a hospital or Integrated Community Health Services Centre (ICHSC), the provision of premises, equipment, supplies, and personnel are funded by the facility and not included in the physician fee. See .
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