S258C – Repair of Anal Sphincter - Anaesthesia
OHIP Urology Code — Digestive System Surgical Procedures · Schedule of Benefits
Anaesthesia service for the repair of the anal sphincter. The amount payable for this service is calculated by adding the number of basic and time units and multiplying the total by the anaesthesiologist unit fee. See pages - for detailed rules on calculation, after hours premiums, special visit premiums, and extra units.
When to Use
- Use S258C for anaesthesia services during a formal surgical repair of an anal sphincter defect, such as a primary or secondary sphincteroplasty.
- Select S258C when the procedure is performed in an operating room setting, distinguishing it from minor office-based procedures that do not qualify for anaesthesia unit-based billing.
Common Pitfalls
- Failing to document the specific start and end times of the anaesthesia service, which is required to calculate the time units correctly in addition to the basic units.
- Incorrectly applying extra units (e.g., E022C or E017C) without explicitly documenting the ASA physical status in the anaesthesia record, leading to potential audit recovery.
Billing Tips
- Ensure the total units billed (basic units + time units + extra units) are clearly reconciled against the anaesthesia record to support the claim during a Ministry review.
- Always verify if the case qualifies for E400C or E401C based on the exact start time, as these premiums are calculated on the total anaesthetic fee including all units.
Effective: January 1, 2025
Anaesthesiologists' Services
Digestive System Surgical Procedures
Surgical
Anaesthesiologists' Services
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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