S259 – Repair of anal sphincter and ano-rectal ring
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Surgical procedure for the repair of the anal sphincter and ano-rectal ring. The '#' prefix indicates that for this service when performed in a hospital, the premises, equipment, supplies, and personnel used to perform all elements of the service are funded by the hospital global budget (). Payment for an assistant (S259B) is calculated based on 6 basic units plus time units as per -. Payment for an anaesthetist (S259C) is calculated based on 6 basic units plus time units as per -.
When to Use
- Use S259 for the primary surgical repair of a disrupted anal sphincter or ano-rectal ring, typically following obstetric trauma or previous surgical complications.
- Select S259 when the procedure involves formal reconstruction of the sphincter mechanism, distinguishing it from simple debridement or minor anorectal repairs.
Common Pitfalls
- Billing S259 alongside other minor anorectal procedures performed under the same anaesthetic is restricted; you must only claim the major procedure's basic units for the assistant and anaesthetist.
- Attempting to bill for a second surgical assistant without prior authorization from a medical consultant will result in automatic rejection, as S259 is not on the pre-approved list for multiple assistants.
Billing Tips
- Ensure the start time of the procedure is accurately recorded to support the application of after-hours (E409) or night (E410) premiums, as these are based on the commencement time of the surgery.
Effective: April 1, 2026
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
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