S265 – Living donor, hepatectomy
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Living donor hepatectomy is a complex surgical procedure involving the partial or total removal of the liver from a living individual to be used for an orthotopic liver transplant in a recipient. This fee code covers the surgeon's services for the donor operation.
When to Use
- Use S265 specifically for the surgical removal of liver tissue from a living donor intended for an orthotopic liver transplant.
- Do not use S265 for standard therapeutic hepatectomies (e.g., for malignancy or benign tumors); those procedures fall under different codes such as S266 or S274.
Common Pitfalls
- Billing a cholecystectomy in addition to S265 is prohibited if the resection involves liver segments #4 or #5, leading to automatic claim rejection.
- Failure to clearly document the donor status in the operative report can trigger audit flags, as this code is exclusively reserved for living organ donation.
Billing Tips
- Ensure that the surgical assistant and anaesthesiologist claims are linked to the major procedure S265 to ensure correct calculation of basic units and applicable premiums.
Effective: April 1, 2025
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
All insured services must be documented in the patient's medical record to establish that the service was provided, medically necessary, and is the service for which the account is submitted, as per .
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