S269 – Local excision of liver lesion (less than 5 cm)
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
S269 is a surgical procedure for the hepatectomy of a liver lesion by local excision, where the lesion is less than 5 cm in size. The fee for this service may be claimed by the operating surgeon (suffix A), a surgical assistant (suffix B), and an anaesthesiologist (suffix C). Fees for the assistant and anaesthesiologist are calculated based on basic units plus time units as defined in the Schedule of Benefits. See pages and for detailed calculation rules.
When to Use
- Use S269 for the surgical excision of a solitary liver lesion measuring less than 5 cm in diameter.
- Use S269 when performing a wedge resection or local excision of a benign or malignant liver mass that does not require a formal anatomical lobectomy or segmentectomy.
Common Pitfalls
- Billing S269 for lesions 5 cm or larger, which requires a different procedural code; ensure the operative report explicitly states the lesion size to support the claim.
- Attempting to bill S269 in conjunction with other major liver resection codes (e.g., S270 or S271) for the same lesion, which constitutes unbundling and will result in rejection.
- Failure to apply the E793 premium when the procedure is performed laparoscopically, as this is a common omission for this specific code.
Billing Tips
- Always append the E793 premium code to your claim if the excision was performed laparoscopically to capture the 25% fee increase.
- Ensure the operative report clearly documents the size of the lesion and the specific technique used to justify the use of S269 over more extensive hepatectomy codes.
Effective: April 1, 2025
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
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