S293 – Biliary duct atresia, infant
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
S293 is for the surgical repair of biliary duct atresia in an infant. The surgeon's fee is determined by Independent Consideration (IC). Claims must be submitted with a supporting letter explaining the fee, an operative report, and a comparison to other procedures as outlined on . The service includes 8 basic units for an assistant and 12 basic units for anaesthesia.
When to Use
- Use S293 specifically for the Kasai hepatoportoenterostomy procedure performed on infants aged 29 days to under 2 years for biliary atresia.
- Select S293 when the complexity of the biliary reconstruction exceeds the scope of standard biliary tract surgeries like S281, necessitating an Independent Consideration (IC) claim.
Common Pitfalls
- Submitting the claim without the mandatory supporting letter and operative report will result in an automatic rejection for manual review.
- Failing to explicitly compare the procedure's complexity to a non-IC code (e.g., S281) in the letter is a frequent cause for denied fee requests.
- Incorrectly applying age premiums; ensure the 25% premium for infants <1 year or 20% for 1-2 years is calculated based on the final approved IC fee, not just the base expectation.
Billing Tips
- When drafting the comparison letter, quantify the surgical time and technical difficulty against S281 to justify the higher IC fee request.
- Ensure the operative report clearly details the extent of the porta hepatis dissection, as this is the primary driver for justifying the IC amount.
No fee information available.
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
supporting letter explaining the amount of the fee claimed
appropriate operative or consultation report
comparison of the scope and difficulty of the procedure in relation to non-IC procedures in the Schedule
Service is for an infant, defined as a person from 29 days of age up to, but not including, 2 years of age.
(see General Preamble )
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