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S295
S295 – Repeat liver transplant
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Repeat liver transplant is the surgical procedure for a patient who has previously undergone a liver transplant and requires a subsequent one. This procedure includes the removal of the failed allograft and implantation of a new donor liver.
When to Use
- Use S295 specifically for a re-transplantation procedure where the primary graft has failed and requires total removal and replacement.
- Use S295 when the clinical documentation confirms a previous liver transplant has occurred, distinguishing it from a primary transplant procedure.
Common Pitfalls
- Billing S295 in conjunction with a cholecystectomy is strictly prohibited; ensure no separate claim is submitted for gallbladder removal during the transplant.
- Failure to document the specific nature of the 'repeat' procedure can lead to audit scrutiny; ensure the operative report clearly describes the explantation of the failed allograft.
- Incorrectly applying trauma premiums (E420) without explicit documentation of the required Injury Severity Score (ISS) will result in automatic rejection.
Billing Tips
- Always verify if the patient qualifies for age-based premiums, as these are calculated as a percentage increase on the $4299.90 base fee and are significant for pediatric cases.
- When performing multiple procedures under the same anaesthetic, ensure the assistant and anaesthetist units are billed based solely on the major procedure (S295) to avoid claim processing errors.
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