S305 – Pancreatic cyst - gastrostomy
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
S305 is a surgical procedure for the repair of a pancreatic cyst by creating a drainage connection to the stomach (gastrostomy). The service includes all constituent and common elements of an insured service, as well as the specific elements for a surgical procedure, such as pre-operative preparation, the operation itself, and immediate post-operative care. This procedure is eligible for assistant and anaesthesia services, which are calculated based on basic and time units.
When to Use
- Use S305 for the surgical creation of a cystogastrostomy to provide internal drainage for a symptomatic pancreatic pseudocyst.
- Select S305 when the procedure involves the specific creation of a drainage connection between the pancreatic cyst and the stomach, distinguishing it from external drainage procedures like S306 (pancreatic cyst - external drainage).
Common Pitfalls
- Billing S305 for endoscopic drainage procedures; this code is intended for surgical (open or laparoscopic) gastrostomy, not endoscopic cystogastrostomy.
- Failure to include the required referral documentation from a physician or nurse practitioner, which is mandatory for this surgical service.
- Incorrectly billing S305 when the procedure is limited to simple aspiration or external drainage, which may be covered under different surgical codes.
Billing Tips
- Ensure the operative report clearly describes the creation of the gastrostomy connection to support the use of S305 over other pancreatic drainage codes.
- If the procedure is performed on an emergency basis, ensure the appropriate non-elective premium (E409A or E410A) is applied to the surgeon's fee to maximize the claim.
Effective: April 1, 2025
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
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