S309 – Distal, left-sided or central pancreatectomy
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure involving the excision of the distal portion of the pancreas, which includes the body and tail, and also includes the removal of the spleen (splenectomy). This procedure may or may not involve creating an anastomosis. This is an operative procedure and is eligible for surgeon (suffix A), assistant (suffix B), and anaesthetist (suffix C) fees. Add-on codes for laparoscopic assistance (E793) and concurrent cholecystectomy (E709) may apply. Payment for a second assistant is not automatically eligible and requires authorization from a medical consultant.
When to Use
- Use S309 for a standard distal pancreatectomy that includes a splenectomy, which is the primary procedure for lesions in the body or tail of the pancreas.
- Use S309 when performing a central pancreatectomy if the surgical approach and complexity align with the distal resection classification, provided it does not meet the criteria for a Whipple procedure (S300).
Common Pitfalls
- Do not bill S309 if the spleen is preserved; use S299 instead, as S309 explicitly includes the splenectomy fee.
- Avoid billing a second assistant fee automatically; S309 is not on the pre-approved list, and claims will be rejected without prior authorization and a supporting letter from the surgeon.
- Failure to append E793 when the procedure is performed laparoscopically results in a 25% underpayment, as this add-on is not automatically triggered by the base code.
Billing Tips
- Always append E709 when a cholecystectomy is performed concurrently with S309 to capture the additional flat fee of $122.05.
- Ensure the operative report clearly documents the necessity of a second assistant if you intend to pursue the required medical consultant authorization for additional staffing.
Effective: April 1, 2026
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
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