S311 – Umbilical vein intra-abdominal dissection and catheterization
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
S311 represents the intra-abdominal dissection and catheterization of the umbilical vein. The fee for the surgeon (suffix A) is a set amount. The fee for an assistant (suffix B) is calculated based on 6 basic units plus time units. The fee for an anaesthetist (suffix C) is calculated based on 6 basic units plus time units. A note in the Schedule of Benefits advises that for services rendered to a vascular newborn, physicians should refer to the 'Diagnostic & Therapeutic Procedures - Vascular Cannulation' section.
When to Use
- Use S311 specifically for the surgical dissection and catheterization of the umbilical vein in a neonate requiring central venous access.
- Do not use S311 for simple percutaneous umbilical vein catheterization, which is typically billed under the 'Diagnostic & Therapeutic Procedures - Vascular Cannulation' section.
Common Pitfalls
- Billing S311 when only a percutaneous procedure was performed, which risks rejection or audit recovery as S311 requires surgical dissection.
- Failing to apply the mandatory age-based premium (e.g., AGE_PREMIUM_UNDER_30D) for neonates, which is a significant missed revenue opportunity for this procedure.
Billing Tips
- Ensure the operative report clearly documents the surgical dissection component to justify the use of S311 over lower-valued percutaneous cannulation codes.
- Always verify if the procedure qualifies for after-hours premiums (E409/E410) based on the exact start time of the surgery, as this significantly impacts the total procedural fee.
Effective: April 1, 2025
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
For vascular newborn - see Diagnostic & Therapeutic Procedures - Vascular Cannulation.
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