S312 – Laparotomy
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure involving an incision into the abdomen (laparotomy). This can be performed with or without a biopsy, or specifically for Hirschsprung's disease. The procedure explicitly excludes biopsies of the stomach, liver, pancreas, and multiple para-aortic lymph nodes. Notes from the Schedule of Benefits: 1. S312 may be used for the division or removal of adhesions, provided no other intra-abdominal surgery is performed (except for In-surg-op-p-t). 2. If this procedure is for omentectomy for tumour debulking, professional assessment by a Ministry of Health Medical Consultant may be requested.
When to Use
- Use S312 when performing an exploratory laparotomy where no definitive intra-abdominal procedure is completed, such as a negative finding or diagnostic inspection only.
- Use S312 for the lysis of adhesions as a standalone procedure when no other intra-abdominal surgery is performed during the same operative session.
- Use S312 for a laparotomy specifically indicated for the management of Hirschsprung's disease when no other specific surgical code applies.
Common Pitfalls
- Claiming S312 in conjunction with other intra-abdominal surgical codes (e.g., bowel resection) will result in a rejection, as it is considered an inclusive component of more definitive procedures.
- Billing S312 for a biopsy of the stomach, liver, pancreas, or para-aortic lymph nodes is prohibited by the Schedule of Benefits and will trigger an audit or rejection.
- Failing to recognize that S312 is not a 'base' code that can be added to other major abdominal surgeries; it is intended for cases where the laparotomy itself is the primary and sole procedure.
Billing Tips
- If performing an omentectomy for tumour debulking, ensure you have documented the extent of the procedure thoroughly to support a request for professional assessment by a Ministry of Health Medical Consultant for potential fee adjustment.
- When performing an exploratory laparotomy that leads to a more complex procedure, bill only the definitive procedure code and not S312, as the laparotomy is considered an integral part of the surgical approach.
Effective: April 1, 2025
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
1. S312 - use for division or removal of adhesions, if no other abdominal surgery performed - may not be claimed with other intra-abdominal procedures (except for IOP).
2. Omentectomy for tumour debulking - professional assessment by the Ministry of Health Medical Consultant is available and may be requested.
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