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S313

S313Peritoneal abscess - subphrenic

OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

S313 is the fee code for the surgical incision and drainage of a subphrenic peritoneal abscess. This procedure falls under the Abdomen, Peritoneum and Omentum section of the Schedule of Benefits.

When to Use

  • Use S313 for the open surgical drainage of a confirmed subphrenic abscess when the procedure is performed as a standalone intervention.
  • Use this code when the drainage is performed via an open incision, distinguishing it from percutaneous image-guided drainage which is billed under different diagnostic imaging codes.

Common Pitfalls

  • Do not bill S313 in conjunction with S310 or S315, as these are explicitly restricted and will trigger an automatic rejection.
  • Avoid billing S313 alongside any open or laparoscopic abdominal procedure, as the Ministry considers the drainage of an abscess to be inclusive of the primary surgical fee in those contexts.

Billing Tips

  • If the procedure is performed after hours or on weekends, ensure you append the appropriate E409 or E410 premium to the S313 claim to maximize the procedural fee.
  • If the patient meets the specific trauma criteria, ensure the Injury Severity Score (ISS) is clearly documented in the chart to support the E420 trauma premium, as this cannot be combined with after-hours premiums.
Provider Fee$370.95
Surgical Assistant Fee$87.57
Anaesthetist Fee$108.43
Non-Anaesthetist Fee$108.43

Effective: April 1, 2025

Category

S. Digestive System Surgical Procedures

Subcategory

DIGESTIVE SYSTEM SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Digestive System Surgical Procedures

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