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S328
S328 – Unilateral inguinal or femoral hernia repair with exploration of other side - infants and children
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Unilateral inguinal and/or femoral herniotomy with exploration of the contralateral side, performed on infants and children as defined in the Schedule. This surgical procedure () has an assistant base unit value of 6 and an anaesthesia base unit value of 7.
When to Use
- Use S328 for a unilateral inguinal or femoral hernia repair in a pediatric patient when the contralateral side is also explored during the same operative session.
- Use S328 instead of S326 when the clinical plan specifically includes the mandatory exploration of the asymptomatic contralateral side in a child.
Common Pitfalls
- Billing S328 alongside a separate code for a contralateral repair is incorrect, as the exploration and potential repair are bundled into the S328 fee.
- Failing to apply the mandatory age-based surgical premium (GP64) for patients under 16 years of age, which is a percentage increase on the base fee.
- Attempting to bill a hospital admission assessment on the day of surgery, which is disallowed unless it qualifies as the major pre-operative consultation.
Billing Tips
- Ensure the age-based surgical premium is calculated correctly based on the specific bracket (e.g., 10% for ages 5-15, up to 30% for <30 days) to avoid under-billing.
- If the hernia is recurrent, append E725 to S328 to capture the additional flat fee, provided the patient meets the age criteria for the add-on.
Provider Fee$458.40
Surgical Assistant Fee$75.06
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
Age Restriction
infants and children
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