S340 – Hernia fascial defect repair
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure for the repair of a ventral or incisional hernia. This fee schedule code applies to cases where the hernia fascial defect has a diameter of less than 5 cm, or for any size of hernia repaired with primary closure. This service includes all common elements (, ) and the specific elements of a surgical procedure. The service is payable to the surgeon (suffix A), surgical assistant (suffix B), and anaesthetist (suffix C).
When to Use
- Use S340 for primary repair of a ventral or incisional hernia where the fascial defect diameter is less than 5 cm.
- Use S340 for any size ventral or incisional hernia, regardless of defect diameter, provided the repair is performed via primary closure.
- Use S340 for elective hernia repairs that do not meet the criteria for more complex abdominal wall reconstruction codes like S344.
Common Pitfalls
- Billing S340 for complex hernia repairs involving mesh or component separation that should be billed under S344, leading to potential audit recovery.
- Attempting to bill S340 in conjunction with other abdominal procedures without ensuring the surgical approach or site is distinct and eligible for independent billing.
- Failure to document the fascial defect size in the operative report, which is essential for justifying the use of S340 over higher-valued codes.
Billing Tips
- Ensure the operative note explicitly states 'primary closure' if the hernia defect exceeds 5 cm to justify the use of S340.
- Always verify if the procedure qualifies for the E409 or E410 after-hours premiums, as these are frequently missed for non-elective hernia repairs performed at night or on weekends.
Effective: April 1, 2025
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures
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