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S347
S347 – Congenital diaphragmatic hernia - Second or subsequent stage repair
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Surgical procedure for the second or subsequent stage repair of a congenital diaphragmatic hernia. The fee is eligible for suffix A (Surgeon), B (Assistant), and C (Anaesthetist). - Surgical Assistant (Suffix B): The fee is calculated based on 9 basic units plus time units. Time units are calculated per 15-minute increment as per . - Anaesthetist (Suffix C): The fee is calculated based on 13 basic units plus time units. Time units are calculated per 15-minute increment as per .
When to Use
- Use S347 specifically for the second or subsequent stage repair of a congenital diaphragmatic hernia, distinguishing it from the initial repair coded under S346.
- Apply this code when the surgical procedure is a planned follow-up or secondary intervention for a previously addressed diaphragmatic defect.
Common Pitfalls
- Billing S347 for an initial repair, which must be billed under S346, will result in a rejection or audit recovery.
- Failing to document the specific stage of the repair in the operative report can lead to claim denials if the Ministry questions the 'subsequent' nature of the procedure.
- Incorrectly applying age-based premiums (e.g., AGE_PREMIUM_LT30D) without verifying the patient's exact age in days at the time of the procedure can trigger automated billing errors.
Billing Tips
- Ensure that the operative report clearly justifies the 'second or subsequent' status to support the use of S347 over S346.
- When billing for surgical assistants (Suffix B) or anaesthetists (Suffix C), always append the appropriate after-hours premium (E400B/C or E401B/C) based on the exact start time of the procedure to maximize eligible units.
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