S348 – Omphalocele and gastroschisis - Primary or first stage repair
OHIP Urology Code — DIGESTIVE SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
S348 is for the primary or first stage surgical repair of omphalocele and gastroschisis. This procedure addresses congenital defects of the abdominal wall where abdominal organs protrude. An add-on code, E691, is available if mobilization of the abdominal wall musculature is required. The fee for this service is eligible for age-based premiums for patients under 16 years old as per . Assistant and anaesthesia services are payable with 7 basic units each.
When to Use
- Use S348 for the initial surgical closure or primary repair of a congenital omphalocele or gastroschisis defect.
- Use S348 when performing the first stage of a staged repair for large abdominal wall defects requiring subsequent interventions.
Common Pitfalls
- Failing to append the age-based premium (GP64) for patients under 16, which is a significant missed revenue opportunity given the neonatal nature of these repairs.
- Billing E691 without explicit documentation of abdominal wall musculature mobilization, which is a specific requirement for this add-on code.
- Incorrectly billing S348 for subsequent or secondary repairs, which should be coded under alternative surgical codes rather than the primary repair code.
Billing Tips
- Always verify the patient's exact age in days at the time of procedure to ensure the correct percentage increase (30% for <30 days) is applied to both the surgeon and assistant fees.
- Ensure the anaesthesiologist includes the appropriate age-specific add-on units (E014C or E021C) in addition to the 7 basic units to maximize the anaesthesia claim.
Effective: April 1, 2026
S. Digestive System Surgical Procedures
DIGESTIVE SYSTEM SURGICAL PROCEDURES
Surgical
Digestive System Surgical Procedures, Surgical Assistants' Services, Anaesthesiologists' Services
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