S401 – Drainage of renal or perirenal abscess
OHIP Urology Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
S401 is a surgical procedure for the drainage of a kidney abscess, categorized under Urogenital and Urinary Surgical Procedures. The service allows for a surgeon (`S401A), a surgical assistant (S401B), and an anaesthetist (S401C`). The surgeon's fee is a set fee. The assistant's fee is calculated based on 7 base units plus time units as described in . The anaesthetist's fee is calculated based on 7 base units plus time units as described in .
When to Use
- Use S401 for the formal surgical drainage of a renal or perirenal abscess, distinct from percutaneous drainage procedures which may fall under different diagnostic imaging or interventional radiology codes.
- Select S401 when the procedure is performed as an open or laparoscopic surgical intervention to evacuate a confirmed abscess collection within or surrounding the kidney.
Common Pitfalls
- Billing S401 alongside J069 is prohibited; ensure you are not submitting these on the same claim as they are restricted codes.
- Assuming a second surgical assistant is automatically covered; S401 is not on the pre-approved list, and you must obtain prior authorization from a medical consultant with a formal letter of necessity.
- Failing to document the Injury Severity Score (ISS) when attempting to claim the E420 trauma premium, which is a common cause for automatic rejection.
Billing Tips
- When performing multiple surgical procedures under one anaesthetic, ensure the assistant and anaesthetist only claim the 7 base units associated with the major procedure.
- Always verify the start time of the procedure against the E400/E401 series premiums to ensure you are capturing the correct after-hours or night-time percentage increase for the assistant and anaesthetist.
Effective: April 1, 2026
T. Urogenital and Urinary Surgical Procedures
UROGENITAL AND URINARY SURGICAL PROCEDURES
Surgical
Urogenital and Urinary Surgical Procedures
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