S403 – Exploration of Renal and Peri-Renal Tissues (With or without Biopsy or Unroofing of Cyst)
OHIP Urology Code — Kidney and Upper Urinary Tract · Schedule of Benefits
S403 is an operative procedure for the exploration of renal and peri-renal tissues. This service includes all common elements as described in - of the Schedule of Benefits. The description 'with or without' indicates that performing a biopsy or unroofing a cyst is optional, but if rendered, is included in the fee for the listed service as per . When this procedure is performed laparoscopically, an additional 25% premium is payable by claiming E792 in addition to S403A.
When to Use
- Use S403 for open or laparoscopic surgical exploration of the renal or peri-renal space where no definitive major procedure (like nephrectomy) is performed.
- Use S403 when performing a renal biopsy or the unroofing of a simple renal cyst as the primary surgical objective.
- Use S403 for diagnostic exploration of the retroperitoneal space surrounding the kidney when the findings do not necessitate a more complex procedure code.
Common Pitfalls
- Do not bill S403 in addition to a nephrectomy or other major renal procedure; the exploration is considered an inherent part of the major surgery.
- Avoid billing S403 for simple percutaneous needle biopsies, which are typically covered under different diagnostic imaging or interventional codes.
- Failure to append E792 when the procedure is performed laparoscopically results in a 25% underpayment of the surgical fee.
Billing Tips
- Always ensure the operative report clearly documents the exploration of renal or peri-renal tissues to justify S403 if the primary finding is negative or limited to a biopsy.
- When performing the procedure laparoscopically, claim S403A plus E792 to trigger the 25% premium automatically.
Effective: April 1, 2025
Urogenital and Urinary Surgical Procedures
Kidney and Upper Urinary Tract
Surgical
Urogenital and Urinary Surgical Procedures
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