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S430
S430 – Removal of Staghorn Calculus Filling Renal Pelvis and Calyces - Open, with or without X-Ray Control And/or Anatrophic Nephrolithotomy
OHIP Urology Code — Kidney and Upper Urinary Tract · Schedule of Benefits
Removal of staghorn calculus filling renal pelvis and calyces - open, with or without x-ray control and/or anatrophic nephrolithotomy. This is a major surgical procedure to remove a complex type of kidney stone.
When to Use
- Use S430 for open surgical removal of a staghorn calculus that occupies the renal pelvis and multiple calyces, specifically when an anatrophic nephrolithotomy is performed.
- Select S430 when the complexity of the stone burden necessitates an open approach rather than endoscopic alternatives like percutaneous nephrolithotomy (PCNL).
Common Pitfalls
- Do not bill S430 in conjunction with endoscopic stone removal codes, as S430 is specific to open surgical procedures.
- Avoid billing S430 for simple pyelolithotomy; the clinical documentation must confirm the staghorn nature of the calculus and its extension into the calyces to justify this specific code.
Billing Tips
- Ensure the operative report explicitly details the anatrophic nephrolithotomy or the extent of the staghorn calculus to support the higher fee associated with S430 compared to simpler renal procedures.
- Apply the appropriate age-based fee premium (e.g., AGE_PREMIUM_LT_16Y) if the patient meets the age criteria, as these are calculated as a percentage increase on the base fee of S430.
Provider Fee$657.75
Specialist Fee$0.00
Surgical Assistant Fee$87.57
Anaesthetist Fee$139.41
Non-Anaesthetist Fee$139.41
Effective: April 1, 2025
Category
Urogenital and Urinary Surgical Procedures
Subcategory
Kidney and Upper Urinary Tract
Service Type
Surgical
Code Classes
Urogenital and Urinary Surgical Procedures
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