S437 – Renal Autotransplantation
OHIP Urology Code — Kidney and Upper Urinary Tract · Schedule of Benefits
Renal autotransplantation (S437) is a major surgical procedure where a patient's own kidney is moved to a new site, typically the iliac fossa. This service is categorized under Renal Transplantation Procedures. The fee for the surgeon is a flat rate, while the fees for the assistant (suffix B) and anaesthetist (suffix C) are calculated based on basic units (7 for assistant, 10 for anaesthetist) plus time units, as detailed in the Schedule of Benefits on pages - and -.
When to Use
- Use S437 when performing a formal renal autotransplantation where the kidney is harvested and relocated to the iliac fossa, distinct from simple nephrectomy (S434) or standard renal transplantation (S435).
- Select S437 for complex reconstructive cases involving renal vascular pathology where the kidney must be removed and reimplanted to facilitate surgical access or repair.
Common Pitfalls
- Billing S437 alongside other major urological procedures without acknowledging that assistant and anaesthetist basic units are restricted to the major procedure only.
- Failing to document the Injury Severity Score (ISS) in the medical record when attempting to claim the E420 trauma premium, which leads to automatic rejection.
- Incorrectly applying age-based premiums; ensure the patient's age at the time of the procedure strictly aligns with the specific percentage tiers defined in the Schedule of Benefits.
Billing Tips
- When billing for the anaesthetist or assistant, ensure you only claim basic units for S437 if it is the primary procedure; secondary procedures performed during the same session do not attract additional basic units.
- Always verify the start time of the procedure to accurately apply after-hours premiums (E400/E401 series), as these are triggered by the commencement time of the case.
Effective: April 1, 2025
Urogenital and Urinary Surgical Procedures
Kidney and Upper Urinary Tract
Surgical
Urogenital and Urinary Surgical Procedures
As per , all insured services must be documented in appropriate records to establish that: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
For nephrological components - see Diagnostic and Therapeutic Procedures.
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