S447 – Ureterotomy - upper 2/3 - where ureter has been previously opened
OHIP Urology Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
S447 represents a ureterotomy of the upper two-thirds of the ureter, performed in cases where the ureter has been previously opened. The fee for this service encompasses all constituent and common elements of an insured service as described in the Schedule of Benefits (-). This includes pre-operative evaluation, the surgical procedure itself, and post-operative care components. This service can be billed by the surgeon (suffix A), an assistant (suffix B), or an anaesthetist (suffix C).
When to Use
- Use S447 specifically for a ureterotomy in the upper two-thirds of the ureter when there is documented evidence of a prior surgical opening at that same site.
- Select S447 over primary ureterotomy codes when the surgical field is complicated by previous intervention, necessitating the specific fee associated with re-entry.
Common Pitfalls
- Billing S447 for a primary ureterotomy; this code is strictly reserved for cases where the ureter has been previously opened.
- Attempting to bill for a second surgical assistant without prior authorization, as S447 is not on the pre-approved list for multiple assistants.
Billing Tips
- Ensure the operative report explicitly details the previous ureterotomy to justify the use of this specific code over primary procedure codes.
- If the procedure is cancelled after anaesthesia induction but before the incision, bill E006B for the assistant or E006C for the anaesthetist rather than the full S447 fee.
Effective: April 1, 2025
T. Urogenital and Urinary Surgical Procedures
UROGENITAL AND URINARY SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
Supervision of Medical Trainees: A service rendered by a Medical Trainee (Resident or Clinical Fellow) may be eligible for payment to the Supervising Physician if the specific requirements for supervision, presence, and documentation outlined in the Schedule of Benefits are met. See to for detailed payment rules and limitations.
When a surgical procedure is performed by a Clinical Fellow with an OHIP billing number under the supervision of a Supervising Physician, the procedure is eligible for payment to the Clinical Fellow as a surgical assistant (suffix B), while the Supervising Physician claims as the operating surgeon (suffix A).
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