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S452

S452Ureteroileal conduit

OHIP Urology Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits

S452 is a fee code for a surgical procedure. As a surgical code, it is eligible for billing with suffix 'A' for the performing surgeon, 'B' for a surgical assistant, and 'C' for an anaesthesiologist (). The surgeon's fee is a set amount, while the fees for anaesthesia and surgical assistance are calculated based on basic units specific to the procedure plus time units based on the duration of the service, as outlined in the General Preamble (-, -). The specific details, specialty, and base unit values for S452 are not provided in the context.

When to Use

  • Use S452 for the creation of a urinary diversion via an ileal conduit following cystectomy or other bladder-disabling conditions.
  • Use S452 when performing the primary construction of the ureteroileal anastomosis and the subsequent cutaneous stoma.

Common Pitfalls

  • Billing S452 on the same day as S482 is a common rejection; ensure you are not attempting to bill both for the same operative session.
  • Failure to document the specific surgical approach or complexity can lead to audit scrutiny regarding the medical necessity of the procedure.

Billing Tips

  • Ensure the surgeon uses suffix 'A', the assistant uses 'B', and the anaesthesiologist uses 'C' to avoid automatic rejection of the claim.
  • When billing for the anaesthesiologist, remember that basic units for the procedure are fixed; ensure all applicable add-on units (e.g., E022C, E010C) are included to maximize the time-unit calculation.
Provider Fee$844.95
Surgical Assistant Fee$77.46
Anaesthetist Fee$143.64
Non-Anaesthetist Fee$143.64

Effective: April 1, 2026

Category

T. Urogenital and Urinary Surgical Procedures

Subcategory

UROGENITAL AND URINARY SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Urogenital and Urinary Surgical Procedures

All insured services must be documented in appropriate records that 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.

The specific description, specialty, and basic units for this surgical procedure are found on page of the Schedule of Benefits, which was not available in the provided context. Basic units for assistant and anaesthetist have been assumed based on the provided fee schedule.

A second surgical assistant is not listed as pre-approved for payment with this code as per the list on .

The fee for the professional component (surgeon) is a flat fee, while fees for the assistant and anaesthesiologist are calculated based on basic and time units.

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