S454 – Ureteroureterostomy with ureterectomy and ileal replacement
OHIP Urology Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
This procedure, S454, involves the creation of a ureteroileal conduit, which is a surgical diversion of urine using a segment of the ileum. Additionally, it includes a ureterectomy (surgical removal of a ureter) and the replacement of the removed ureter segment with an ileal segment. This complex reconstructive surgery addresses significant ureteral pathology.
When to Use
- Use S454 when performing a formal ureteroileal conduit diversion that specifically includes the resection of a ureteral segment and its replacement with an ileal segment.
- Select this code for complex reconstructive urological cases involving ureteral pathology where the ileal segment serves as the primary conduit for urinary diversion.
Common Pitfalls
- Do not bill S454 in conjunction with S482, as these codes are mutually restricted to prevent duplicate billing for overlapping urinary diversion procedures.
- Avoid billing S454 for simple ureteral repairs or non-conduit procedures, as the code specifically mandates the inclusion of ureterectomy and ileal replacement.
Billing Tips
- Since S454 allows for a second surgical assistant without prior authorization, ensure both assistants submit their claims clearly to avoid processing delays.
- Always verify if the procedure qualifies for E409 or E410 after-hours premiums based on the exact start time of the surgery to maximize the procedural fee.
Effective: April 1, 2026
T. Urogenital and Urinary Surgical Procedures
UROGENITAL AND URINARY SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
When more than one assistant is required, the second assistant's service is eligible for payment without special authorization.
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