S458 – Ureterostomy, Cutaneous - unilateral
OHIP Urology Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
This code represents a surgical procedure within the Musculoskeletal System category. Payment is governed by general surgical rules, with fees for the surgeon (S458A), surgical assistant (S458B), and anaesthetist (S458C). The fees for the assistant and anaesthetist are calculated using a base unit value and time units as described in and . Add-on premiums are available for age (), non-elective procedures performed after hours (, , ), and trauma cases meeting specific Injury Severity Score (ISS) criteria ().
When to Use
- Use S458 when performing a primary cutaneous ureterostomy for urinary diversion in a patient where a single-sided approach is clinically indicated.
- Select S458 for patients requiring permanent urinary diversion due to bladder exstrophy, severe neurogenic bladder, or following a cystectomy where a conduit is not feasible.
Common Pitfalls
- Billing S458 bilaterally is a common error; the code is specifically for unilateral procedures, and bilateral attempts will result in automatic rejection.
- Failing to document the specific surgical indication or the necessity of the unilateral approach can trigger audit reviews regarding the choice of diversion method.
- Incorrectly applying after-hours premiums (E409A/E410A) to elective procedures; these must only be used for non-elective, urgent surgical cases.
Billing Tips
- Ensure the surgical assistant and anaesthetist units are calculated strictly according to the base units defined in GP85 and GP92, ensuring the total time is accurately reflected in the operative report.
- When performing multiple procedures during the same session, ensure S458 is identified as the major procedure to correctly establish the base units for the surgical team.
Effective: April 1, 2026
T. Urogenital and Urinary Surgical Procedures
UROGENITAL AND URINARY SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
The fee for a surgical assistant (suffix B) is calculated by adding basic units and time units, multiplied by the unit fee ($12.51). See for details.
The fee for an anaesthesiologist (suffix C) is calculated by adding basic units and time units, multiplied by the unit fee ($15.49). See for details.
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