S463 – Ureterostomy, Cutaneous - with lower third ureterotomy
OHIP Urology Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
S463 is a listed surgical procedure. The specific details of the procedure are not available in the provided context. As a surgical service, it includes all common and specific elements applicable to surgical procedures as outlined in the Schedule of Benefits. This includes pre-operative evaluation, the surgical procedure itself, and post-operative care. Payment for this service is governed by the rules for surgical procedures, including the use of suffixes A (surgeon), B (assistant), and C (anaesthetist).
When to Use
- Use S463 for the creation of a cutaneous ureterostomy specifically involving a lower third ureterotomy, distinguishing it from general urinary diversion procedures.
- Select S463 when the surgical approach requires mobilization and exteriorization of the distal ureter to the skin surface as the primary therapeutic intervention.
Common Pitfalls
- Billing S463 in conjunction with other urological reconstruction codes without clear documentation of separate, distinct surgical sites may lead to rejection for 'incidental' or 'included' services.
- Failure to document the specific anatomical level of the ureterotomy can trigger audits, as S463 is strictly defined by the involvement of the lower third of the ureter.
Billing Tips
- Ensure the operative report explicitly details the lower third ureterotomy to justify the specific fee for S463 over more generic urinary diversion codes.
- When performing S463 alongside other procedures, verify that the additional services are not considered 'pre-operative' or 'post-operative' components already bundled into the $409.10 fee.
Effective: April 1, 2026
T. Urogenital and Urinary Surgical Procedures
UROGENITAL AND URINARY SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures, Surgical Assistants' Services, Anaesthesiologists' Services
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