S531 – Urethrostomy
OHIP Urology Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
Urethrostomy is a surgical procedure to create a new opening in the urethra. The fee for this service is for the surgeon's work (suffix A) and is not unit-based. Fees for surgical assistant (suffix B) and anaesthesiologist (suffix C) services are calculated based on basic units plus time units. In addition to the common elements outlined in to , this surgical service includes specific elements for the surgeon, assistant, and anaesthesiologist as applicable. **Surgical-Specific Elements ():** - Preparing the patient for the procedure. - Performing the procedure and managing immediate post-operative care. - Arranging for related assessments or therapy. - Post-procedure monitoring until the first post-operative visit. - Discussions with the patient or representative about the service. **Anaesthesia-Specific Elements ():** - Pre-anaesthetic evaluation. - The anaesthetic procedure and all associated supportive measures. - Post-anaesthetic follow-up.
When to Use
- Use S531 for the surgical creation of a permanent or temporary urethrostomy opening when the procedure is distinct from more complex reconstructions like S532 (Urethral reconstruction).
- Select S531 when performing a primary urethrostomy for urinary diversion or stricture management where the scope of work is limited to the creation of the stoma.
Common Pitfalls
- Billing S531 in conjunction with other urological procedures that are considered inclusive under the Schedule of Benefits, leading to automatic claim rejection for unbundling.
- Failing to document the specific surgical approach, which can lead to audit scrutiny if the procedure is later reclassified as a more complex reconstructive surgery (e.g., S532).
Billing Tips
- Ensure that any applicable age-based premiums are applied to the S531 fee, as the base rate is strictly for the surgeon's work and does not automatically adjust for pediatric patients.
- When performing this procedure on a non-elective basis after hours, ensure the correct premium (E409A or E410A) is appended to the S531 claim to capture the 50% or 75% increase respectively.
Effective: April 1, 2026
T. Urogenital and Urinary Surgical Procedures
UROGENITAL AND URINARY SURGICAL PROCEDURES
Surgical
Urogenital and Urinary Surgical Procedures
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