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S538
S538 – Urethrotomy - repeat procedure within 6 months by same surgeon
OHIP Urology Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
This service is for a repeat transurethral (visual) urethrotomy. Payment is conditional on this procedure being performed by the same surgeon who performed the initial procedure (S532), and within a 6-month timeframe following that initial surgery.
When to Use
- Use S538 when performing a repeat urethrotomy on a patient who underwent an initial S532 procedure by you within the preceding 6 months.
- Use this code for secondary stricture management where the clinical necessity for a repeat intervention arises shortly after the primary S532 procedure.
Common Pitfalls
- Billing S538 when the initial procedure was performed by a different surgeon, which will trigger an automatic rejection.
- Submitting S538 for a procedure performed more than 6 months after the initial S532, as this code is strictly time-limited.
- Attempting to bill S538 as a primary procedure; it is specifically designated for repeat interventions and requires the history of a preceding S532.
Billing Tips
- Ensure your claim for S538 clearly references the date of the initial S532 to avoid manual review delays or audit flags regarding the 6-month window.
- Verify that the patient's record clearly documents the recurrence of the stricture to justify the repeat procedure within the short timeframe.
Provider Fee$102.65
Surgical Assistant Fee$77.46
Anaesthetist Fee$95.76
Non-Anaesthetist Fee$95.76
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
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