S540 – Revision or removal of artificial urinary sphincter
OHIP Urology Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
Revision or removal of an artificial urinary sphincter. This procedure is billable by the surgeon (suffix A), an assistant (suffix B), and an anaesthetist (suffix C). The assistant's fee is calculated based on 6 basic units plus time units as per . The anaesthetist's fee is calculated based on 7 basic units plus time units as per . Additional premiums for after-hours service, trauma, and specific patient factors (e.g., age, ASA status) may apply as outlined in the General Preamble.
When to Use
- Use S540 for the surgical revision or complete removal of an existing artificial urinary sphincter device due to mechanical failure, erosion, or infection.
- Select S540 when performing a secondary procedure on a previously implanted sphincter, distinguishing it from the initial implantation (S539).
Common Pitfalls
- Billing S540 alongside S539 for the same anatomical site is generally considered unbundling; ensure the documentation clearly supports the revision/removal as a distinct clinical necessity.
- Failure to document the specific reason for removal or revision (e.g., cuff erosion vs. pump malfunction) can lead to audit scrutiny regarding the medical necessity of the procedure.
Billing Tips
- Ensure the surgical assistant and anaesthetist utilize the correct base units (6 and 7 respectively) as defined in GP86 and GP93 to avoid automatic claim rejection.
- If the procedure is performed after hours, apply the appropriate E-code premium (E400B/E401B for assistants or E400C/E401C for anaesthetists) based on the exact time of case commencement.
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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