S545 – Urethroplasty - first stage - posterior
OHIP Urology Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
S545 is a surgical procedure listed under the Urogenital and Urinary Surgical Procedures section of the Schedule of Benefits. The specific details of this procedure are not available in the provided context. However, it is designated as a service for which a second surgical assistant's service is payable without requiring prior authorization from a medical consultant.
When to Use
- Use S545 for the initial stage of a multi-stage posterior urethroplasty, typically involving the creation of a perineal urethrostomy or similar reconstructive maneuver.
- Select S545 when the surgical plan explicitly dictates a staged approach for complex posterior urethral strictures, distinguishing it from definitive single-stage repairs.
Common Pitfalls
- Billing S545 in conjunction with a definitive repair code on the same date, which will trigger a rejection for unbundling or duplicate service.
- Failing to document the specific 'first stage' nature of the procedure, which may lead to audit scrutiny if the claim appears to represent a complete repair.
Billing Tips
- Ensure that any subsequent stages of the urethroplasty are billed using the appropriate corresponding codes, as S545 only accounts for the initial surgical intervention.
- Since S545 allows for a second surgical assistant without prior authorization, ensure the second assistant's claim is submitted with the appropriate B suffix to avoid manual review delays.
Effective: April 1, 2025
T. Urogenital and Urinary Surgical Procedures
UROGENITAL AND URINARY SURGICAL PROCEDURES
Surgical
Urogenital and Urinary Surgical Procedures
A second assistant's service is eligible for payment for this procedure and does not require authorization by a medical consultant.
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