S561 – Re-implantation of ureter with extensive tapering with or without ureterolysis
OHIP Urology Code — UROGENITAL AND URINARY SURGICAL PROCEDURES · Schedule of Benefits
This service is for a spinal surgical procedure. The fee for the surgeon (suffix A) covers the performance of the procedure and associated post-operative care as defined by the surgical preamble. The fees for the surgical assistant (suffix B) and anaesthesiologist (suffix C) are calculated separately based on basic and time units as outlined in the General Preamble (, ).
When to Use
- Use S561 for open surgical re-implantation of the ureter involving extensive tapering, such as in cases of megaureter repair.
- Use S561 when the procedure is performed laparoscopically, ensuring the addition of code E792 to the claim to capture the 25% fee increase.
Common Pitfalls
- Billing a hospital admission assessment by the surgeon on the same day as S561 is prohibited per GP40, as the surgical fee includes post-operative care.
- Attempting to bill S561 concurrently with S482 will result in a rejection, as these procedures are mutually exclusive on the same day.
- Failing to document the Injury Severity Score (ISS) when attempting to claim the E420 trauma premium will lead to an automatic audit rejection.
Billing Tips
- If performing the procedure laparoscopically, you must explicitly append code E792 to the claim to trigger the 25% premium; it is not applied automatically.
- When multiple surgical procedures are performed, ensure that the basic units for the surgical assistant and anaesthesiologist are claimed only against the major procedure (S561) to avoid billing errors.
Effective: April 1, 2026
T. Urogenital and Urinary Surgical Procedures
UROGENITAL AND URINARY SURGICAL PROCEDURES
Surgical
Spinal Surgical Procedures, Surgical Assistants' Services, Anaesthesiologists' Services
All insured services must be documented in appropriate records to establish that an insured service was provided, the service for which the account is submitted is the service that was rendered, and the service was medically necessary.
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