S567 – Slit of prepuce - newborn
OHIP Urology Code — MALE GENITAL SURGICAL PROCEDURES · Schedule of Benefits
This service covers the surgical procedure of slitting the prepuce, also known as a dorsal slit. It is specifically for a newborn patient, defined as from birth up to and including 28 days of age (see ). The fee includes the complete care associated with the procedure. For the same procedure on an S568 infant or S569 adult or child, different codes apply.
When to Use
- Use S567 exclusively for a dorsal slit procedure performed on a newborn patient aged 0 to 28 days inclusive.
- Select S567 for urgent relief of phimosis in a neonate, whereas S568 should be used for infants older than 28 days up to one year.
Common Pitfalls
- Billing S567 for patients older than 28 days will result in an automatic rejection; ensure the date of birth is verified against the date of service.
- Attempting to bill an office visit or consultation code on the same day as S567 is generally disallowed as the fee includes the complete care associated with the procedure.
Billing Tips
- Always append the 30% age premium for patients under 30 days of age to maximize the claim value for this procedure.
- If the procedure is performed after hours, ensure you select the appropriate E-code (E409 or E410) to apply the percentage increase to the base fee of $61.35.
Effective: April 1, 2025
U. Male Genital Surgical Procedures
MALE GENITAL SURGICAL PROCEDURES
Surgical
Male Genital Surgical Procedures
All insured services must be documented in appropriate records that establish: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
A newborn patient from birth up to, and including, 28 days of age.
Male
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