S578 – Hypospadias or Epispadia - one stage repair - with meatus to but not into glans
OHIP Urology Code — MALE GENITAL SURGICAL PROCEDURES · Schedule of Benefits
This service is a one-stage surgical repair for hypospadias or epispadias. It is indicated for cases where the urinary meatus opens on the underside of the penis at a location proximal to the glans penis but does not extend into the glans itself. The service fee is for the surgical procedure (<suffix>A</suffix>), and may be billed with services for an assistant (<suffix>B</suffix>) and anaesthetist (<suffix>C</suffix>) when required. Assistant and anaesthetist fees are calculated based on basic units plus time units as per the General Preamble (-, -). The basic units are 6 for an assistant and 7 for anaesthesia as listed in the Schedule.
When to Use
- Use S578 for a single-stage repair when the meatus is located on the penile shaft or at the corona, but specifically proximal to the glans.
- Select S578 when the surgical plan does not involve extending the urethral reconstruction into the glans tissue itself, distinguishing it from distal repairs like S579.
Common Pitfalls
- Billing S578 for a procedure that includes glanular reconstruction will result in a rejection or audit risk; ensure the anatomical site matches the 'not into glans' requirement.
- Failure to apply the correct age-based premium (e.g., AGE_PREMIUM_UNDER_5_YEARS) is a common missed revenue opportunity for this pediatric procedure.
Billing Tips
- Always verify the exact anatomical location of the meatus in your operative report to justify the choice of S578 over more complex multi-stage or glanular-involvement codes.
- Ensure that surgical assistant and anaesthesia units are calculated using the specific basic units (6 and 7 respectively) defined for this code in the Schedule.
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