S625 – Vasovasostomy and/or vasoepididymostomy - including biopsy and vasography
OHIP Urology Code — MALE GENITAL SURGICAL PROCEDURES · Schedule of Benefits
S625 is for a unilateral vasovasostomy and/or vasoepididymostomy, which is a surgical procedure to repair the vas deferens, typically to reverse a vasectomy. The fee includes any required biopsy, vasography, and the use of microscopic control. As per the note on , this service is a form of vasectomy reversal and is an insured benefit only for the treatment of significant symptomatology, and requires prior approval. Re-establishing fertility does not constitute significant symptomatology.
When to Use
- Use for the surgical reversal of a vasectomy when the patient presents with significant, documented physical symptomatology, such as chronic post-vasectomy pain syndrome.
- Use when performing a vasoepididymostomy or vasovasostomy for non-fertility related medical indications that have received prior ministry approval.
Common Pitfalls
- Billing S625 for fertility restoration is a direct violation of the Schedule of Benefits and will result in claim rejection or clawbacks during audit.
- Failure to obtain and document prior approval for the procedure as mandated by Section U6 will lead to automatic rejection of the claim.
- Attempting to bill biopsy or vasography as separate procedures is incorrect, as these are explicitly included in the S625 fee.
Billing Tips
- Ensure the clinical record clearly justifies the 'significant symptomatology' to support the prior approval, as this is the only basis for insured coverage.
- If the procedure duration exceeds 90 minutes, ensure you correctly append the S625C premium for anaesthesia time to capture the additional value.
Effective: April 1, 2025
U. Male Genital Surgical Procedures
MALE GENITAL SURGICAL PROCEDURES
Surgical
Male Genital Surgical Procedures
To include microscopic control if required.
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