S631 – Varicocele excision - single
OHIP Urology Code — MALE GENITAL SURGICAL PROCEDURES · Schedule of Benefits
S631 represents the surgical excision of a single varicocele. This procedure is listed under Male Genital Surgical Procedures and involves the ligation or removal of dilated veins in the spermatic cord. The fee listed is for the surgeon's component (suffix A), while assistant (suffix B) and anaesthetist (suffix C) services are calculated based on basic and time units.
When to Use
- Use S631 for the surgical ligation or excision of a symptomatic varicocele when non-surgical management has failed or is inappropriate.
- Select S631 specifically for a unilateral procedure; if performing a bilateral varicocele excision, bill S631 for the first side and the appropriate secondary procedure code for the contralateral side.
Common Pitfalls
- Billing S631 as a bilateral procedure; the code description explicitly defines it as a single excision, necessitating separate coding for bilateral cases.
- Failing to document the specific side (left or right) in the operative report, which can lead to audit scrutiny regarding the 'single' designation of the code.
Billing Tips
- Ensure the operative report clearly distinguishes the procedure from S630 (Varicocele excision - bilateral) to prevent automatic rejection or recovery during post-payment audits.
- If the procedure is performed on a patient under 16 years of age, remember to append the appropriate age premium code to the surgeon's fee (suffix A) to capture the 10-30% increase.
Effective: April 1, 2026
U. Male Genital Surgical Procedures
MALE GENITAL SURGICAL PROCEDURES
Surgical
Male Genital Surgical Procedures
All insured services must be documented in appropriate records. The record must establish that: 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.
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