S645 – Prostatectomy - Perineal
OHIP Urology Code — MALE GENITAL SURGICAL PROCEDURES · Schedule of Benefits
A perineal prostatectomy is the surgical removal of the prostate gland through an incision made in the perineum (the area between the scrotum and the anus). This procedure is eligible for surgeon (suffix A), assistant (suffix B), and anaesthetist (suffix C) services. The amount payable for assistant and anaesthetist services is calculated using base and time units. As per the note on page of the Schedule, the fee for this procedure includes a vasectomy if performed concurrently, but excludes payment for a separate investigative cystoscopy.
When to Use
- Use S645 specifically for a perineal approach prostatectomy when the surgical intent is the removal of the prostate gland.
- Use this code when performing a concurrent vasectomy, as the vasectomy is considered inclusive to the S645 fee and should not be billed separately.
Common Pitfalls
- Billing a separate investigative cystoscopy (e.g., Z553) on the same day as S645 will result in a rejection, as the Schedule explicitly excludes this service.
- Attempting to bill a separate vasectomy code alongside S645 is a common error that leads to payment adjustments or recovery audits.
Billing Tips
- If the complexity of the case requires a second assistant, bill for them using suffix B without needing prior authorization, as this is specifically permitted for S645.
Effective: April 1, 2025
U. Male Genital Surgical Procedures
MALE GENITAL SURGICAL PROCEDURES
Surgical
Male Genital Surgical Procedures
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