S716 – Anterior or posterior repair
OHIP Urology Code — FEMALE GENITAL SURGICAL PROCEDURES · Schedule of Benefits
Surgical repair of either the anterior or posterior vaginal wall. The '#' prefix indicates this service is typically performed in a facility setting (e.g., hospital), where the premises, equipment, supplies, and personnel are funded by the facility's budget and cannot be billed to the patient. See for details on the '#' prefix.
When to Use
- Use S716 when performing a cystocele repair (anterior colporrhaphy) in isolation.
- Use S716 when performing a rectocele repair (posterior colporrhaphy) in isolation.
- Use S716 when the clinical documentation specifies only one wall repair, distinguishing it from the combined anterior and posterior repair coded as S717.
Common Pitfalls
- Billing S716 in combination with S717 is a common error; S717 is intended to cover the combined procedure and S716 is restricted when S717 is claimed.
- Attempting to bill S716 alongside S720, S721, or S722 will result in automatic rejection due to explicit billing restrictions.
- Failure to recognize that S716 is a facility-based code; attempting to bill for supplies or equipment used during the procedure will lead to audit scrutiny.
Billing Tips
- Ensure the operative report clearly specifies whether the repair was anterior or posterior to justify the use of S716 over more comprehensive codes.
- If the procedure is performed after hours or on a weekend, verify eligibility for E409 or E410 premiums to maximize the procedural fee.
Effective: April 1, 2025
V. Female Genital Surgical Procedures
FEMALE GENITAL SURGICAL PROCEDURES
Surgical
Female Genital Surgical Procedures
Female
The '#' prefix indicates that for services performed in a hospital, the premises, equipment, supplies, and personnel used to perform all elements of the service are funded by the hospital global budget.
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