S718 – Repair of enterocoele and/or vault prolapse
OHIP Urology Code — FEMALE GENITAL SURGICAL PROCEDURES · Schedule of Benefits
This surgical procedure involves the repair of both the anterior and posterior vaginal walls, specifically addressing an enterocoele (a type of hernia where the small intestine pushes against the vaginal wall) and/or a prolapse of the vaginal vault. This code is designated with a '#' prefix, indicating that facility costs (premises, equipment, supplies, personnel) are covered by the hospital's or facility's budget and are not billed separately to OHIP ().
When to Use
- Use S718 when performing a definitive repair of a symptomatic enterocoele, which involves the dissection and closure of the hernial sac in the cul-de-sac.
- Use S718 for the surgical correction of vaginal vault prolapse where the procedure specifically addresses the apex of the vagina, distinguishing it from a simple anterior or posterior colporrhaphy (S717 or S719).
Common Pitfalls
- Billing S718 in conjunction with S717 or S719 is often flagged as unbundling; if the repair is part of a comprehensive vault reconstruction, these codes are generally considered inclusive.
- Failure to document the specific anatomical defect (e.g., enterocoele sac vs. vault descent) can lead to audit rejections, as S718 is a higher-value procedure than standard cystocele or rectocele repairs.
Billing Tips
- Ensure the operative report explicitly details the vault suspension or enterocoele sac excision to justify the use of S718 over lower-valued vaginal wall repair codes.
- If a second surgical assistant is required, you must obtain prior authorization from a medical consultant, as S718 does not carry automatic approval for a second assistant under GP90.
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 are funded by the hospital global budget. For services provided in an Integrated Community Health Services Centre (ICHSC), these costs are funded under the facility costs set out in the Integrated Community Health Services Centres Act, 2023. ()
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