S735 – Fimbriolysis
OHIP Urology Code — FEMALE GENITAL SURGICAL PROCEDURES · Schedule of Benefits
Fimbriolysis, a tubal plastic operation, performed with or without an operating microscope (unilateral or bilateral). This procedure may be performed laparoscopically, in which case an additional 25% premium (E862) is applicable. General rules for surgical procedures, anaesthesia, and surgical assistance apply as outlined in the General Preamble.
When to Use
- Use S735 when performing a primary surgical release of fimbrial adhesions to restore tubal patency, regardless of whether the procedure is unilateral or bilateral.
- Select S735 over S736 (Salpingostomy) when the clinical objective is specifically the lysis of adhesions around the fimbriae rather than the creation of a new tubal opening.
Common Pitfalls
- Billing S735 in conjunction with other tubal procedures like S736 or S739 without clear documentation of distinct, separate surgical sites may trigger a rejection for unbundling.
- Failing to append the E862 premium when the procedure is performed laparoscopically results in a 25% underpayment of the primary fee.
Billing Tips
- Ensure the E862 laparoscopic premium is submitted on the same claim as S735 to automatically trigger the 25% increase on the base fee.
- If a second surgical assistant is required, you must submit a formal letter of justification to the Ministry, as S735 is not pre-approved for secondary assistance.
Effective: April 1, 2025
V. Female Genital Surgical Procedures
FEMALE GENITAL SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
The amount payable for the surgical assistant service (suffix B) is calculated by adding the number of basic and time units and multiplying that total by the unit fee ($12.51).
The amount payable for the anaesthesia service (suffix C) is calculated by adding the number of basic and time units and multiplying the total by the anaesthesiologist unit fee ($15.49).
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