S743 – Repair of extensive unilateral or bilateral tubal and peritubal disease - laparotomy
OHIP Urology Code — FEMALE GENITAL SURGICAL PROCEDURES · Schedule of Benefits
S743 represents a surgical procedure. The fee for the surgeon (suffix A) covers the operation itself and includes pre-operative and post-operative care as defined in the surgical preamble. The fee for the surgical assistant (suffix B) and anaesthesiologist (suffix C) are calculated based on a combination of basic units assigned to the procedure and time units based on the duration of the service, according to the rules in the General Preamble (, ).
When to Use
- Use S743 for extensive surgical repair of tubal and peritubal disease performed via laparotomy when the complexity exceeds simple lysis of adhesions.
- Select S743 when the procedure involves significant reconstruction or repair of both tubes or extensive peritubal disease, distinguishing it from simpler laparoscopic procedures.
Common Pitfalls
- Billing S743 with other pelvic surgical codes without checking the Schedule of Benefits for mutually exclusive procedures or required 'add-on' status.
- Failing to document the specific extent of the tubal and peritubal disease, which is necessary to justify the 'extensive' classification of this code during an audit.
- Incorrectly billing S743 for laparoscopic procedures; this code is strictly for laparotomy, and using it for minimally invasive approaches will trigger a rejection.
Billing Tips
- Ensure that if you are performing additional procedures during the same laparotomy, you verify if they are considered 'included' in the surgical fee or if they can be billed with a reduction (e.g., 50% for the second procedure).
- Always confirm the surgical assistant and anaesthesiologist have documented their specific start and stop times, as these are mandatory for the calculation of their respective time units.
Effective: April 1, 2025
V. Female Genital Surgical Procedures
FEMALE GENITAL SURGICAL PROCEDURES
Surgical
Diagnostic and Therapeutic Procedures
All insured services must be documented in appropriate records establishing that the service was provided, is the service for which the account is submitted, and was medically necessary as per .
For replacement surgical assistant (E005B), start and stop times must be documented in the patient's permanent medical record.
For cancelled surgery after anaesthetic has begun (E006B, E006C), the actual number of time units must be documented.
For replacement anaesthesiologist (E005C), each anaesthesiologist must indicate their starting and finishing times in the medical record.
To claim the trauma premium (E420), the Injury Severity Score (ISS) must be listed in the medical record.
For S162, records must document that a transmural intestinal resection was rendered when billed with S743.
The specific title and description for this surgical procedure are not available in the provided context, as it would be located on the '' page of the Schedule of Benefits which was not provided. The information provided is based on general rules for surgical procedures.
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