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S811
S811 – Rectus abdominus myocutaneous neovaginostomy
OHIP Urology Code — FEMALE GENITAL SURGICAL PROCEDURES · Schedule of Benefits
Rectus abdominus myocutaneous neovaginostomy - includes harvest of longitudinal, vertical or transverse rectus abdominus flap(s), formation of vaginal pouch and insertion of vaginal mold.
When to Use
- Use S811 for the primary creation of a neovagina using a rectus abdominus myocutaneous flap in cases of vaginal agenesis or reconstructive surgery.
- Select S811 when the procedure specifically involves the harvest of a rectus abdominus flap and the insertion of a vaginal mold, distinguishing it from simpler procedures like S730 (vaginoplasty) which may not involve flap transposition.
Common Pitfalls
- Billing S811 concurrently with other vaginal reconstruction codes (e.g., S730) without clear documentation of distinct, separate procedures will lead to rejection for unbundling.
- Attempting to claim a hospital admission assessment or subsequent hospital visits on the same day as S811 is prohibited, as these are considered included in the surgical fee unless they qualify as the major pre-operative visit.
Billing Tips
- Ensure the operative report explicitly details the harvest of the rectus abdominus flap and the creation of the vaginal pouch to support the specific requirements of S811 during an audit.
- If the procedure is performed on an emergency basis or delayed by an intervening emergency, ensure the appropriate after-hours premium (E409 or E410) is appended to the claim to reflect the complexity and timing.
Provider Fee$829.40
Surgical Assistant Fee$100.08
Anaesthetist Fee$123.92
Non-Anaesthetist Fee$123.92
Effective: April 1, 2025
Category
V. Female Genital Surgical Procedures
Subcategory
FEMALE GENITAL SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Female Genital Surgical Procedures
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