Dr. Kevin Lefebvre, OMA Section Chair on General Surgery
June 2026 Section Update
As many are aware, there has been a bit of a shake-up at OMA central with our CEO leaving and a new interim appointed. There have been significant issues raised with the OMA Board by a number of members regarding Governance changes, Board composition and handling of the recent election, and the troubles surrounding access for the split AGM and motions contained therein. The issue is too complex for a short summary, so please review emails from the OMA on this issue and others.
General Surgery specific issues, however, are summarized below.
SURGICAL UNBUNDLING
As of April 1, 2026, the Surgical Preamble (page SP1) has been updated to allow surgeons to bill visits and assessments in the days prior to and 14 days after the procedure. As many of you are aware, this is not currently being paid, as the OHIP computers don’t seem to be able to make the change. The MOH is working on this and have instructed us to continue to bill these codes as per the new SOB, and they will make payments retroactively at a date to be determined. I would advise you to keep track of these codes on your RA until remedied by OHIP.
As a reminder on how to bill the new unbundled codes, see below:
Pre-operative care:
Pre-operative visits may now be billed for all days leading up to the day of surgery using the applicable assessment/premium combinations:
• C122/E083
• C123/E083
• C032/E083
These may be claimed up to, but not including, the day of surgery.
Post-operative care (assuming patient is admitted on day of surgery*):
• Post-op Day 1: C122/E083
• Post-op Day 2: C123/E083
• Post-op Day 3 through discharge: C032/E083
• Day of discharge: C124/E083
* C122, C123 are only eligible for payment 1x per hospital admission
Note: Visit the OMA’s web page on schedule changes for a list of impacted fee codes that we have identified so far and guidance on what to do next. If you are experiencing OHIP rejections related to April 1 schedule changes and the issue is not already listed on the page, please contact the OMA at info@oma.org.
GENERAL SURGERY REQUESTS FOR REMAINDER OF PSA
These requests, which include a number of general increases, are currently with the bipartite PPC for consideration. There will be some back and forth between the PPC and the section executive before a finalized report will be made available to all members likely in the fall.
BURDEN BASED ON-CALL
The groups have been listed on the OMA website, and your hospital has been notified and is in the process or has signed off on said groups.
The big issue is that although new groups were added, groups were expanded, and overall increases (guaranteeing no decreases) occurred, a number of our subspecialty colleagues were denied applications for separate call groups. When known, this had been brought to the OMA for consideration and the response is if there is money left over it will be assessed, but in all likelihood, will not realistically be an option until the next PSA.
I have asked about accountability for BBOC, as well as timing of reassessment for numbers and in particular, allocation into different groups but have as yet not received a response from the OMA.
BILLING REJECTIONS
The OMA is looking for specific examples of billing rejections of things that used to be paid that now are not, or other seemingly random rejections. Please forward those along and we can send on to the OMA, as they are committed to help remedy those scenarios when they need to escalate beyond the “remittance process” or if there are common themes. For the record, they are well aware of the “3 codes = automatic rejection” phenomenon and are trying to remedy this issue. The MOH is frankly less than concerned.
NOTE: Rejection samples can also be forwarded directly to OMA Senior Lead, Daniel Ostrovskiy (Daniel.ostrovskiy@oma.org).
GENERAL ENQUIRIES
Any questions or concerns, please don’t hesitate to reach out to me or other members of the executive through the OAGS or OMA, and we can forward on to the appropriate channels of the OMA if we are unable to answer your questions or deal with your concerns.
As a reminder, Section emails are sent centrally from the OMA, so please review those before immediately deleting them. They should come from “Section on General Surgery (OMA)” if they are coming from the executive and are specific to us.
Sincerely,
Kevin Lefebvre, MD, FRCSC
OMA Section Chair on General Surgery
| Dr. Kevin Lefebvre, OMA Section Chair on General Surgery, is on staff at the Huron Perth Healthcare Alliance – Stratford General Hospital, Associate Professor, General Surgery, Western University. |