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Billing code

P042A — Caesarean Section Including Hysterectomy

Caesarean with hysterectomy

Bill P042 for a caesarean section that includes a hysterectomy.

Watch for: For multiple caesarean births, bill P042 once, then E499 for the second baby and E500 for each later one.

Code

P042A

Description

Caesarean Section Including Hysterectomy

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Apr 1, 2026

Termination date

No end date

Explanation

Updated October 26, 2026

Caesarean section that includes a hysterectomy.

What it covers

P042 is a caesarean section including hysterectomy (K6).

Delivery services have the specific elements of independent operative procedures marked # (K1, SP1). Surgical assistant and anaesthesia basic units are listed for P042 (K6).

Billing rules

• Multiple deliveries by caesarean only: P042 for the first, E499 for the second, and E500 for the third and each later delivery (K6).
• Between 20 and 23 weeks, multiple caesarean deliveries pay P042 plus E499 for the second; E500 is not payable for later ones (K6).
• Vaginal delivery of the first infant followed by caesarean: P042 plus 85% of P006 or P020, and E500 for the third and later deliveries (K6).
• If all fetuses are known to be stillborn, only one delivery code is payable (K6).
• Add E414 when at least one condition is present: fetal prematurity (<32 weeks), severe pregnancy-induced hypertension, IUGR below the 10th percentile, or significant placental insufficiency shown by absent umbilical flow or reversed S/D ratio (K8).
• Add E409 (+50%, weekday evenings and weekend/holiday days) or E410 (+75%, nights) when the delivery is non-elective, or elective but delayed into that period by an emergency (GP103–GP104).
• C989 can be added for the first obstetrical delivery of the calendar day when it required sacrifice of office hours (K7).
• E411 sole delivery premium is not listed for P042 (K7).

Often billed with

• E499 second caesarean delivery (K6).
• E414 high risk obstetrical premium (K8).
• E409/E410 after-hours premium (GP104).

Related codes: P018, P041, E499, E500, E414, C989

Source: Schedule of Benefits (July 1, 2026), Obstetrics, Labour - Delivery, page K6.

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