All codes
T212
T212 – T212
OHIP Other Code · Schedule of Benefits
When to Use
- Use T212 for the surgical repair of a complete or incomplete cleft palate when performed as a primary procedure.
- Use this code for secondary palatal surgery when the clinical documentation confirms a formal revision or reconstruction of the palate following a previous failed or incomplete repair.
Common Pitfalls
- Billing T212 in conjunction with other minor surgical procedures that are considered integral to the palatoplasty, which will trigger a rejection for unbundling.
- Failing to include the appropriate diagnostic code for congenital cleft palate, which may lead to manual review or rejection by the Ministry.
Billing Tips
- Ensure that the operative report clearly details the complexity of the tissue mobilization and closure to justify the high-value fee if audited against standard minor repairs.
Provider Fee$1,379.30
Specialist Fee$1,379.30
Effective: February 1, 2011
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