All codes
T213
T213 – T213
OHIP Other Code · Schedule of Benefits
When to Use
- Use T213 for the surgical repair of a complete or incomplete cleft palate, specifically involving the closure of the palatal defect.
- Apply this code when performing a primary palatoplasty in a pediatric patient to restore anatomical integrity of the hard and soft palate.
Common Pitfalls
- Billing T213 in conjunction with other cleft lip or palate repair codes (e.g., T210 or T212) without ensuring the procedures are distinct and not considered inclusive components of the primary repair.
- Failing to include the necessary diagnostic codes that justify the complexity of the cleft palate repair, which can lead to manual review or rejection by the Ministry.
Billing Tips
- Ensure the operative report clearly delineates the extent of the repair to justify the T213 fee, especially if additional reconstructive maneuvers are performed during the same session.
Provider Fee$1,875.85
Specialist Fee$1,875.85
Effective: February 1, 2011
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