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T214
T214 – T214
OHIP Other Code · Schedule of Benefits
When to Use
- Use T214 for the surgical repair of a complete or incomplete cleft palate when performed as a primary procedure.
- Apply this code for secondary palatal surgery if the procedure involves extensive reconstruction beyond simple revision or fistula closure.
Common Pitfalls
- Billing T214 in conjunction with other cleft repair codes like T210 or T212 is often flagged for audit unless distinct anatomical sites or separate surgical sessions are clearly documented.
- Submitting T214 for minor palatal revisions or simple fistula repairs will result in rejection or recovery; use appropriate minor procedure codes for those instances.
Billing Tips
- Ensure the operative report explicitly details the complexity of the palatal reconstruction to justify the high-value fee of T214 over lower-tier surgical codes.
Provider Fee$1,765.50
Specialist Fee$1,765.50
Effective: February 1, 2011
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