All codes
T260
T260 – T260
OHIP Other Code · Schedule of Benefits
When to Use
- Use T260 for the definitive surgical repair of a laceration involving the eyelid margin, specifically when the repair requires meticulous multi-layer closure to maintain lid integrity.
- Select T260 when performing a full-thickness eyelid laceration repair that involves the tarsus, as this distinguishes the procedure from simple skin-only closures billed under minor laceration codes.
Common Pitfalls
- Billing T260 in conjunction with a general laceration repair code (e.g., G372) is considered unbundling and will result in a rejection for the lesser service.
- Failing to document the involvement of the eyelid margin or tarsus often leads to audit downgrades, as the Ministry expects evidence of complexity justifying the higher fee compared to simple suturing.
Billing Tips
- Ensure the operative report explicitly describes the reconstruction of the lid margin or tarsal plate to support the T260 claim during a post-payment review.
Provider Fee$168.35
Specialist Fee$168.35
Effective: February 1, 2011
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