All codes
T265
T265 – T265
OHIP Other Code · Schedule of Benefits
When to Use
- Use T265 for the surgical repair of a laceration of the eyelid involving the margin, requiring precise anatomical reconstruction.
- Apply this code for full-thickness eyelid lacerations that necessitate layered closure to prevent post-operative notching or lagophthalmos.
Common Pitfalls
- Billing T265 in conjunction with a minor procedure code like E542 is often rejected as the repair is considered inclusive of the primary surgical intervention.
- Submitting T265 for simple superficial skin lacerations that do not involve the eyelid margin is a common audit trigger; use standard minor laceration codes (e.g., Z001) for those cases.
Billing Tips
- Ensure the operative report explicitly describes the involvement of the eyelid margin to justify the higher complexity fee compared to standard skin repair codes.
Provider Fee$274.34
Specialist Fee$274.34
Effective: February 1, 2011
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