All codes
T266
T266 – T266
OHIP Other Code · Schedule of Benefits
When to Use
- Use T266 for the surgical repair of a ruptured or lacerated globe where the injury involves the sclera or cornea requiring complex microsurgical closure.
- Select T266 when performing a primary repair of a penetrating ocular injury that necessitates formal debridement and multi-layered suturing of the ocular wall.
Common Pitfalls
- Billing T266 in conjunction with minor ocular procedures like superficial foreign body removal (E020) is considered unbundling and will trigger a rejection.
- Failing to document the specific depth and extent of the ocular wall involvement often leads to audit recovery, as T266 is reserved for full-thickness or complex injuries.
Billing Tips
- If the procedure requires an operating room setting, ensure you append the appropriate facility code, as T266 is a high-value surgical fee that assumes significant resource utilization.
Provider Fee$247.53
Specialist Fee$247.53
Effective: February 1, 2011
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