All codes
T274
T274 – T274
OHIP Other Code · Schedule of Benefits
When to Use
- Use T274 for the surgical repair of a complete or incomplete cleft palate, typically performed by a plastic or pediatric surgeon.
- Apply this code when performing a primary palatoplasty in a pediatric patient to address velopharyngeal insufficiency or anatomical defects.
Common Pitfalls
- Do not bill T274 in conjunction with secondary revision procedures like pharyngoplasty (T276) unless distinct, separate surgical sites are addressed during the same operative session.
- Avoid billing T274 if the procedure is limited to a minor soft tissue revision; use appropriate minor surgical codes if the criteria for a full palatoplasty are not met.
Billing Tips
- Ensure the operative report explicitly details the complexity of the palatal closure to justify the full fee, as auditors look for evidence of primary repair versus minor revision.
Provider Fee$247.53
Specialist Fee$247.53
Effective: February 1, 2011
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