All codes
T353
T353 – T353
OHIP Other Code · Schedule of Benefits
When to Use
- Use T353 for the surgical repair of a complete or incomplete cleft palate, typically performed by a plastic surgeon or otolaryngologist.
- Apply this code when the procedure involves the primary closure of the palatal defect, distinguishing it from secondary revisions or pharyngoplasty procedures.
Common Pitfalls
- Do not bill T353 in conjunction with other minor surgical procedures on the same site unless they meet the criteria for multiple procedure rules, as this often triggers manual review.
- Avoid billing T353 if the procedure is a secondary palatal lengthening or revision, as these require specific secondary cleft codes rather than the primary repair code.
Billing Tips
- Ensure the operative report clearly details the extent of the cleft and the specific closure technique used to support the primary repair classification against potential audit queries.
Provider Fee$618.70
Specialist Fee$618.70
Effective: February 1, 2011
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