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T359

T359T359

OHIP Other Code · Schedule of Benefits

When to Use

  • Use T359 for the surgical excision of a malignant lesion of the skin or mucous membrane where the defect requires a complex reconstruction, such as a rotational or advancement flap.
  • Select T359 instead of simple excision codes like S061 when the clinical documentation confirms the complexity of the tissue rearrangement required for closure.

Common Pitfalls

  • Billing T359 in conjunction with simple closure codes is a common audit trigger, as the complexity of the flap is already factored into the T359 fee.
  • Submitting T359 for a standard elliptical excision with primary closure will result in a rejection or recovery, as this does not meet the criteria for complex reconstruction.

Billing Tips

  • Ensure your operative report explicitly describes the flap design and the specific surgical technique used to mobilize the tissue, as this is the primary documentation required to justify the higher fee over standard excision codes.
Provider Fee$1,074.66
Specialist Fee$1,074.66

Effective: April 1, 2025

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