All codes
T382
T382 – T382
OHIP Other Code · Schedule of Benefits
When to Use
- Use T382 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 closure of the palatal defect, distinct from secondary procedures like pharyngoplasty or fistula repair.
Common Pitfalls
- Billing T382 in conjunction with other major palatal procedures without clear documentation of distinct surgical sites or separate clinical indications may trigger a rejection for unbundling.
- Failure to include the appropriate diagnostic code for congenital cleft palate can lead to automatic claim rejection by the Ministry of Health.
Billing Tips
- Ensure that the operative report explicitly details the complexity of the closure to support the high-value fee associated with this code during potential post-payment audits.
Provider Fee$1,175.92
Specialist Fee$1,175.92
Effective: April 1, 2025
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