All codes
T514
T514 – T514
OHIP Other Code · Schedule of Benefits
When to Use
- Use T514 for the surgical repair of a complete third-degree perineal laceration involving the anal sphincter and rectal mucosa.
- Apply this code when performing a formal repair of a fourth-degree obstetric tear in the delivery room or operating theatre following vaginal delivery.
- Select T514 instead of standard episiotomy repair codes when the extent of the injury specifically involves the disruption of the anal canal.
Common Pitfalls
- Billing T514 in addition to a standard vaginal delivery fee (E842) is often flagged if the documentation does not explicitly describe the involvement of the rectal mucosa.
- Submitting T514 alongside minor perineal repair codes like T512 is considered double-billing, as the higher-value code is intended to encompass the complexity of the repair.
- Failure to document the specific degree of the tear (fourth-degree) will lead to automatic rejection or recovery during a post-payment audit.
Billing Tips
- Ensure the operative note clearly distinguishes the repair of the anal sphincter from the rectal mucosa to justify the use of T514 over lower-tier laceration codes.
- If the repair is performed under general or regional anesthesia in an operating room, ensure the facility code is correctly linked to avoid processing delays.
Provider Fee$783.00
Specialist Fee$783.00
Effective: February 1, 2011
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.