All codes
T533
T533 – T533
OHIP Other Code · Schedule of Benefits
When to Use
- Use T533 for the surgical repair of a complete third-degree perineal laceration involving the anal sphincter and rectal mucosa during delivery.
- Apply this code when performing a formal secondary repair of a breakdown of a previous third-degree perineal tear that requires extensive reconstruction.
Common Pitfalls
- Billing T533 in conjunction with a standard delivery code (e.g., S410) is often flagged; ensure the documentation clearly indicates the repair was distinct and complex, not part of a routine episiotomy or minor laceration repair.
- Submitting T533 for a second-degree laceration is a common audit trigger; second-degree repairs should be billed under the appropriate minor laceration codes rather than this major reconstructive fee.
Billing Tips
- Ensure the operative report explicitly describes the involvement of the rectal mucosa and the specific technique used for the anal sphincter reconstruction to justify the high-value fee.
Provider Fee$1,127.33
Specialist Fee$1,127.33
Effective: February 1, 2011
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