All codes
T540
T540 – T540
OHIP Other Code · Schedule of Benefits
When to Use
- Use T540 for the definitive 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, including the mobilization of mucoperiosteal flaps and muscle reconstruction.
Common Pitfalls
- Do not bill T540 in conjunction with minor palatal revisions or secondary procedures; use the appropriate secondary cleft repair codes instead.
- Avoid billing T540 if the procedure is limited to a simple palatal fistula repair, as this is considered a distinct and less complex service.
Billing Tips
- Ensure the operative report clearly details the extent of the cleft and the specific techniques used for closure to justify the full fee of T540 during potential audits.
Provider Fee$913.14
Specialist Fee$913.14
Effective: February 1, 2011
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