All codes
T545
T545 – T545
OHIP Other Code · Schedule of Benefits
When to Use
- Use T545 for the definitive surgical repair of a complete or incomplete cleft palate, typically performed by a plastic surgeon or otolaryngologist.
- Apply this code when performing a primary palatoplasty in a pediatric patient to address velopharyngeal insufficiency or anatomical clefting.
Common Pitfalls
- Billing T545 in conjunction with other major surgical procedures without ensuring the second procedure is eligible for 100%/50% or 100%/75% fee reduction rules.
- Submitting T545 for minor revisions or secondary procedures that are more appropriately billed under specific revision codes or minor surgical fee codes.
Billing Tips
- Ensure the operative report clearly details the complexity of the palatal closure to justify the high-value fee if audited against standard minor surgical codes.
Provider Fee$564.84
Specialist Fee$564.84
Effective: February 1, 2011
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