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T547

T547T547

OHIP Other Code · Schedule of Benefits

When to Use

  • Use T547 for the surgical excision of a malignant lesion of the eyelid requiring a full-thickness wedge resection or similar complex reconstruction.
  • Apply this code when the procedure involves a significant reconstructive component that exceeds the scope of a simple excision billed under E547 or similar minor surgery codes.

Common Pitfalls

  • Billing T547 in conjunction with minor excision codes for the same lesion will trigger a rejection for duplicate service or unbundling.
  • Failure to document the specific dimensions and the complexity of the reconstruction often leads to claim downgrades during post-payment audits.

Billing Tips

  • Ensure the operative report clearly details the reconstructive technique used, as this justifies the higher fee compared to standard excision codes.
Provider Fee$1,321.18
Specialist Fee$1,321.18

Effective: February 1, 2011

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