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T550
T550 – T550
OHIP Other Code · Schedule of Benefits
When to Use
- Use T550 for the 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 primary closure of the palatal defect, distinguishing it from secondary revisions or pharyngoplasty procedures.
Common Pitfalls
- Billing T550 in conjunction with other minor surgical procedures that are considered bundled into the global surgical fee of a major palatoplasty.
- Failing to account for the global period, which prevents billing for routine post-operative office visits (A007) within the specified timeframe following the procedure.
Billing Tips
- Ensure the operative report clearly details the complexity of the closure to support the use of T550 over lower-valued minor repair codes if audited.
Provider Fee$1,321.18
Specialist Fee$1,321.18
Effective: February 1, 2011
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