All codes
T551
T551 – T551
OHIP Other Code · Schedule of Benefits
When to Use
- Use T551 for the primary surgeon performing a definitive repair of a ruptured or lacerated diaphragm, typically following significant blunt or penetrating trauma.
- Apply this code when the procedure is performed via laparotomy or thoracotomy as the definitive surgical intervention for diaphragmatic injury.
Common Pitfalls
- Do not bill T551 in conjunction with other major abdominal or thoracic procedures unless the diaphragmatic repair is a distinct, separate injury requiring a separate incision or extensive additional work.
- Avoid billing T551 for minor diaphragmatic defects or incidental findings discovered during unrelated surgery, as these are often considered part of the primary procedure's global fee.
Billing Tips
- Ensure the operative report clearly details the extent of the diaphragmatic defect and the complexity of the repair to justify the high-value fee if audited against standard trauma codes.
Provider Fee$1,321.18
Specialist Fee$1,321.18
Effective: February 1, 2011
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