All codes
T554
T554 – T554
OHIP Other Code · Schedule of Benefits
When to Use
- Use T554 for the surgical repair of a complete third-degree perineal laceration involving the anal sphincter and rectal mucosa.
- Apply this code when performing a secondary repair of a complex obstetric perineal injury that requires formal reconstruction of the anal canal.
Common Pitfalls
- Billing T554 in conjunction with a standard delivery code (e.g., S400) is often flagged; ensure the clinical note clearly distinguishes the complexity of the repair from routine episiotomy or minor laceration management.
- Submitting T554 for a second-degree laceration is a common audit trigger; use the appropriate minor repair codes instead to avoid recovery of funds.
Billing Tips
- Ensure the operative report explicitly describes the involvement of the rectal mucosa and the specific layers of the anal sphincter repaired to justify the high-value fee of T554.
Provider Fee$1,493.09
Specialist Fee$1,493.09
Effective: February 1, 2011
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