All codes
T558
T558 – T558
OHIP Other Code · Schedule of Benefits
When to Use
- Use T558 for the surgical repair of a complete or incomplete rectal prolapse via the abdominal approach (rectopexy).
- Select this code when performing a laparoscopic or open abdominal fixation of the rectum, distinguishing it from perineal approaches like the Altemeier procedure (T557).
Common Pitfalls
- Billing T558 in conjunction with a bowel resection (e.g., Z511) without clear documentation of medical necessity for the additional procedure, which may trigger a manual review.
- Attempting to bill T558 alongside a diagnostic laparoscopy (Z960) is considered unbundling, as the diagnostic component is included in the global fee for the definitive repair.
Billing Tips
- Ensure the operative report explicitly details the fixation technique used, as the Ministry may audit to confirm the procedure meets the definition of an abdominal rectopexy rather than a simple mucosal resection.
Provider Fee$1,178.79
Specialist Fee$1,178.79
Effective: February 1, 2011
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