All codes
T631
T631 – T631
OHIP Other Code · Schedule of Benefits
When to Use
- Use T631 for the initial assessment and treatment of a minor laceration requiring simple closure with sutures or staples.
- Apply this code when managing a single wound that does not require extensive debridement or complex layered closure techniques covered by higher-tier codes.
- Select T631 when the procedure is performed in an office setting for a patient presenting with a superficial cut that is not deep enough to involve underlying structures like tendons or nerves.
Common Pitfalls
- Billing T631 in addition to a minor assessment code (A007) is often rejected unless the laceration repair is the primary reason for the visit and documented as a separate procedure.
- Attempting to bill T631 for multiple wounds can lead to audit flags; use the appropriate multiple-wound modifiers or higher-value codes if the total length or complexity exceeds the scope of a single T631.
- Failure to document the specific length of the laceration can result in a reversal if the Ministry determines the wound complexity warranted a different procedural code.
Billing Tips
- Ensure the clinical note explicitly states the number of sutures or staples used, as this supports the classification of the procedure as a simple repair under T631.
- If the laceration repair is performed during a visit where another unrelated issue is addressed, bill the assessment code with the appropriate diagnostic code and append the procedure code to the claim.
Provider Fee$16.77
Specialist Fee$20.10
Effective: April 1, 2025
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