All codes
T386
T386 – T386
OHIP Other Code · Schedule of Benefits
When to Use
- Use T386 for the surgical repair of a complex or extensive abdominal wall hernia requiring mesh reinforcement or significant tissue reconstruction.
- Select T386 when the procedure involves a recurrent hernia or a large incisional hernia that necessitates a more comprehensive operative approach than the standard repair covered under T384 or T385.
Common Pitfalls
- Billing T386 in conjunction with other hernia repair codes for the same anatomical site will trigger an automatic rejection for unbundling.
- Failure to document the specific complexity or the use of prosthetic mesh can lead to audit recovery if the claim is downgraded to a lower-valued hernia code.
Billing Tips
- Ensure the operative report explicitly details the complexity of the dissection and the specific technique used to justify the higher fee compared to standard hernia repair codes.
Provider Fee$2,062.08
Specialist Fee$2,062.08
Effective: April 1, 2025
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