All codes
T409
T409 – T409
OHIP Other Code · Schedule of Benefits
When to Use
- Use T409 for the surgical repair of a complex or recurrent ventral/incisional hernia where the complexity necessitates a high-value procedural code.
- Select T409 when the procedure involves extensive adhesiolysis or mesh reconstruction that exceeds the scope of standard hernia repair codes like T405 or T406.
Common Pitfalls
- Billing T409 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 recurrent nature of the hernia often leads to audit downgrades to lower-valued hernia repair codes.
Billing Tips
- Ensure the operative report explicitly details the complexity of the dissection and the specific technique used to justify the high-value fee associated with T409.
Provider Fee$1,773.06
Specialist Fee$1,773.06
Effective: April 1, 2025
Since Apr 2004, this fee has increased 28.0% vs 57.0% CPI inflation
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