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T454

T454T454

OHIP Other Code · Schedule of Benefits

When to Use

  • Use T454 for the surgical repair of a complete or incomplete rupture of the Achilles tendon.
  • Apply this code when performing an open primary repair of an acute Achilles tendon rupture in an operating room setting.

Common Pitfalls

  • Do not bill T454 in conjunction with minor surgical procedures or local debridement codes that are considered integral to the primary repair.
  • Avoid billing T454 if the procedure is performed percutaneously, as this may require a different code or a specific manual assessment depending on the surgical technique used.

Billing Tips

  • Ensure the operative report clearly documents the open nature of the repair to justify the T454 fee over less invasive procedural codes.
  • If additional procedures are performed during the same operative session, verify the Schedule of Benefits for applicable multiple procedure rules or potential fee reductions.
Provider Fee$331.76
Specialist Fee$331.76

Effective: February 1, 2011

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