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T455
T455 – T455
OHIP Other Code · Schedule of Benefits
When to Use
- Use T455 for the primary repair of a ruptured abdominal aortic aneurysm (AAA) when performed as an open surgical procedure.
- Select T455 instead of endovascular codes like E840 when the clinical requirement necessitates a traditional laparotomy and graft replacement.
Common Pitfalls
- Billing T455 in conjunction with other vascular procedures that are considered inclusive under the Schedule of Benefits for Physician Services, leading to automatic claim rejection.
- Failing to account for the 'major procedure' rule when T455 is performed alongside minor procedures, which may result in the reduction of the secondary fee to 50% or 75%.
Billing Tips
- Ensure that the operative report clearly details the extent of the aortic involvement to justify the complexity of the T455 procedure during potential post-payment audits.
Provider Fee$529.45
Specialist Fee$529.45
Effective: February 1, 2011
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