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T456

T456T456

OHIP Other Code · Schedule of Benefits

When to Use

  • Use T456 for the surgical repair of a complete or incomplete rupture of the Achilles tendon, typically performed in an operating room setting.
  • Select T456 when performing an open repair of an acute Achilles tendon rupture, as opposed to percutaneous techniques which may fall under different procedural codes.

Common Pitfalls

  • Billing T456 in conjunction with an assessment code (A007) on the same day is generally rejected unless a separate, unrelated clinical issue is addressed and documented.
  • Failing to include the appropriate diagnostic code for the tendon rupture (e.g., ICD-727.67) will result in an automatic claim rejection.

Billing Tips

  • Ensure that the operative report clearly details the open nature of the repair to justify the T456 fee over minor procedure codes like S062.
Provider Fee$771.14
Specialist Fee$771.14

Effective: February 1, 2011

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