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T457
T457 – T457
OHIP Other Code · Schedule of Benefits
When to Use
- Use T457 for the surgical repair of a ruptured abdominal aortic aneurysm (AAA) when performed as an emergency procedure.
- Apply this code for open surgical management of an aortic aneurysm involving the infrarenal aorta, distinguishing it from endovascular repair (EVAR) codes.
- Select T457 when the procedure involves the replacement of the abdominal aorta with a prosthetic graft due to rupture or symptomatic expansion.
Common Pitfalls
- Billing T457 in conjunction with endovascular aneurysm repair (EVAR) codes is a common audit trigger for duplicate billing of the same anatomical site.
- Failure to include the appropriate emergency premium (e.g., E409) when the procedure is performed outside of scheduled operating hours results in significant underpayment.
- Submitting T457 for elective aneurysm repairs that do not meet the criteria for open surgical intervention often leads to claim rejection or manual review.
Billing Tips
- Ensure the operative report clearly details the extent of the graft placement to justify the use of T457 over less invasive vascular codes.
- Always verify if the procedure qualifies for additional surgical assistant fees or complex modifiers based on the specific patient comorbidities documented in the operative note.
Provider Fee$1,138.64
Specialist Fee$1,138.64
Effective: February 1, 2011
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