All codes
T471
T471 – T471
OHIP Other Code · Schedule of Benefits
When to Use
- Use T471 for the primary surgeon's fee for a total hip arthroplasty, including the insertion of a prosthesis.
- Apply this code when performing a standard elective primary total hip replacement for osteoarthritis or avascular necrosis.
- Use this code for the definitive procedure when the surgery involves both the acetabular and femoral components.
Common Pitfalls
- Billing T471 in conjunction with Z471 is a common error, as the latter is a diagnostic code and not a procedural add-on.
- Attempting to bill additional components of the hip procedure separately will result in rejection, as T471 is a comprehensive fee.
- Failure to document the specific implant type or approach can lead to audit failures if the claim is reviewed for medical necessity.
Billing Tips
- Ensure that any applicable premiums, such as the Age Premium or After Hours premiums, are appended correctly to the T471 claim to maximize the total reimbursement.
- If a revision is performed instead of a primary replacement, use the appropriate revision-specific codes rather than T471 to avoid claim rejection.
Provider Fee$684.97
Specialist Fee$684.97
Effective: April 1, 2025
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