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T489
T489 – T489
OHIP Other Code · Schedule of Benefits
When to Use
- Use T489 for the surgical repair of a complex or recurrent inguinal hernia, specifically when the procedure involves mesh placement or extensive dissection that exceeds the scope of standard hernia repair codes.
- Select T489 when performing a bilateral inguinal hernia repair in a single operative session, as it is designed to capture the increased complexity and time associated with dual-site intervention.
Common Pitfalls
- Billing T489 in conjunction with other hernia repair codes like T487 or T488 is a common cause for rejection, as the Ministry considers these bundled into the comprehensive T489 fee.
- Failing to include the appropriate diagnostic code for recurrent hernia can trigger an audit, as the higher fee for T489 is predicated on the increased difficulty of secondary surgical intervention.
Billing Tips
- Ensure the operative report explicitly details the complexity of the dissection or the use of mesh, as this documentation is required to justify the higher reimbursement of T489 over standard repair codes.
Provider Fee$782.63
Specialist Fee$897.10
Effective: April 1, 2025
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