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T548
T548 – T548
OHIP Other Code · Schedule of Benefits
When to Use
- Use T548 for the definitive surgical repair of a complex abdominal wall hernia, specifically when involving mesh placement or significant reconstruction.
- Select this code over minor hernia repair codes like T540 when the procedure requires extensive dissection or management of recurrent or incarcerated defects.
Common Pitfalls
- Billing T548 in conjunction with an E079 or other minor procedure codes often triggers an automatic rejection for unbundling.
- Failure to document the specific size or complexity of the hernia repair can lead to audit recovery if the claim is downgraded to a lower-valued hernia code.
Billing Tips
- Ensure the operative report clearly details the complexity of the repair to justify the higher fee compared to standard hernia repair codes.
Provider Fee$1,321.18
Specialist Fee$1,321.18
Effective: February 1, 2011
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