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T561

T561T561

OHIP Other Code · Schedule of Benefits

When to Use

  • Use T561 for the primary surgeon's fee for a total hip arthroplasty, including the global surgical period for post-operative care.
  • Select this code when performing a standard elective total hip replacement for osteoarthritis, as it encompasses the entire procedure and routine follow-up.

Common Pitfalls

  • Billing T561 alongside an assistant fee (E860) without ensuring the assistant is actually present and documented, as this is a frequent audit trigger.
  • Attempting to bill additional minor procedures performed during the same operative session that are considered integral to the total hip arthroplasty, which will result in automatic rejection.

Billing Tips

  • Ensure the operative report clearly details the complexity of the arthroplasty to justify the global fee if queried during a post-payment review.
Provider Fee$1,321.18
Specialist Fee$1,321.18

Effective: February 1, 2011

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