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T594

T594T594

OHIP Other Code · Schedule of Benefits

When to Use

  • Use T594 for the professional fee associated with a therapeutic abortion performed via dilation and evacuation (D&E) in a hospital or clinic setting.
  • Select this code when the procedure involves the surgical termination of pregnancy beyond the first trimester, typically between 14 and 20 weeks gestation.

Common Pitfalls

  • Do not bill T594 in conjunction with a standard office visit fee (A007) on the same day, as the global fee for the procedure is intended to cover the immediate pre-operative and post-operative assessment.
  • Avoid billing T594 if the procedure is performed as a medical abortion using pharmacological agents, as this code specifically requires a surgical intervention.

Billing Tips

  • Ensure the associated diagnostic code reflects the indication for the procedure, such as ICD-9 635, to avoid automatic rejections during the claim adjudication process.
  • If an ultrasound is performed immediately prior to the procedure to confirm gestational age, it is generally considered part of the global surgical fee and should not be billed separately.
Provider Fee$491.17
Specialist Fee$491.17

Effective: February 1, 2011

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