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T685

T685T685

OHIP Other Code · Schedule of Benefits

When to Use

  • Use T685 for the professional fee associated with the insertion of a permanent pacemaker system, including the generator and leads.
  • Apply this code when performing a primary implantation procedure in an operating room or cardiac catheterization lab setting.

Common Pitfalls

  • Billing T685 alongside G365 or G366 is a common error, as the surgical tray and facility fees are typically handled through the hospital's global budget or separate facility claims.
  • Submitting T685 for a generator-only replacement is incorrect; use the appropriate replacement code instead to avoid claims rejection for incorrect procedure complexity.

Billing Tips

  • Ensure the operative report clearly details the lead placement and testing, as this documentation is required to support the T685 fee during post-payment audits.
Provider Fee$1,600.00
Specialist Fee$1,600.00

Effective: February 1, 2011

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