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T689

T689T689

OHIP Other Code · Schedule of Benefits

When to Use

  • Use T689 for the professional fee associated with a specific complex surgical procedure as defined in the Schedule of Benefits, typically involving major reconstructive or specialized organ-based interventions.
  • Apply this code when the clinical documentation confirms the completion of the full procedure scope, distinguishing it from partial or diagnostic-only codes like T688 or T690.

Common Pitfalls

  • Billing T689 in conjunction with other surgical codes that are already included in the global fee structure, which will trigger automatic rejection for unbundling.
  • Failing to append the required diagnostic code that justifies the medical necessity of a high-value procedure, leading to manual review or audit flags.

Billing Tips

  • Ensure that any additional intraoperative services that are not part of the T689 global period are billed with the appropriate 'M' prefix or modifier to avoid claim denial.
Provider Fee$1,600.00
Specialist Fee$1,600.00

Effective: February 1, 2011

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