E063 – Add-on for open reduction of AO/OTA Group C distal radial fracture with dorsal and volar internal fixation.
OHIP Surgical Assists Code · Schedule of Benefits
This code is a percentage-based add-on to fee code F030. It applies to the open reduction of an AO/OTA Group C complete intra-articular distal radial fracture when the procedure requires both dorsal and volar internal fixation.
When to Use
- Use E063 as an add-on to F030 when treating a complete articular (AO/OTA Group C) distal radial fracture that necessitates a dual-approach (dorsal and volar) internal fixation.
- Apply this code specifically when the complexity of the articular comminution requires both plates to achieve stable reduction, distinguishing it from standard F030 procedures using a single approach.
Common Pitfalls
- Billing E063 for AO/OTA Group A or B fractures, which do not meet the complete articular criteria required for this add-on.
- Failing to explicitly document the use of both dorsal and volar plates in the operative report, which leads to automatic rejection during audit.
- Attempting to bill E063 alongside F021, which is a restricted code and will result in a claim rejection.
Billing Tips
- Ensure the operative note clearly references the AO/OTA Group C classification and details the specific hardware placement for both the dorsal and volar surfaces to justify the add-on.
- When performing the surgery after-hours, calculate your E409 or E410 premiums based on the combined total of F030 and E063 to maximize the percentage-based increase.
Effective: April 1, 2026
Surgery
Premium
Both dorsal and volar internal fixation must be described in the operative report to be eligible for payment.
The fracture must meet the AO/OTA Group C criteria: a complete articular fracture.
AO/OTA Classification for distal radial fractures: A – extra-articular; B – partial articular; C – complete articular.
E063 is specifically for Group C fractures requiring dual-surface fixation.
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