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E560
E560 – Phalanx fracture - each additional
OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This is an add-on fee payable for each additional phalanx fracture of the foot treated with rigid immobilization but without reduction. This code must be billed in conjunction with F056 (Phalanx - no reduction - rigid immobilization). This service is listed under the Musculoskeletal System Surgical Procedures for the foot and ankle.
When to Use
- Use E560 when treating a patient with multiple phalanx fractures of the foot where the primary fracture is billed under F056 and subsequent fractures are managed with rigid immobilization without reduction.
- Apply this code for each additional toe fracture beyond the first one when the clinical management for all fractures involves only rigid immobilization (e.g., buddy taping or splinting) without the need for manual reduction.
Common Pitfalls
- Billing E560 as a standalone code; it is strictly an add-on and will be rejected if not submitted on the same claim as F056.
- Attempting to bill E560 when a reduction was performed; if reduction is required, you must use the appropriate reduction codes (e.g., F058) rather than the non-reduction F056/E560 pairing.
- Miscalculating the number of units; ensure the number of E560 units corresponds exactly to the number of additional fractured phalanges treated beyond the primary one.
Billing Tips
- If the procedure is performed in your office, remember to add E584 if a plaster cast is applied, as this is a separate eligible add-on for fracture management.
- Always ensure the primary code F056 is the first line item on your claim to avoid automatic rejection of the E560 add-on.
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