E825 – Nasal bones - open reduction - with mini-plate(s)
OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This is an add-on code to be claimed in addition to F137 (open reduction of nasal bones) when mini-plates are used for fixation. This fee is applicable for each major fracture line that is repaired with a mini-plate. The note on page clarifies that one mini-plate fee should be billed per each major fracture line (e.g., infraorbital, malar-zygomatic, nasal-frontal, LeFort I, LeFort II and III) per major fracture line per side.
When to Use
- Use E825 as an add-on to F137 only when internal fixation with mini-plates is required for complex nasal bone fractures.
- Claim E825 for each distinct major fracture line (e.g., nasal-frontal) that requires stabilization with a mini-plate, up to the maximum allowed per side.
Common Pitfalls
- Billing E825 for simple nasal fracture reductions that do not involve mini-plate fixation, which will lead to audit recovery.
- Over-billing by claiming multiple units of E825 for a single fracture line; the code is restricted to one fee per major fracture line per side.
- Failing to link E825 to the primary procedure F137 on the same claim, which often triggers automatic rejection.
Billing Tips
- Ensure your operative report explicitly identifies each major fracture line treated with a mini-plate to justify the number of E825 units claimed.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
** Where mini-plate(s) are used, one mini-plate fee per each major fracture line (e.g. infraorbital, malar-zygomatic, nasal-frontal, LeFort I, LeFort II and III) (per major fracture line per side) should be billed.
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