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F005
F005 – Phalanx - closed reduction
OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Represents the closed reduction of a fracture of a phalanx (a bone in the finger or toe). This procedure does not involve a surgical incision to expose the bone. An additional fee, E584, may be claimed for the application of a plaster cast if performed outside of a hospital. Use E558 for each additional phalanx fracture reduction.
When to Use
- Use F005 for the closed reduction of a single displaced phalanx fracture where no surgical incision is required to manipulate the bone fragments.
- Use F005 in conjunction with E558 when multiple phalanx fractures are reduced during the same operative session.
Common Pitfalls
- Claiming E584 for cast application when the procedure is performed in a hospital setting; E584 is strictly for office-based procedures.
- Attempting to bill F005 for open reductions, which require different surgical codes; F005 is exclusively for closed, non-incisional reductions.
- Failing to document the specific number of phalanges reduced, leading to missed revenue from E558 for additional fractures.
Billing Tips
- Always append E584 as a separate line item on the same claim when applying a plaster cast in your office to ensure the $11.15 add-on is captured.
- Ensure the primary procedure F005 is listed first on the claim, followed by E558 for each additional phalanx to prevent automated rejection.
Provider Fee$99.25
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
Effective: April 1, 2025
Since Oct 2005, this fee has increased 0.0% vs 51.4% CPI inflation
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
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