F015 – Fracture reduction - open
OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Performs an open reduction for a Bennett's fracture, which is an intra-articular fracture at the base of the first metacarpal bone. This procedure involves surgically exposing the fracture site for direct alignment and fixation. The fee listed is for the surgeon's service (suffix 'A'). When an assistant is required, their service (suffix 'B') is calculated using 6 base units plus time units. The anaesthetist's service (suffix 'C') is calculated using 7 base units plus time units.
When to Use
- Use F015 specifically for an open reduction of a Bennett's fracture requiring surgical exposure for internal fixation.
- Choose F015 over closed reduction codes like F012 or F013 when the procedure involves an incision to directly visualize and reduce the intra-articular fracture.
Common Pitfalls
- Billing F015 for a closed reduction or percutaneous pinning without open surgical exposure will trigger a rejection or audit recovery.
- Failing to document the specific intra-articular nature of the Bennett's fracture can lead to claims being downgraded to a simpler fracture reduction code.
Billing Tips
- Ensure the operative report explicitly describes the open approach and the specific fixation method used to support the F015 claim.
- If the procedure is performed after hours, remember to append the appropriate E409 or E410 premium to the F015 base fee to ensure correct payment.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
The fee for a surgical assistant (suffix 'B') is calculated based on 6 base units plus time units. The fee for an anaesthetist (suffix 'C') is calculated based on 7 base units plus time units. See - and - for unit calculation details.
Age-based premiums () and after-hours premiums () may apply to the surgeon's fee.
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