F021 – Osteochondral radial or ulnar fracture and/or isolated radial styloid fracture - open reduction
OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Open surgical repair of a fracture involving both the articular cartilage and underlying bone, typically within the elbow and forearm. This procedure is eligible for assistant and anaesthesia fees, with specific base units assigned for each role (Asst: 6, Anae: 7) as listed in the Schedule of Benefits. Refer to (PDF page ).
When to Use
- Use F021 for open reduction of an isolated radial styloid fracture when internal fixation is required.
- Use F021 for surgical repair of osteochondral fractures involving the articular surface of the distal radius or ulna, distinct from general distal radius fracture codes like F023.
- Use F021 when the procedure involves open reduction of an intra-articular osteochondral fragment in the forearm, provided it does not meet the criteria for more complex multi-fragmentary fracture codes.
Common Pitfalls
- Billing F021 alongside other fracture fixation codes for the same anatomical site is often rejected as unbundling; ensure the procedure is distinct.
- Failure to document the Injury Severity Score (ISS) in the clinical record will result in a clawback of the E420 trauma premium if audited.
- Confusing F021 with F023 (Distal radius fracture) can lead to payment discrepancies; F021 is specific to osteochondral or isolated styloid injuries.
Billing Tips
- Ensure the surgical assistant and anaesthesiologist use the corresponding suffix codes (F021B and F021C) to trigger the correct base unit calculations.
- Verify that the 'major pre-operative visit' is claimed separately if the decision to operate was made during a distinct assessment, as the standard hospital admission assessment is included in the F021 fee.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
When claiming the trauma premium (E420), the medical record must list the Injury Severity Score (ISS).
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