F023 – Open reduction of ulna plus closed reduction radial head (Monteggia fracture)
OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Represents a surgical procedure on the musculoskeletal system. The specific details, including the exact nature of the procedure, are described in the Musculoskeletal System section of the OHIP Schedule of Benefits. As a surgical service, it includes pre-operative and post-operative care as defined in the General Preamble. This service is eligible for billing by the surgeon (suffix A), an assistant (suffix B), and an anaesthetist (suffix C), with fees for the assistant and anaesthetist calculated based on basic and time units. Refer to the specific listing for F023 on page for complete details.
When to Use
- Use F023 specifically for a Monteggia fracture involving an open reduction of the ulnar shaft fracture combined with a closed reduction of the associated radial head dislocation.
- Do not use F023 if the radial head also requires an open reduction; in that scenario, you must bill the appropriate open reduction code for the radial head in addition to the ulnar procedure.
Common Pitfalls
- Billing F023 when both the ulna and radial head require open reduction, which constitutes a more complex procedure than the code describes.
- Failing to document the specific nature of the radial head reduction as 'closed' in the operative report, which may lead to audit scrutiny regarding the appropriateness of the code selection.
Billing Tips
- Ensure the operative report clearly distinguishes the open reduction of the ulna from the closed reduction of the radial head to justify the use of F023 over separate fracture management codes.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures, Surgical Assistants' Services, Anaesthesiologists' Services
All insured services must be documented in appropriate medical records to establish that the service was provided, is the service for which the account is submitted, and was medically necessary, as per .
The specific procedure description, basic units for anaesthesia, and basic units for assistant for F023 are listed in the Musculoskeletal System section of the Schedule of Benefits (page ), which was not provided in the context.
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