F025 – Radius and ulnar shaft - closed reduction
OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This code represents a surgical procedure listed in the Musculoskeletal System section of the Schedule of Benefits. Specific procedural details are not available in the provided context. Billing requires the use of appropriate suffixes: 'A' for the operating surgeon, 'B' for the assistant, and 'C' for the anaesthetist (as per ). Payment for assistant and anaesthetist services is calculated based on basic units and time-based units as described in the General Preamble (, ).
When to Use
- Use F025 for the closed reduction of both radius and ulnar shaft fractures when no internal fixation is performed.
- Use this code for pediatric forearm fractures where closed reduction and casting are sufficient to achieve acceptable alignment.
Common Pitfalls
- Do not bill F025 if open reduction and internal fixation (ORIF) is performed; use the appropriate open reduction code instead.
- Avoid billing a separate fracture consultation fee on the same day as F025, as the surgical fee includes the major pre-operative assessment.
- Do not bill F025 in addition to a cast application code, as the application of the initial cast is considered part of the surgical procedure.
Billing Tips
- Ensure the operative report clearly describes the reduction maneuver to support the use of F025 over a simple fracture management code.
- If the patient requires a trauma premium (E420), ensure the Injury Severity Score (ISS) is explicitly documented in the chart to prevent audit recovery.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
All insured services must be documented in appropriate records. The Act requires that the record establish that: an insured service was provided; the service for which the account is submitted is the service that was rendered; and the service was medically necessary.
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