F026 – Radius and ulnar shaft - open reduction
OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This billing code is for a surgical procedure related to fractures and/or dislocations. The specific anatomical location and type of procedure are not defined in the provided context. As a surgical code, it is eligible for various premiums including those for age, after-hours services, and trauma, subject to the conditions outlined in the OHIP Schedule of Benefits General Preamble. Claims for this service should include the appropriate suffix: 'A' for the surgeon, 'B' for the assistant, and 'C' for the anaesthesiologist.
When to Use
- Use F026 for open reduction and internal fixation (ORIF) of both the radius and ulnar shafts when performed as a single operative session.
- Select F026 when the procedure involves an open approach to address fractures of both forearm bones, distinguishing it from closed reduction codes like F024 or F025.
Common Pitfalls
- Billing F026 in addition to separate codes for radius (F024) and ulna (F025) fractures is considered unbundling and will result in claim rejection.
- Failure to document the specific surgical approach and fixation method can lead to audit recovery, as F026 implies an open procedure rather than percutaneous pinning.
Billing Tips
- If a secondary, unrelated procedure is performed during the same anaesthetic, ensure the major procedure (F026) is listed first to correctly trigger the primary surgical fee and appropriate assistant/anaesthesia units.
Effective: April 1, 2026
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: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
The detailed description for F026 is not present in the provided context. The 'F' prefix generally corresponds to Fracture and Dislocation services. All rules and premiums associated with surgical procedures from the General Preamble are assumed to apply.
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