F030 – Radius - distal - open reduction, other than isolated radial styloid fracture
OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This code represents a surgical procedure on the integumentary system. As a surgical service, it includes all constituent and common elements of insured services as outlined in the General Preamble (-). Payment is based on the role of the physician: * Surgeon (Suffix A): The listed fee for the procedure. * Surgical Assistant (Suffix B): Fee is calculated based on basic units plus time units as described in and . * Anaesthetist (Suffix C): Fee is calculated based on basic units plus time units as described in and . This procedure may be eligible for various add-on premiums for age, after-hours services, and trauma, as specified in the General Preamble.
When to Use
- Use F030 for open reduction and internal fixation (ORIF) of intra-articular or extra-articular distal radius fractures that require surgical exposure.
- Select F030 over F033 or F036 when the primary surgical focus is the distal radius, provided the fracture is not an isolated radial styloid fracture.
Common Pitfalls
- Billing F030 in conjunction with E064 when the ulnar procedure is a simple closed reduction, as E064 specifically requires an open reduction of the distal ulna or DRUJ repair.
- Attempting to bill a hospital admission assessment separately; this is disallowed under GP40 unless it qualifies as the major pre-operative assessment where the decision to operate was finalized.
Billing Tips
- Always append the appropriate suffix (A for surgeon, B for assistant, C for anaesthetist) to ensure the claim processes against the correct fee schedule.
Effective: April 1, 2026
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Integumentary 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.
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