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F035
F035 – Olecranon - closed reduction
OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Olecranon - closed reduction. This is a surgical procedure. As per the general payment rules, claims should be submitted with the appropriate suffix: 'A' for the surgeon, 'B' for the assistant, and 'C' for the anaesthetist. Fee calculations for assistants and anaesthetists are based on basic and time units as outlined in the Schedule of Benefits (see : and :).
When to Use
- Use F035 when performing a closed reduction of an olecranon fracture without internal fixation.
- Use F035 for manual manipulation of a displaced olecranon fracture in the emergency department or operating room setting.
Common Pitfalls
- Billing F035 in addition to an open reduction procedure (e.g., F036) is considered unbundling and will be rejected as the closed reduction is included in the open procedure.
- Failing to include the required 'A' suffix on the claim will result in an automatic rejection by the Ministry.
- Billing F035 for a simple assessment or splinting without an actual reduction maneuver is an audit risk for misrepresentation of service.
Billing Tips
- If the procedure is performed after hours, ensure you append the appropriate premium code (E409 or E410) to the claim to receive the 50% or 75% increase on the surgeon's fee.
- Always document the specific reduction maneuver and post-reduction radiographic confirmation in the chart to support the claim in the event of a post-payment audit.
Provider Fee$129.00
Surgical Assistant Fee$75.06
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
Effective: April 1, 2025
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
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