F036 – Olecranon - open reduction
OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
The specific details for billing code F036 are not available in the provided context from target page . It is identified as a surgical procedure due to its fee structure, which includes provider, assistant, and anaesthetist fees, and eligibility for A, B, and C suffixes. As a surgical procedure, the service includes common and specific elements as defined in the Schedule of Benefits. This typically includes the pre-operative evaluation where the decision to operate is made, the surgical procedure itself, and normal post-operative care. For surgical assistants, the service includes preparation, assistance, recovery room procedures, and post-procedure monitoring until the first post-operative visit (). For anaesthetists, it includes pre-anaesthetic evaluation, the anaesthetic procedure, and post-anaesthetic follow-up ().
When to Use
- Use F036 for open reduction and internal fixation (ORIF) of displaced olecranon fractures requiring surgical stabilization.
- Choose F036 when performing open reduction of non-union or malunion of the olecranon that requires hardware revision or bone grafting.
- Use F036 for complex olecranon fractures that cannot be managed with closed reduction or percutaneous pinning (F033).
Common Pitfalls
- Billing a hospital admission assessment (A005/A007) on the same day as F036 is a common rejection; only the major pre-operative visit is permitted.
- Failing to apply the multiple procedure rule when performing additional procedures (e.g., radial head excision) during the same operative session will lead to audit adjustments.
- Attempting to bill F036 alongside closed reduction codes (F033) for the same site is redundant and will be rejected as inclusive.
Billing Tips
- If the procedure is performed as an emergency after hours, ensure you append the appropriate E409 or E410 premium to the F036 claim to capture the 50-75% increase.
- Always document the Injury Severity Score (ISS) in the chart if claiming the E420 trauma premium for severe olecranon fractures resulting from major trauma.
Effective: April 1, 2026
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Female Genital Surgical Procedures
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