F041 – Transcondylar/condylar - open reduction
OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This code represents an open reduction surgical procedure for transcondylar/condylar fractures of the elbow and forearm, as listed under 'N. Musculoskeletal System Surgical Procedures'. General rules for surgical procedures, assistant services, and anaesthesia services apply. Refer to - for detailed calculation rules for assistant and anaesthesiologist services.
When to Use
- Use F041 for open reduction and internal fixation (ORIF) of transcondylar or condylar fractures of the distal humerus, where the fracture anatomy necessitates formal arthrotomy and direct visualization.
- Select F041 when the complexity of the fracture pattern precludes closed reduction and percutaneous pinning (which would be billed under different codes) and requires hardware placement such as plates and screws.
Common Pitfalls
- Billing F041 for percutaneous pinning or closed reduction procedures; these must be billed using the appropriate closed reduction or percutaneous fixation codes to avoid audit scrutiny.
- Failing to document the specific fracture classification or the necessity of the open approach, which is critical for justifying the higher fee associated with F041 compared to closed reduction codes.
- Incorrectly appending after-hours premiums (E409/E410) to elective cases that do not meet the strict criteria of non-elective surgery or emergency delays.
Billing Tips
- Ensure the operative report clearly describes the open reduction technique, including the surgical approach (e.g., posterior, medial, or lateral) and the specific hardware used, to substantiate the F041 claim.
- When performing multiple procedures during the same session, ensure the major procedure is billed at 100% and secondary procedures are billed according to the Multiple Procedure Rules (typically 100% for the first and 85% or 50% for subsequent procedures depending on the specific code).
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Integumentary System Surgical Procedures
All insured services must be documented in appropriate records to 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 amount payable for surgical assistant (suffix B) and anaesthesiologist (suffix C) services are calculated based on basic units plus time-based units. The assistant fee of $84.84 corresponds to approximately 7 basic units, and the anaesthetist fee of $122.57 corresponds to approximately 8 basic units. Refer to - for detailed calculation rules.
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