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F042
F042 – Fracture of shaft - no reduction
OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Management of a fracture of the humeral shaft without reduction. This service is for fractures that are non-displaced or minimally displaced and do not require manipulative reduction.
When to Use
- Use F042 for humeral shaft fractures that are stable, non-displaced, or minimally displaced where the treatment plan is immobilization (e.g., a sling or functional brace) without any attempt at manual reduction.
- Select this code when the clinical management involves the application of a splint or brace to a stable fracture, as opposed to F043 which requires manipulative reduction.
Common Pitfalls
- Billing F042 in conjunction with a consultation or assessment code (e.g., A007) on the same day is often flagged; ensure the procedural fee is claimed as the primary service if the visit was specifically for the fracture management.
- Confusing F042 with F044 (fracture of the humeral shaft with internal fixation); F042 is strictly for non-operative, non-reduction management.
Billing Tips
- If the patient requires an after-hours visit for the initial stabilization, ensure you append the appropriate premium (E409 or E410) to the F042 claim to capture the 50-75% increase on the procedural fee.
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