F044 – Fracture of shaft - open reduction
OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Open reduction for a fracture of the humeral shaft. This is a surgical procedure listed in the Musculoskeletal System section of the Schedule of Benefits. Payment to the surgeon (F044A) includes the associated pre-operative and post-operative care as defined in the surgical preamble. Assistant services (F044B) are valued at 6 basic units plus time. Anaesthesia services (F044C) are valued at 6 basic units plus time.
When to Use
- Use F044 for open reduction of a humeral shaft fracture where internal fixation is required, distinguishing it from F042 (closed reduction with percutaneous fixation) or F043 (closed reduction with manipulation).
- Select F044 when the surgical approach requires an incision to directly visualize and reduce the fracture site, rather than relying on closed manipulation techniques.
Common Pitfalls
- Billing F044 alongside a closed reduction code for the same site is a common audit trigger; the surgical preamble dictates that the open procedure includes the reduction.
- Failing to document the Injury Severity Score (ISS) in the chart will result in the rejection of the E420 trauma premium, even if the clinical presentation is severe.
Billing Tips
- Ensure the operative report explicitly describes the open reduction technique to support the use of F044 over the lower-valued closed reduction codes.
- When performing multiple procedures during the same session, remember that F044 serves as the major procedure for calculating assistant and anaesthesia basic units, with subsequent procedures subject to the 100/85/75 multiple procedure rule.
Effective: April 1, 2026
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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