F048 – Tuberosity fracture - closed reduction
OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This surgical service is for the closed reduction of a fracture of the tuberosity of the humerus. This is a non-operative procedure to realign the fractured bone without a surgical incision. It is an alternative to F047 (no reduction) and F049 (open reduction). Services for a surgical assistant (suffix B) and anaesthetist (suffix C) are also payable for this procedure. Their fees are calculated using 6 basic units plus time-based units as per the General Preamble ( and ).
When to Use
- Use F048 when you perform a physical manipulation to realign a displaced tuberosity fracture of the humerus without making a surgical incision.
- Select F048 instead of F047 when the fracture requires active reduction, as F047 is strictly for cases where no reduction is performed.
- Use F048 when the procedure is closed, distinguishing it from F049, which is reserved for open reduction requiring surgical exposure of the fracture site.
Common Pitfalls
- Billing F048 for a simple fracture that was managed conservatively without manipulation, which should be billed as F047.
- Attempting to bill F048 alongside an after-hours premium (E409/E410) and a trauma premium (E420) simultaneously; the trauma premium is not applicable when after-hours premiums are claimed.
- Failing to document the specific reduction maneuver performed, which is necessary to justify the use of the reduction code (F048) over the non-reduction code (F047) during an audit.
Billing Tips
- Ensure the operative note explicitly describes the reduction technique used, as this is the primary differentiator between F048 and F047.
- If the patient is a trauma case, remember that the Injury Severity Score (ISS) must be documented in the chart to support the E420 premium, provided no after-hours premium is claimed.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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