F051 – Fracture of neck with dislocation of head - closed reduction
OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This procedure involves the non-surgical manipulation to realign a fracture of the neck of the humerus that is also accompanied by a dislocation of the head of the humerus. Payment for this service includes surgeon (F051A), assistant (F051B), and anaesthesiologist (F051C) components. The assistant fee is based on 6 basic units plus time units. The anaesthetist fee is based on 6 basic units plus time units. For detailed calculation rules, refer to the Surgical Assistants' Services () and Anaesthesiologists' Services () sections of the General Preamble.
When to Use
- Use F051 when performing a closed reduction of a humeral neck fracture that is specifically complicated by a concurrent dislocation of the humeral head.
- Select F051 over F050 when the clinical documentation confirms both the fracture and the dislocation were addressed via non-surgical manipulation.
Common Pitfalls
- Billing F051 for a simple fracture without a documented dislocation, which should instead be coded under F050 or other appropriate fracture codes.
- Failing to document the specific reduction maneuver, which is essential to justify the 'closed reduction' classification and distinguish it from open surgical procedures.
- Incorrectly applying after-hours premiums (E409/E410) to the base fee while forgetting to apply the corresponding assistant (E400B/E401B) or anaesthesia (E400C/E401C) premiums.
Billing Tips
- Ensure the assistant and anaesthesiologist units are calculated using the 6 basic units defined for F051, as these differ from other musculoskeletal codes.
- If multiple procedures are performed during the same anaesthetic, only the major procedure's basic units apply for the assistant and anaesthesiologist, as per the General Preamble.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
The medical record must establish that an insured service was provided, the service for which the account is submitted is the service that was rendered, and the service was medically necessary.
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