F057 – Intra-articular fracture - I.P. Joint - closed reduction
OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service is for the closed (non-surgical) reduction of a fracture within an interphalangeal (I.P.) joint of the foot or ankle. It is listed as a surgical procedure but does not involve an incision. Application of a plaster cast, if required and performed outside of a hospital, can be billed separately using E584.
When to Use
- Use F057 for the manual closed reduction of a confirmed intra-articular fracture of a toe or ankle interphalangeal joint where no surgical incision is required.
- Use this code when you have successfully manipulated the fracture into alignment under local or regional anesthesia in an office or clinic setting.
Common Pitfalls
- Do not bill F057 if an incision was made to achieve reduction, as this would require a different surgical code; F057 is strictly for closed procedures.
- Avoid billing F057 for simple dislocations without an associated intra-articular fracture, as this does not meet the specific patient condition requirement.
- Ensure E584 is only added when the cast is applied in an office or home setting; it is not eligible for separate billing if the procedure occurs in a hospital.
Billing Tips
- Always append the appropriate age-based surgical premium if the patient is under 16 years of age to maximize the procedural fee.
- If the procedure is performed after hours or on a weekend, ensure you apply the relevant E409 or E410 premium to the F057 fee to capture the 50-75% increase.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
All insured services must be documented in appropriate records to 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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