F059 – Open reduction - Intra-articular fracture - I.P. Joint
OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service covers the open reduction of a fracture within an interphalangeal joint of the foot. The fee for the surgeon (F059A) is a flat rate. Fees for the surgical assistant (F059B) and anaesthetist (F059C) are unit-based. - **Surgical Assistant (F059B):** The fee is calculated by adding 6 base units to time units, multiplied by the surgical assistant unit fee. See - for full calculation details. - **Anaesthetist (F059C):** The fee is calculated by adding 7 base units to time units, multiplied by the anaesthesiologist unit fee. See - for full calculation details.
When to Use
- Use F059 when an open reduction is required for an intra-articular interphalangeal joint fracture of the foot, specifically when the joint must be surgically opened to achieve anatomical reduction.
- Use F059 instead of F057 when the fracture is unstable or displaced to a degree that closed reduction is insufficient or failed, necessitating direct visualization.
Common Pitfalls
- Billing F059 alongside F057 for the same fracture is a common rejection; these codes are mutually exclusive and represent different management approaches.
- Failure to document the Injury Severity Score (ISS) in the medical record when claiming the E420 trauma premium will lead to automatic audit recovery.
- Incorrectly applying after-hours premiums (E409/E410) to elective procedures that were not delayed by an intervening surgical emergency.
Billing Tips
- When performing multiple or bilateral procedures under the same anaesthetic, ensure the base units for the assistant (F059B) and anaesthetist (F059C) are calculated based on the major procedure as defined in the Schedule of Benefits.
- Always verify if the patient qualifies for age-based premiums (under 16 years) to automatically increase the procedural fee by 10% to 30% depending on the specific age bracket.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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