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F061

F061Metatarsus fracture - one or more

OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

This service is for the management of a fracture of one or more metatarsal bones. This listing applies to fractures that do not require active reduction or rigid immobilization, as those interventions are listed under separate codes (F062 for rigid immobilization, F063 for closed reduction).

When to Use

  • Use F061 for non-displaced metatarsal fractures that are managed conservatively with a simple walking boot or stiff-soled shoe without requiring formal casting.
  • Use this code for stable fractures where the patient is instructed on weight-bearing as tolerated and no manipulation or rigid immobilization is performed.

Common Pitfalls

  • Billing F061 when a cast is applied; if rigid immobilization is provided, you must use F062 instead.
  • Attempting to bill F061 in conjunction with F063; F063 is reserved for closed reduction, which is mutually exclusive with the non-reduction criteria of F061.
  • Failing to recognize that F061 is a surgical procedure code; ensure your documentation clearly describes the management plan to justify the surgical fee versus a standard office visit code.

Billing Tips

  • If the patient requires an after-hours assessment for the fracture, ensure you apply the appropriate E409 or E410 premium to the F061 fee, provided the criteria for non-elective status are met.
  • Always verify if the fracture management meets the definition of 'rigid immobilization' (F062) before defaulting to F061, as the fee difference reflects the intensity of the intervention.
Provider Fee$49.20

Effective: April 1, 2025

Category

N. Musculoskeletal System Surgical Procedures

Subcategory

MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Musculoskeletal System Surgical Procedures

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