F072 – Open reduction - os calcis fracture or talus fracture
OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
F072 represents the open reduction of an os calcis (heel bone) fracture with repair of both the subtalar and calcaneocuboid joints or a talus fracture with repair of the talar neck or body. As a surgical procedure, payment includes the common elements of insured services as defined in the Schedule of Benefits (-), such as arranging appointments, obtaining history, maintaining records, and providing prescriptions. It also includes the specific elements of a surgical assistant's service () and an anaesthesiologist's service () when billed with suffixes B or C respectively. This includes pre-operative evaluation, the surgical procedure itself, and normal post-operative care. The fee is eligible for various premiums, including those for age, after-hours services, and trauma.
When to Use
- Use F072 for open reduction and internal fixation (ORIF) of an os calcis fracture specifically involving repair of both the subtalar and calcaneocuboid joints.
- Use F072 for ORIF of a talus fracture involving the talar neck or body, distinguishing it from simpler talar procedures or closed reductions.
- Select F072 when the procedure complexity exceeds that of F070 or F071, which typically cover less extensive or isolated joint repairs.
Common Pitfalls
- Billing F072 for a closed reduction or percutaneous fixation, which are not considered 'open reduction' and should be billed under appropriate alternative codes.
- Failing to document the specific involvement of both the subtalar and calcaneocuboid joints for os calcis fractures, which is a requirement for this specific code definition.
- Attempting to bill F072 alongside other fracture repair codes for the same anatomical site; this is considered unbundling and will lead to claim rejection.
Billing Tips
- Ensure the operative report explicitly details the open reduction and the specific joint repairs performed to support the higher fee of F072 over lower-level musculoskeletal codes.
- If the patient meets trauma criteria, remember to document the Injury Severity Score (ISS) in the chart to justify the E420 trauma premium, which is 50% of the procedural fee.
Effective: April 1, 2026
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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