F095 – Closed reduction of femoral fracture
OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service is for the application of traction to the femur. This procedure is applicable to adult and adolescent patients as defined in the Schedule of Benefits. As a surgical service, it includes all pre-procedural, intra-procedural, and post-procedural care typically associated with the procedure, unless otherwise specified. It is eligible for anaesthesia and assistant services.
When to Use
- Use F095 for the closed reduction of a femoral shaft fracture requiring traction in adult or adolescent patients (age 16+).
- Use F095 for pediatric patients (age 0-15) specifically when the procedure involves the application of a hip spica cast following the reduction.
Common Pitfalls
- Billing F095 on the same day as E555, Z207, or Z209 will result in an automatic rejection due to explicit same-day billing restrictions.
- Attempting to bill F095 for open surgical management is incorrect; use appropriate open reduction codes instead, as F095 is strictly for closed reduction and traction.
Billing Tips
- Ensure the Injury Severity Score (ISS) is documented in the chart if claiming the E420 trauma premium, as this is a mandatory audit requirement for the 50% increase.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
For adult or adolescent patients; or For infant or child with hip spica cast option
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