F108 – Ankle fracture with tibial Plafond burst - open reduction
OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Open reduction for an ankle fracture with a tibial Plafond burst. This is a surgical procedure and is eligible to be billed with suffixes 'A' for the surgeon, 'B' for an assistant, and 'C' for an anaesthesiologist. The fee for the surgeon (F108A) is a set amount. The fees for the assistant (F108B) and anaesthesiologist (F108C) are calculated based on base units plus time units. The base units for the assistant are 6, and for the anaesthesiologist are 6, as specified in the Schedule of Benefits on page .
When to Use
- Use F108A specifically for open reduction of an ankle fracture involving a tibial plafond burst, as it is distinct from standard ankle fracture repairs like F104.
- Apply this code when the surgical procedure includes the repair of associated medial, lateral, or syndesmotic ligaments, as these are considered included elements.
Common Pitfalls
- Failure to document the Injury Severity Score (ISS) in the medical record will lead to the rejection or clawback of the E420 Trauma premium.
- Billing F108A alongside restricted codes like F076 or F077 will result in an automatic claim rejection due to procedural overlap.
Billing Tips
- Ensure the surgical assistant (F108B) and anaesthesiologist (F108C) claims are calculated using the mandatory 6 base units plus time units as defined in the Schedule of Benefits.
- Verify that the E420 Trauma premium is only applied if the service occurs within 24 hours of the trauma and the patient meets the specific age-based ISS thresholds.
Effective: April 1, 2026
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
For the Trauma premium (E420) to be payable, the medical record must list the Injury Severity Score (ISS).
All insured services must be documented in appropriate records establishing that the service was provided, medically necessary, and matches the submitted claim.
If performed by a Medical Trainee, the Supervising Physician must ensure specific documentation requirements are met, including signing off on the service in the patient's medical record.
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