F118 – Clavicle - open reduction
OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
F118A covers the open reduction for a fracture of the clavicle. This surgical procedure involves making an incision to directly access and repair the bone, often with internal fixation. The fee is payable to the surgeon (suffix A), an assistant (suffix B, see F118B), and an anaesthesiologist (suffix C, see F118C). Assistant and anaesthesia fees are calculated using a unit-based system as described in the General Preamble (see pages - for assistant and - for anaesthesia).
When to Use
- Use F118A for open reduction and internal fixation (ORIF) of a clavicle fracture, which is distinct from the closed reduction procedure F110.
- Use F118A when the surgical approach requires an incision to access the fracture site for plate and screw fixation.
Common Pitfalls
- Billing F118A for a closed reduction procedure, which should be billed under F110, will lead to claim rejection or audit recovery.
- Failing to document the Injury Severity Score (ISS) in the medical record when claiming the E420 trauma premium for F118A is a frequent cause of audit clawbacks.
Billing Tips
- Ensure that the surgical assistant (F118B) and anaesthesiologist (F118C) use the correct corresponding suffix to avoid processing delays.
- Verify that the procedure start time is accurately recorded to support after-hours premiums (E409, E410) or assistant/anaesthesia after-hours modifiers.
Effective: April 1, 2026
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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