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F119
F119 – Scapula fracture - no reduction
OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service covers the non-operative management of a scapular fracture. It is claimed when the fracture is stable and alignment is acceptable, thus not requiring a reduction procedure. This fee includes the assessment confirming the treatment plan and associated non-operative care as per the Schedule's guidelines for surgical services.
When to Use
- Use F119 for stable, non-displaced scapular fractures where the clinical decision is to manage conservatively with a sling or immobilization.
- Use this code when you have performed the initial assessment and confirmed that no surgical reduction or fixation (like F121) is required.
Common Pitfalls
- Do not bill a separate hospital admission assessment or subsequent hospital visits on the same day as F119, as these are considered included in the surgical procedure fee.
- Avoid billing F119 if you proceed to open or closed reduction; those procedures require different codes and F119 is strictly for non-reduction management.
Billing Tips
- Ensure you append the appropriate age-based premium if the patient is under 16 years old, as F119 is a surgical procedure code eligible for these modifiers.
- If the patient meets the criteria for a major trauma (ISS > 15 for adults), you may claim the E420 trauma premium in addition to F119, provided it is documented.
Provider Fee$67.80
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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