F121 – Scapula - open reduction
OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Open reduction of a fracture of the scapula. This is a surgical procedure listed under the Musculoskeletal System section. It involves surgically exposing the fractured scapula to realign the bone fragments, which may then be held in place with internal fixation devices. The service is eligible for surgeon (<suffix>A</suffix>), assistant (<suffix>B</suffix>), and anaesthetist (<suffix>C</suffix>) fees. Fees for the assistant and anaesthetist are calculated based on basic units plus time units as detailed in the General Preamble (, , , ).
When to Use
- Use F121 for open reduction and internal fixation (ORIF) of a displaced scapular fracture requiring surgical exposure to achieve anatomical alignment.
- Use F121 when closed reduction attempts have failed or are contraindicated for complex scapular fractures, necessitating direct visualization and hardware placement.
Common Pitfalls
- Billing F121 in conjunction with other fracture management codes for the same anatomical site is a common audit trigger for unbundling.
- Failure to document the specific start and end times for the surgical assistant and anaesthetist will lead to a rejection of the time-based units.
- Attempting to bill F121 alongside a consultation fee for the same patient on the same day without a clear, separate diagnostic indication will result in a claim rejection.
Billing Tips
- Ensure the operative report explicitly details the surgical approach and internal fixation method to support the 'open reduction' requirement of F121.
- If the procedure qualifies as trauma, ensure the Injury Severity Score (ISS) is documented in the chart to support the addition of the E420 trauma premium.
Effective: April 1, 2026
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
All insured services must be documented in appropriate records to establish that the service was provided, medically necessary, and is the same service for which the account is submitted.
For unit-based services (anaesthesia and surgical assistant), the physician must record the start and end times of the service in the patient's permanent medical record or chart.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.