F124

F124 – Sternum - open reduction - pleura open

OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

Open reduction of a fracture of the sternum where the pleura is opened. The surgeon's fee (suffix A) for this service is determined by Independent Consideration and requires submission of a supporting letter with a comparison of the scope and difficulty of the procedure in relation to non-IC procedures. Refer to the General Preamble for IC guidelines. The service has 9 basic units for an assistant (suffix B) and 13 basic units for anaesthesia (suffix C).

When to Use

Use F124 when performing an open reduction of a sternal fracture that necessitates entry into the pleural space, distinguishing it from the simpler F123 which does not involve pleural opening.
Select this code for complex sternal trauma cases where the surgical approach requires thoracic cavity access to manage associated injuries or to achieve adequate reduction.

Common Pitfalls

Failing to submit the required letter for Independent Consideration (IC) will result in automatic rejection of the claim.
Confusing F124 with F123 or F125; ensure the operative report explicitly confirms the pleura was opened to justify the IC status of F124 over standard fee codes.
Neglecting to provide a clear comparison to non-IC procedures in the supporting letter, which is mandatory under GP12 guidelines for IC assessment.

Billing Tips

When drafting your IC letter, explicitly detail the additional time, complexity, and surgical risk associated with opening the pleura compared to a standard sternal reduction (F123).
Ensure the operative report clearly documents the extent of the pleural involvement to support the IC claim during potential post-payment audits.

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