F125 – Sternum fracture - open reduction - pleura closed
OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Open reduction of a sternum fracture where the pleura is not opened. The surgeon's fee (<suffix>A</suffix>) is payable on an Independent Consideration (IC) basis. Assistant (<suffix>B</suffix>) and anaesthesia (<suffix>C</suffix>) fees are calculated based on time and base units. As an IC service, claims must be submitted with a supporting letter explaining the fee, an operative report, and a comparison to other listed procedures as described in the General Preamble ().
When to Use
- Use F125 for open reduction and internal fixation of a sternal fracture where the pleural space is not breached.
- Use this code when the complexity of the sternal repair exceeds standard closed reduction techniques but does not involve thoracic cavity entry, distinguishing it from thoracotomy-related codes.
Common Pitfalls
- Submitting the claim without the required GP12 documentation, which leads to automatic rejection of the IC fee.
- Failing to provide a comparative analysis of the procedure's difficulty against a non-IC listed procedure, which is a mandatory requirement for all IC submissions.
- Omitting the operative report, which is essential for the Ministry to verify that the pleura remained closed.
Billing Tips
- When drafting your supporting letter, explicitly reference the time, technical difficulty, and specific instrumentation used to justify the IC fee amount relative to similar musculoskeletal surgical codes.
- Ensure the operative report clearly states the status of the pleura to justify the use of F125 over more invasive thoracic procedures.
No fee information available.
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
For Independent Consideration (IC) services, claims must be submitted with a supporting letter explaining the amount of the fee claimed, and must include an appropriate operative or consultation report, and a comparison of the scope and difficulty of the procedure in relation to non-IC procedures in the Schedule.
(see General Preamble )
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