F131 – Ribs - pleura closed
OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Represents the surgical reduction of one or more rib fractures where the pleura remains closed. As this service is designated for Independent Consideration (IC), the claim for the surgeon's fee must be submitted with a supporting letter explaining the amount claimed, an appropriate operative report, and a comparison of the procedure's scope and difficulty relative to other non-IC procedures in the Schedule, as detailed in .
When to Use
- Use F131 for the open reduction and internal fixation (ORIF) of rib fractures where the pleural space remains intact.
- Use this code when performing surgical stabilization of rib fractures (SSRF) for flail chest or multiple displaced fractures, provided the pleura is not entered or breached during the procedure.
Common Pitfalls
- Failure to submit a detailed letter of explanation as required by the Independent Consideration (IC) designation often leads to immediate claim rejection or payment at a default minimum rate.
- Billing F131 for procedures involving thoracic entry or pleural involvement; such cases may require different codes or additional documentation to justify the complexity beyond a standard closed-pleura procedure.
- Neglecting to provide a clear comparison to a non-IC procedure in the Schedule, which is a mandatory requirement for all IC submissions under GP12.
Billing Tips
- When submitting your IC letter, explicitly benchmark the complexity, time, and surgical effort of your specific case against a similar non-IC musculoskeletal procedure to provide the Ministry with a clear frame of reference.
- Ensure your operative report highlights the integrity of the pleura to justify the use of F131 over more invasive thoracic surgical codes.
No fee information available.
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
For Independent Consideration (IC) services, the claim 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.
pleura closed (see General Preamble )
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