F135 – Anterior pelvic ring fracture excluding sacrum, sacro-iliac joint(s) or acetabulum
OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Open reduction for a pelvic ring fracture. This surgical procedure involves exposing the fracture site to directly visualize and realign the fractured pelvic bones. Internal fixation devices may be used to hold the bones in place. The service includes all common elements as defined in the Schedule (, ) and specific elements for surgical assistance and anaesthesia as applicable (, ).
When to Use
- Use F135 for open reduction and internal fixation of anterior pelvic ring fractures, such as pubic rami fractures, where the sacrum and sacro-iliac joints are not involved.
- Select F135 when the surgical approach requires direct visualization of the anterior pelvic ring to achieve anatomical reduction, distinguishing it from closed reduction techniques.
- Use F135 when the fracture is isolated to the anterior ring, specifically excluding any involvement of the acetabulum, which would otherwise fall under different surgical coding categories.
Common Pitfalls
- Billing F135 for fractures involving the sacrum or sacro-iliac joints, which are excluded by the definition and require different procedural codes.
- Failing to document the Injury Severity Score (ISS) when claiming the E420 trauma premium, leading to automatic rejection of the 50% premium.
- Incorrectly billing F135 for acetabular fractures, which are distinct entities and carry different fee values and surgical requirements.
Billing Tips
- Ensure the ISS is clearly documented in the operative report to support the E420 trauma premium, as this is a frequent audit target for pelvic trauma cases.
- Since F135 is pre-authorized for a second surgical assistant, ensure both assistants are billed appropriately on the same claim to avoid manual review delays.
Effective: April 1, 2026
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
For Trauma Premium (E420), the medical record must list the Injury Severity Score (ISS).
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