F144 – Cranial-facial separation
OHIP Anaesthesia Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service is for the surgical repair of a cranial-facial separation, a type of midface fracture. It is categorized under reductions for fractures of the skull and mandible.
When to Use
- Use F144 for the surgical reduction and fixation of complex midface fractures involving craniofacial separation, such as LeFort II or III fractures.
- Use this code when the clinical procedure involves the stabilization of the midface to the cranium, distinguishing it from isolated maxillary repairs.
Common Pitfalls
- Do not bill F144 in combination with maxillary repair codes, as the fee for F144 is intended to be comprehensive for the cranial-facial separation.
- Avoid billing F144 for simple zygomatic or orbital floor fractures, as these do not meet the definition of a cranial-facial separation.
- Failure to document the specific major fracture lines (e.g., LeFort III) can lead to audit scrutiny regarding the medical necessity of the base fee.
Billing Tips
- Maximize the claim by appending E830 for every major fracture line treated with mini-plates, ensuring you specify the location (e.g., infraorbital, malar-zygomatic) per side in the claim notes.
- If the procedure is performed on a trauma patient, ensure the Injury Severity Score (ISS) is clearly documented in the chart to support the use of the E420 trauma premium.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
All insured services must be documented in appropriate records that establish the service was provided, the service for which the account is submitted is the service that was rendered, and the service was medically necessary. (Source: , ).
Where mini-plate(s) are used, one mini-plate fee per each major fracture line (e.g. infraorbital, malar-zygomatic, nasal-frontal, LeFort I, LeFort II and III) (per major fracture line per side) should be billed.
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