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F146 – Complicated fracture reduction

OHIP Musculoskeletal System Surgical Procedures Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

Surgical procedure for a complicated fracture of the mandible. As per , this service is designated for Independent Consideration (IC), meaning it does not have a specified fee. 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. The fees for the surgeon (suffix A), assistant (suffix B), and anaesthetist (suffix C) are all subject to this process.

For anaesthesia services (suffix C) where basic units are listed as IC, the amount payable is calculated by adding the appropriate time units to the basic units listed for a comparable procedure (taking into account the region, modifying conditions, or techniques).

For assistant services (suffix B) where basic units are listed as IC, payment is determined by a medical consultant following submission of a letter from the surgeon outlining the reason the assistant was required and details of the service provided. Submit claims for this type of service using fee code M400B.

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