M112 – Sternal debridement and rewiring
OHIP Ophthalmology Code — RESPIRATORY SURGICAL PROCEDURES · Schedule of Benefits
This service involves the surgical debridement and rewiring of the sternum, with or without the use of special mechanical instrumentation. As per the surgical preamble, this fee includes associated pre-operative and post-operative care. Payment for the surgeon (`M112A) is a set fee. Payment for the assistant (M112B) is based on 6 basic units plus time units. Payment for the anaesthetist (M112C`) is based on 7 basic units plus time units. Time units for both are calculated as per the General Preamble. This procedure is explicitly listed as a service for which a second assistant is payable without requiring special authorization from a medical consultant.
When to Use
- Use M112 for the surgical management of sternal dehiscence or deep sternal wound infection requiring formal debridement and re-fixation.
- Use this code when performing a secondary closure of the sternum following a previous cardiac procedure where the primary closure has failed or become infected.
Common Pitfalls
- Claiming M112 in conjunction with other major thoracic procedures will trigger the 85% multiple procedure rule, reducing the secondary procedure's value.
- Failing to document the Injury Severity Score (ISS) when attempting to claim the E420 trauma premium alongside this procedure will result in a mandatory audit rejection.
- Attempting to bill a subsequent hospital visit code (e.g., C002) on the same day as M112 is prohibited, as the surgical fee includes all associated post-operative care.
Billing Tips
- Since M112 is explicitly approved for a second surgical assistant, ensure both assistants bill their respective codes to avoid under-remuneration for complex sternal reconstructions.
- Always verify the anaesthetist's claim includes the appropriate ASA physical status or BMI-based extra units (e.g., E010C, E022C) to maximize the total procedural value.
Effective: April 1, 2025
P. Respiratory Surgical Procedures
RESPIRATORY SURGICAL PROCEDURES
Surgical
Respiratory Surgical Procedures
If the E420 trauma premium is claimed, the Injury Severity Score (ISS) must be documented in the patient's medical record.
Anaesthesia Extra Units: The anaesthetist fee (M112C) may be eligible for additional extra units based on patient factors, such as age (E021C, E014C, E009C, E019C, E007C, E018C), high BMI (E010C), surgical position (E011C, E024C), massive transfusion (E025C), malignant hyperthermia risk (E012C), or ASA physical status (E022C, E017C, E016C, E020C).
Surgical Assistant: The fee for an assistant (M112B) is calculated using 6 basic units plus time units as per the rules on pages - of the Schedule.
Anaesthesiologist: The fee for an anaesthetist (M112C) is calculated using 7 basic units plus time units as per the rules on pages - of the Schedule.
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