< Billing codes

Billing code

F004A — Phalanx (finger) fracture – no reduction, rigid immobilization

Finger fracture, no reduction

Bill for a finger (phalanx) fracture treated without reduction, using a custom-molded rigid device you apply.

Watch for: A simple metal splint isn't rigid immobilization and is billed as a visit only.

Code

F004A

Description

Phalanx (finger) fracture – no reduction, rigid immobilization

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Apr 1, 2025

Termination date

No end date

Explanation

Updated October 26, 2026

Treatment of a finger (phalanx) fracture without reduction, using rigid immobilization the physician custom-molds and applies.

What it covers

F004 is definitive treatment of a phalanx fracture of the hand without reduction, using rigid immobilization (N14).

Rigid immobilization means a custom-molded device applied by the physician. A simple metal splint does not qualify; that is a visit only (N1).

Billing rules

• Rigid immobilization means a custom-molded device applied by the physician. A simple splint, such as a metal splint, is not rigid immobilization and is billed as a visit only (N1).
• Add E558 for each additional phalanx fracture (N14; Agreement p.92).
• The major pre-operative visit (the consultation or assessment) can be billed in addition (N1).
• A cast or corrective splint applied during the first 2 weeks is included in the fracture or dislocation fee; later casts are billed from the cast listings (N7).
• If you transfer the patient to another physician for after-care, bill 75% of the listed fee; the physician giving after-care bills visit fees (N2).
• Multiple fractures or dislocations: the major one is paid at 100% and each of the others at 85% (N1).
• Patients under 16: payment is increased by 10% to 30% depending on age (GP64).
• FHO: a Schedule 4 code that counts toward the office procedures special payment when done in your office for enrolled patients (Agreement p.67 §8.7, p.92).

Often billed with

• E558 for each additional phalanx fracture (N14).
• The consultation or assessment that is the major pre-operative visit (N1).

Related codes: F005, E558, F007, F006, F008, Z201, Z202

Source: Schedule of Benefits (July 1, 2026), Musculoskeletal System Surgical Procedures, Hand and Wrist, page N14.

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