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D004
D004 – Closed reduction - Metacarpal/phalangeal dislocation
OHIP Orthopaedic Surgery Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
When to Use
- Use D004 for the manual closed reduction of a single metacarpophalangeal (MCP) or interphalangeal (IP) joint dislocation.
- Use D004 in conjunction with E577A when multiple distinct joints (e.g., two separate fingers) are reduced during the same encounter.
Common Pitfalls
- Do not bill D004 for a fracture reduction; use the appropriate fracture management codes (e.g., D001 or D003) instead.
- Avoid billing E584A for cast application if the procedure was performed within a hospital setting, as this is strictly for non-hospital environments.
- Do not attempt to bill D004 alongside a general assessment code unless a separate, identifiable, and medically necessary assessment was performed beyond the pre-procedural evaluation.
Billing Tips
- Ensure the specific joint and the direction of the dislocation are clearly documented to support the medical necessity of the reduction.
- If an assistant is required for a complex reduction, you must submit the claim via M400B with a letter of explanation, as assistance is not automatically payable with D004.
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