D004

D004 – Closed reduction - Metacarpal/phalangeal dislocation

OHIP Orthopaedic Surgery Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

This service covers the closed reduction of a single metacarpal/phalangeal joint dislocation. An additional fee is payable using E577A for each additional dislocation reduced. If a plaster cast is applied outside of a hospital setting, E584A may also be claimed.

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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Provider Fee$57.50

Anaesthetist Fee$92.94

Non-Anaesthetist Fee$92.94

Effective: April 1, 2025

Show CPI inflation

Since Oct 2005, this fee has increased 0.0% vs 51.4% CPI inflation

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