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D009
D009 – Closed reduction of elbow joint dislocation
OHIP Orthopaedic Surgery Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure for the closed reduction of a dislocated elbow joint. This is a non-delegable surgical procedure (see -). This service is eligible for surgeon (suffix A) and anaesthetist (suffix C) billing. Assistant services are not eligible for payment. The anaesthesia service (D009C) includes 6 base units plus time units. This procedure may be eligible for after-hours premiums and the trauma premium (E420) if specific conditions are met. Age-based premiums also apply for patients under 16 years of age.
When to Use
- Use D009 for the successful closed reduction of a dislocated elbow joint performed under sedation or general anaesthesia.
- Use D009 when the procedure is performed as a non-elective surgical intervention, distinct from simple joint manipulation or casting codes like R400.
Common Pitfalls
- Billing D009 alongside an assessment code (e.g., A007) is a common rejection; the assessment is generally considered included in the surgical fee unless a separate, unrelated problem is addressed.
- Attempting to bill for an assistant is a frequent error, as D009 is explicitly ineligible for assistant fee claims.
- Failing to document the Injury Severity Score (ISS) in the chart when attempting to claim the E420 trauma premium will result in automatic audit recovery.
Billing Tips
- Ensure the procedure start time is clearly documented to support after-hours premiums (E409/E410) or emergency department premiums (E412/E413) if applicable.
- Always verify the patient's exact age at the time of the procedure to ensure the correct age-based premium is applied, as these are significant percentage increases over the base fee.
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