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D014

D014Acromio-clavicular/sterno-clavicular - no reduction

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

Management of a dislocation of the acromio-clavicular or sterno-clavicular joint, where no reduction procedure is performed. This service is listed under the Musculoskeletal System Surgical Procedures section for the shoulder, arm, and chest.

When to Use

  • Use D014 for the initial assessment and management of an acromio-clavicular or sterno-clavicular dislocation where you determine that no reduction (manipulation) is required.
  • Use this code when providing non-operative management, such as sling immobilization or conservative care, for a confirmed joint dislocation.

Common Pitfalls

  • Do not bill D014 if you perform a reduction; use D025 instead if a closed reduction is actually carried out.
  • Avoid billing D014 in conjunction with a standard office visit (A007) on the same day, as the surgical fee for D014 is intended to cover the assessment and management of the injury.
  • Billing D014 for simple soft tissue contusions or sprains without a documented dislocation is an audit risk, as the code specifically requires a dislocation diagnosis.

Billing Tips

  • Ensure the medical record clearly states the diagnosis of a dislocation and specifies that no reduction was performed to justify the use of D014 over D025.
  • If the procedure occurs after hours or on weekends, remember to append the appropriate E-code (E409 or E410) to the D014 claim to maximize the procedural fee.
Provider Fee$67.80

Effective: April 1, 2025

Category

N. Musculoskeletal System Surgical Procedures

Subcategory

MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES

Service Type

Surgical

Code Classes

Musculoskeletal System Surgical Procedures

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