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D015
D015 – Glenohumeral joint - closed reduction without anaesthetic
OHIP Orthopaedic Surgery Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure for the closed reduction of a dislocated glenohumeral (shoulder) joint. As per the service description on page , this procedure is specifically performed without the use of an anaesthetic. It is listed under the 'SHOULDER, ARM AND CHEST' section of the Musculoskeletal System Surgical Procedures.
When to Use
- Use D015 for the manual reduction of an acute shoulder dislocation performed in the office or emergency department without the administration of any anesthetic agents.
- Use this code when the reduction is successful and requires only physical manipulation, distinguishing it from D016 or D017 which involve anesthetic or more complex management.
Common Pitfalls
- Billing D015 when sedation or a regional nerve block was administered; this code strictly requires the absence of anesthetic, otherwise, it may be considered an incorrect claim.
- Attempting to bill an assessment code (e.g., A007) as a stand-alone visit when the primary purpose of the encounter was the reduction; while D015 can be billed with an assessment, ensure the assessment is medically necessary and distinct from the procedure itself.
Billing Tips
- Ensure the procedure note explicitly states 'no anesthetic used' to support the use of D015 over other surgical codes that assume anesthesia.
- If the patient meets trauma criteria, remember to append the E420 trauma premium to the D015 claim, provided the Injury Severity Score is documented in the chart.
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