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D017
D017 – Glenohumeral joint - open reduction, early
OHIP Orthopaedic Surgery Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service, D017, covers the open reduction of an early dislocation of the glenohumeral joint, as listed on page of the Schedule. The surgeon's fee is a flat rate. The assistant's fee is based on 6 base units plus time units. The anaesthetist's fee is based on 6 base units plus time units.
When to Use
- Use D017 for the open reduction of a glenohumeral dislocation when closed reduction (R472) has failed or is contraindicated.
- Use this code specifically for 'early' dislocations where the surgical intervention is performed promptly following the injury, distinguishing it from chronic or recurrent cases requiring more complex reconstruction.
Common Pitfalls
- Billing D017 alongside a closed reduction (R472) for the same joint on the same day is a common audit trigger; only the definitive surgical procedure is payable.
- Failure to document the 'early' nature of the dislocation can lead to claims being questioned if the procedure is performed significantly post-injury, where other reconstructive codes may be more appropriate.
- Incorrectly billing a hospital admission assessment; remember that the surgeon's admission assessment is included in the surgical fee unless it qualifies as the 'major pre-operative visit'.
Billing Tips
- Ensure the operative report clearly details the open approach and the reduction technique to justify the use of D017 over simpler closed reduction codes.
- If the procedure is performed after hours, ensure you append the correct premium (E409 or E410) to the surgeon's fee, as these are not automatically calculated.
Provider Fee$323.85
Surgical Assistant Fee$75.06
Anaesthetist Fee$92.94
Non-Anaesthetist Fee$92.94
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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