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D026

D026Closed reduction, one or more joints

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

This procedure involves the non-operative (closed) reduction of a dislocation affecting one or more tarso-metatarsal joints. According to the Schedule of Benefits, this service may be eligible for payment in conjunction with applicable fracture services such as F063 or F065.

When to Use

  • Use D026 for the non-operative reduction of a dislocation involving one or more tarso-metatarsal joints.
  • Use this code when performing a closed reduction on a patient who also requires a concurrent closed reduction of metatarsal fractures (F063).

Common Pitfalls

  • Do not bill D026 for open reductions; open procedures for these joints are billed under different codes, and using D026 will lead to rejection or audit.
  • Avoid billing D026 as a standalone procedure if a fracture reduction (F063) was performed simultaneously, as these are intended to be billed together when applicable.

Billing Tips

  • Ensure the procedure is documented as a closed reduction to justify the use of D026 over open surgical alternatives.
  • Always append applicable after-hours (E409A/E410A) or age-based premiums to the D026 claim to ensure the full procedural value is captured.
Provider Fee$147.60
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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