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D028
D028 – Open reduction, one joint
OHIP Orthopaedic Surgery Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Open reduction of one joint. For each additional joint, claim E508A as an add-on. Assistant and Anaesthesia fees are payable for this service.
When to Use
- Use D028 for the open reduction of a single joint dislocation or fracture-dislocation where surgical exposure is required.
- Use D028 in conjunction with E508A when multiple joints (e.g., multiple tarso-metatarsal joints) are reduced during the same operative session.
Common Pitfalls
- Do not bill D028 for closed reductions; these are covered under separate fracture/dislocation codes (e.g., F063 or F065).
- Avoid billing D028 and E508A for the same joint; E508A is strictly for each additional joint beyond the primary joint covered by D028.
- Failure to document the specific joint and the necessity of the open approach can lead to audit recovery, as the distinction between open and closed reduction is critical for this fee.
Billing Tips
- Ensure the primary procedure code D028 is listed first, followed by E508A for each additional joint, to ensure the add-on logic triggers correctly in the claims system.
- If the procedure is non-elective and performed after hours, remember to apply the appropriate E409A or E410A premium to the D028 fee, but note that these cannot be combined with the E420 trauma premium.
Provider Fee$545.70
Surgical Assistant Fee$77.46
Anaesthetist Fee$95.76
Non-Anaesthetist Fee$95.76
Effective: April 1, 2026
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
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