D033 – Closed reduction
OHIP Orthopaedic Surgery Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
This service is for the closed reduction of a dislocation involving the tarsal bones of the foot. The procedure involves manually manipulating the bones back into their proper alignment without a surgical incision. The fee for this service covers the surgeon's work (suffix A). An accompanying anaesthesia service (suffix C) is calculated based on 6 base units plus time units. If a plaster cast is applied outside of a hospital setting, E584 may be claimed in addition.
When to Use
- Use D033 for the manual closed reduction of a tarsal bone dislocation where no surgical incision is required.
- Use this code for acute tarsal dislocations presenting in the emergency department or clinic setting that are successfully reduced without open surgery.
Common Pitfalls
- Do not bill D033 if an open reduction (surgical incision) is performed; that would require a different surgical code.
- Avoid billing E584 if the reduction is performed in a hospital setting, as the E584 add-on is strictly for office-based procedures.
- Ensure the trauma premium E420 is only applied if the patient meets specific age-based Injury Severity Score (ISS) thresholds and the score is documented in the chart.
Billing Tips
- When performing the reduction in an office setting, always append E584 to the claim to capture the additional fee for plaster cast application.
- If the procedure is non-elective and performed after hours, ensure you select the appropriate premium (E409 or E410) based on the exact start time of the procedure to maximize the procedural fee.
Effective: April 1, 2025
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
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