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D034
D034 – Open reduction
OHIP Orthopaedic Surgery Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
D034 represents the open reduction of a dislocation of the tarsus. As a surgical procedure, the fee for the surgeon (suffix A), assistant (suffix B), and anaesthetist (suffix C) are calculated based on a combination of basic units and time-based units. The Schedule of Benefits lists 7 base units for anaesthesia and 6 base units for the surgical assistant for this procedure.
When to Use
- Use D034 for the open reduction of a tarsal dislocation when closed reduction (D033) has failed or is clinically inappropriate due to instability or entrapment.
- Select D034 when the procedure requires formal arthrotomy or open surgical exposure to achieve anatomical reduction of the tarsal bones.
Common Pitfalls
- Billing D034 alongside D033 is considered unbundling; if an attempt at closed reduction fails and you proceed to open reduction, only the definitive procedure (D034) is billable.
- Failure to document the Injury Severity Score (ISS) in the medical record will result in the rejection of the E420 trauma premium, even if the clinical scenario otherwise qualifies.
Billing Tips
- Ensure that the surgical assistant fee is only claimed if the complexity of the procedure meets the criteria for assistance, as D034 is not on the pre-approved list for a second assistant without prior authorization.
Provider Fee$298.55
Surgical Assistant Fee$75.06
Anaesthetist Fee$108.43
Non-Anaesthetist Fee$108.43
Effective: April 1, 2025
Since Oct 2005, this fee has increased 18.3% vs 51.4% CPI inflation
Category
N. Musculoskeletal System Surgical Procedures
Subcategory
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Service Type
Surgical
Code Classes
Musculoskeletal System Surgical Procedures
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