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D038
D038 – Knee dislocation - closed reduction
OHIP Orthopaedic Surgery Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
A surgical procedure to perform a closed reduction of a dislocated knee.
When to Use
- Use D038 for the manual, closed reduction of a knee dislocation performed in an emergency or surgical setting.
- Select this code when the reduction is achieved without an open arthrotomy or surgical exposure of the joint capsule.
Common Pitfalls
- Billing D038 in addition to an open surgical procedure on the same joint is considered unbundling; if an open reduction is performed, use the appropriate open surgical code instead.
- Failure to document the specific reduction maneuver and the post-reduction neurovascular status can lead to claim rejection during post-payment audits.
- Do not bill D038 for simple joint aspirations or injections; it is strictly for the reduction of a dislocated knee.
Billing Tips
- If the procedure is performed as a non-elective emergency, ensure you append the appropriate after-hours premium (E409A or E410A) to maximize the procedural fee.
- If the patient meets the trauma criteria, ensure the Injury Severity Score (ISS) is documented in the chart to support the addition of the E420 trauma premium.
Provider Fee$207.90
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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