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D046
D046 – Acetabulum open reduction - one pillar
OHIP Orthopaedic Surgery Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Open reduction of a one-pillar fracture of the acetabulum. This is a surgical procedure to repair a specific type of fracture in the hip socket. As a surgical procedure, this fee includes all common elements of insured services as outlined in the Schedule of Benefits (see -).
When to Use
- Use D046 for the open reduction and internal fixation of a single acetabular column fracture, such as an isolated anterior or posterior column fracture.
- Select D046 when the surgical approach is limited to one pillar, distinguishing it from the more complex D047 which covers both columns or associated fractures.
Common Pitfalls
- Billing D046 alongside D047 for the same hip is a common audit trigger; the Schedule of Benefits generally considers these mutually exclusive for a single surgical site.
- Failing to document the specific pillar involved can lead to rejections if the Ministry audits the claim against the operative report for complexity.
Billing Tips
- Ensure you append the appropriate surgical assistant code if a second assistant is utilized, as D046 is pre-authorized for two assistants under GP90.
- Always apply the 15% age premium (AGE_PREMIUM_65) for patients 65 and older, as this is a surgical procedure eligible for the age-based increase.
Provider Fee$1,458.50
Surgical Assistant Fee$77.46
Anaesthetist Fee$159.60
Non-Anaesthetist Fee$159.60
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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