D047 – Two pillars
OHIP Orthopaedic Surgery Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
Performs an open reduction of an acetabulum dislocation involving two pillars. This is a major surgical procedure and the fee listed is for the surgeon's service (suffix 'A'). The service includes all common elements (-) and specific elements of a surgical service, which typically involve preparing the patient, performing the procedure, post-operative monitoring, and arranging follow-up care as described in .
- **Assistant Service (D047B): The surgical assistant service is compensated based on 8 basic units** plus time units. For calculation details, see -.
- **Anaesthesia Service (D047C): The anaesthetist service is compensated based on 12 basic units** plus time units. This includes pre-anaesthetic evaluation, the anaesthetic procedure, and post-anaesthetic follow-up. For calculation details, see -.
When to Use
- Use D047 for open reduction of acetabular fractures involving both the anterior and posterior columns, distinguishing it from the single-column approach of D046.
- Select D047 when the surgical plan necessitates a complex approach to stabilize both pillars of the acetabulum, rather than a simpler ORIF procedure.
Common Pitfalls
- Billing D047 alongside other fracture fixation codes for the same site often triggers a rejection for unbundling; ensure the procedure is coded as a single comprehensive service.
- Failure to correctly calculate the assistant's time units (D047B) beyond the 8 base units is a frequent cause of underpayment, as the assistant fee is strictly time-dependent.
Billing Tips
- Ensure the operative report explicitly details the involvement of both pillars to justify the use of D047 over D046 in the event of a post-payment audit.
- Always verify if the procedure qualifies for the emergency premium (E020C) if the surgery commences within 24 hours of booking, as this significantly impacts the anaesthesia (D047C) claim.
Effective: April 1, 2026
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
This procedure is for the open reduction of a dislocation of the acetabulum involving two pillars. The amount payable for the assistant's service (D047B) is calculated based on 8 base units plus time units. The amount payable for the anaesthetist's service (D047C) is calculated based on 12 base units plus time units.
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