D052 – Lips
OHIP Orthopaedic Surgery Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits
D052 is a surgical procedure for the open reduction of a dislocation of the acetabular lips. This service is performed by a surgeon (suffix A), and may be supported by a surgical assistant (suffix B) and an anaesthesiologist (suffix C). The fees for assistant and anaesthesia services are calculated based on basic units plus time-based units as per the Schedule of Benefits.
When to Use
- Use D052 specifically for the open reduction of a dislocated acetabular lip, distinguishing it from closed reduction procedures (D046/D047).
- Apply this code when the surgical approach requires an open incision to address the acetabular labral or lip pathology, rather than an arthroscopic or closed manipulation.
Common Pitfalls
- Failing to document the start and end times in the surgical record, which is mandatory for the calculation of time-based units for surgical assistants (suffix B) and anaesthesiologists (suffix C).
- Incorrectly billing D052 alongside other musculoskeletal procedures without adhering to the multiple procedure rule, where only the major procedure's basic units apply for the assistant and anaesthesiologist.
Billing Tips
- Ensure the trauma premium (E420) is only applied if the Injury Severity Score (ISS) is documented in the chart and the procedure occurs within 24 hours of the trauma event.
- When billing for ASA status (E022C, E017C, E016C), ensure the classification is clearly supported by the patient's pre-operative systemic disease status in the medical record to withstand audit.
Effective: April 1, 2026
N. Musculoskeletal System Surgical Procedures
MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
Surgical
Musculoskeletal System Surgical Procedures
For time-based components (surgical assistance, anaesthesia), the start and end times must be recorded in the patient's permanent medical record ().
The medical record must establish that an insured service was provided, the service for which the account is submitted is the service that was rendered, and the service was medically necessary ().
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