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E504

E504Metacarpal - each additional

OHIP Surgical Assists Code — MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES · Schedule of Benefits

This fee code is payable for each additional metacarpal fracture that undergoes a closed reduction during the same operative session. It is an add-on to F009, which covers the first metacarpal fracture reduction.

When to Use

  • Use E504 when performing a closed reduction on a second or subsequent metacarpal fracture during the same operative session as the primary reduction billed under F009.
  • Use this code for each additional metacarpal bone treated; if you reduce three metacarpal fractures, you should bill F009 for the first and E504 twice.

Common Pitfalls

  • Billing E504 without an associated F009 on the same claim will result in an automatic rejection.
  • Do not use E504 for phalangeal fractures; those require different codes such as F008 or F011 depending on the specific anatomy and procedure.
  • Attempting to bill E504 for open reductions is incorrect, as this code is strictly defined for closed reductions.

Billing Tips

  • Ensure the number of units for E504 matches the number of additional metacarpals reduced to avoid manual review or claim adjustment.
  • If after-hours premiums like E409 or E410 apply, ensure they are calculated based on the total procedural fee including the E504 add-on.
Provider Fee$22.20

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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