< Billing codes

Billing code

D010A — Dislocations - Elbow Joint - Open Reduction Acute

Elbow dislocation, open reduction

Bill for surgically reducing an acute elbow dislocation, including any internal or external fixation.

Watch for: Closed reduction is D009 and chronic recurrent dislocation repair is R400; transferring after-care means you bill 80%.

Code

D010A

Description

Dislocations - Elbow Joint - Open Reduction Acute

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Apr 1, 2026

Termination date

No end date

Explanation

Updated October 26, 2026

Open reduction of an acute elbow joint dislocation. Closed reduction is D009; repair of a chronic, recurrent dislocation is R400.

What it covers

D010 is open reduction of an acute dislocation of the elbow joint (N20). Open reduction means treatment by closed intramedullary fixation or by an operation that exposes the injury, and the fee includes fixation by internal or external devices (N1).

It is marked #: the fee doesn't include the premises, equipment, supplies and personnel, which are funded by the hospital budget in hospital (GP13). Radial head dislocations have their own codes: D012 for closed reduction of a pulled elbow and D011 for open reduction (N20).

Billing rules

• The major pre-operative visit (consultation or appropriate assessment) is billed in addition to D010 (N1).
• With multiple fractures or dislocations, the major one is paid at 100% and the others at 85% (N1).
• For repeat reductions of the same dislocation, the final reduction and after-care are claimed in full and earlier reductions by the same surgeon at 85% (N2).
• If the patient is transferred to another physician for after-care, the surgeon who did the open reduction claims 80% of the fee (N2).
• E556 adds 50% to the reduction fee when extensive debridement of a compound dislocation is needed (N4).
• A non-elective reduction started in the evening, at night, or on a weekend or holiday takes E409 (+50%) or E410 (+75%), or E412/E413 for an emergency department physician billing H-prefix codes (GP103, GP104).
• The surgical assistant bills 6 basic units with suffix B and the anaesthetist 7 basic units with suffix C (N20, SP5).
• Surgical procedures for patients under 16 are paid with an age premium of 10% to 30% depending on age (GP64).

Often billed with

• The consultation or assessment where the decision to operate is made, as the major pre-operative visit (N1, GP4).
• E409 or E410 after-hours premium for a non-elective reduction (GP104).
• E556 for extensive debridement of a compound dislocation (N4).

Related codes: D009, R400, D011, D012, E556, E409

Source: Schedule of Benefits (July 1, 2026), Musculoskeletal System Surgical Procedures, Elbow and Forearm, Dislocations, page N20; section preamble N1–N2 and N4; General Preamble GP13, GP64, GP103–GP104; Surgical Preamble SP5

APEX checks every paid claim against the Schedule of Benefits and flags codes billed below what the visit qualified for. See how APEX works · Pricing