< Billing codes

Billing code

D038A — Knee dislocation – closed reduction

Knee dislocation, closed reduction

Bill for putting a dislocated knee joint back in place without surgery.

Watch for: Kneecap dislocations use their own codes (D040, D031, D041); an anaesthetic you give yourself isn't paid.

Code

D038A

Description

Knee dislocation – closed reduction

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

Closed reduction of a knee dislocation.

What it covers

D038 is closed reduction of a knee dislocation (N48). Open reduction is D039 (N48). Patellar dislocations have their own codes, D040, D031 and D041 (N49).

Billing rules

• Closed reduction means reduction by non-operative methods, including traction (N1).
• An anaesthetic or nerve block you give for your own procedure is not payable (SP5).
• The major pre-operative visit (the consultation or assessment where you decide to treat) may be billed in addition to the fracture or dislocation fee (N1, SP2).
• Multiple fractures or dislocations: the major one is paid at 100% and each other one at 85% (N1).
• If after-care is transferred to another physician, you claim 75% of the fee and the receiving surgeon bills visits (N2).
• Plaster casts or corrective splints applied at surgery or in the first 2 weeks are not billed separately when a fracture or dislocation fee applies (N7).
• Non-elective and started after hours: add E409 (+50%, weekday evenings and weekend/holiday days and evenings) or E410 (+75%, nights 00:00–07:00) (GP103–GP104, SP2).
• Repeat reductions of the same fracture or dislocation: claim the full fee for the final reduction and after-care; earlier reductions by the same surgeon are claimed at 85% (N2).

Related codes: D039, D040, D031, D041

Source: Schedule of Benefits (July 1, 2026), Musculoskeletal System Surgical Procedures, Knee, page N48. Fracture and dislocation rules N1–N2.

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