Schedule of Benefits for Professional Fees 2019 CONSULTATIONS PRE- PARTICIPATING STANDARD PARTICIPATING STANDARD PARTICIPATING STANDARD CODE DESCRIPTION APPROVAL PAYMENT PAYMENT RULES CONSULTANT CONSULTANT ANAESTHETIST ANAESTHETIST RADIOLOGIST RADIOLOGIST REQUIRED INDICATORS RATE RATE RATE RATE RATE RATE

Consultant plastic surgeon, cranio facialplasty, including the correction of 5691 craniosynostoses and facial synostoses No €€1,586.70 €€636.00 €€812.83 €€283.00

5692 Consultant neurosurgeon, neurosurgical involvement with cranio facialplasty No €€1,061.90 €€455.00

Co-surgery benefit for two surgeons who perform neuroendoscopy, intracranial; 647010 with excision of pituitary tumour, transnasal or transsphenoidal approach (I.P.) No Independent procedure Claimable by second surgeon assisting €€1,002.45 €€684.00 €€759.53 €€543.00 - Neurosurgeons benefit in procedure

Co-surgery benefit for two surgeons who perform spinal surgery (I.P.) Claimable by second surgeon assisting 647011 - ENT Surgeons benefit Yes Independent procedure in procedure €€1,002.45 €€684.00 €€759.53 €€543.00

ARTERIES / VEINS PRE- PARTICIPATING STANDARD PARTICIPATING STANDARD PARTICIPATING STANDARD CODE DESCRIPTION APPROVAL PAYMENT PAYMENT RULES CONSULTANT CONSULTANT ANAESTHETIST ANAESTHETIST RADIOLOGIST RADIOLOGIST REQUIRED INDICATORS RATE RATE RATE RATE RATE RATE

5290 Clipping aneurysm, anterior circulation (open procedure) No €€3,505.50 €€773.00 €€1,796.83 €€331.00

5292 Detachable balloon occlusion of carotico cavernous aneurysms and fistulae No €€2,107.40 €€455.00 €€1,072.15 €€136.00

Benefit is payable in full when performed with Contra-lateral carotid and vertebral angiography performed at the same session as code 5711 or 5712 5713 procedure codes 5711 or 5712 above (benefit shown is payable in full with the code No Benefit shown is payable in full with the code €€497.13 €€209.00 €€343.38 €€146.00 €€496.10 €€209.00 for the main procedure) for the main procedure

5779 Arteriovenous malformation, simple (< Spetzler 3) No €€2,129.95 €€1,135.00 €€1,089.58 €€639.00

5781 Arteriovenous malformation, complex (> Spetzler 3) No €€4,274.25 €€2,276.00 €€2,190.43 €€1,282.00

5782 Dural arteriovenous malformation No €€2,033.60 €€1,083.00 €€1,061.90 €€621.00

5783 Clipping aneurysm, posterior circulation (open procedure) No €€3,355.85 €€1,788.00 €€1,719.95 €€1,006.00

Anastomosis, arterial, extracranial-intracranial (e.g. middle cerebral/ cortical) 5784 arteries No €€2,521.50 €€1,342.00 €€1,293.55 €€754.00

BURR HOLES PRE- PARTICIPATING STANDARD PARTICIPATING STANDARD PARTICIPATING STANDARD CODE DESCRIPTION APPROVAL PAYMENT PAYMENT RULES CONSULTANT CONSULTANT ANAESTHETIST ANAESTHETIST RADIOLOGIST RADIOLOGIST REQUIRED INDICATORS RATE RATE RATE RATE RATE RATE

5490 Burr hole for excavation and/ or drainage of subdural haematoma No €€707.25 €€455.00 €€358.75 €€117.00

5645 Burr hole(s) for / abscess tapping No Diagnostic €€1,221.80 €€227.00 €€624.23 €€117.00

5650 Burr hole for ventricular puncture or intensive care monitoring (I.P.) No Independent Procedure €€403.85 €€253.00 €€177.33 €€117.00 BURR HOLES PRE- PARTICIPATING STANDARD PARTICIPATING STANDARD PARTICIPATING STANDARD CODE DESCRIPTION APPROVAL PAYMENT PAYMENT RULES CONSULTANT CONSULTANT ANAESTHETIST ANAESTHETIST RADIOLOGIST RADIOLOGIST REQUIRED INDICATORS RATE RATE RATE RATE RATE RATE

Twist drill, burr hole, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (e.g. , globus 5706 pallidus, subthalamic, nucleus, periventricular, periaqueductal gray), without No €€1,316.10 €€700.00 €€796.43 €€465.00 use of intraoperative microelectrode recording

Twist drill, burr hole, craniotomy or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (e.g. thalamus, globus 5707 pallidus, subthalamic, nucleus, periventricular, periaqueductal gray), with No €€2,173.00 €€1,155.00 €€1,310.98 €€766.00 use of intraoperative microelectrode recording

Burr hole(s) for brain biopsy/ abscess tapping/ implanting ventricular 5744 catheter, reservoir, EEG electrode(s) or pressure recording device No €€1,625.65 €€864.00 €€829.23 €€486.00

CRANIECTOMIES PRE- PARTICIPATING STANDARD PARTICIPATING STANDARD PARTICIPATING STANDARD CODE DESCRIPTION APPROVAL PAYMENT PAYMENT RULES CONSULTANT CONSULTANT ANAESTHETIST ANAESTHETIST RADIOLOGIST RADIOLOGIST REQUIRED INDICATORS RATE RATE RATE RATE RATE RATE

5295 Craniectomy or craniotomy for cerebellar haematoma No €€1,917.78 €€773.00 €€984.00 €€331.00

5320 Craniectomy for excision of brain tumour, supratentorial No €€1,974.15 €€546.00 €€1,011.68 €€331.00

5365 Craniectomy for meningioma, supratentorial No €€2,432.33 €€546.00 €€1,249.48 €€283.00

5410 Craniectomy or craniotomy for intracerebral haematoma No €€1,730.20 €€500.00 €€884.58 €€225.00

5420 Craniectomy or craniotomy for abscess No €€1,774.28 €€500.00 €€912.25 €€225.00

5470 Craniotomy for removal of pituitary tumour or to resect a portion of gland No €€2,173.00 €€683.00 €€1,111.10 €€225.00

5751 Craniectomy for foramen magnum decompression (A-C; syringo) No €€2,068.45 €€1,100.00 €€1,061.90 €€620.00

5752 Craniectomy for nerve section/ decompression No €€1,969.03 €€1,048.00 €€1,011.68 €€591.00

5753 Craniectomy for bone tumour, supratentorial No €€1,244.35 €€662.00 €€635.50 €€372.00

5754 Craniectomy for excision of brain tumour, infratentorial No €€2,588.13 €€1,379.00 €€1,327.38 €€774.00

5757 Craniectomy for meningioma, infratentorial No €€2,870.00 €€1,528.00 €€1,470.88 €€860.00

5758 Craniectomy for cerebellopontine angle tumour (includes acoustic neuroma) No €€3,803.78 €€2,025.00 €€1,951.60 €€1,141.00

5759 Craniectomy for midline base tumour No €€3,085.25 €€1,642.00 €€1,581.58 €€924.00

5768 Craniectomy for excision/ fenestration cyst No €€1,935.20 €€1,029.00 €€989.13 €€580.00

5774 Craniectomy for repair of skull base, encephalocoele No €€1,498.55 €€796.00 €€780.03 €€456.00 CRANIECTOMIES / PRE- PARTICIPATING STANDARD PARTICIPATING STANDARD PARTICIPATING STANDARD CODE DESCRIPTION APPROVAL PAYMENT PAYMENT RULES CONSULTANT CONSULTANT ANAESTHETIST ANAESTHETIST RADIOLOGIST RADIOLOGIST REQUIRED INDICATORS RATE RATE RATE RATE RATE RATE

5747 Craniectomy or craniotomy, exploratory, supratentorial (I.P.) No Independent Procedure €€1,520.08 €€811.00 €€780.03 €€456.00

5748 Craniectomy or craniotomy, exploratory, infratentorial (I.P.) No Independent Procedure €€1,847.05 €€983.00 €€962.48 €€563.00

5749 Craniectomy or craniotomy for extra/ subdural haematoma No €€1,703.55 €€908.00 €€874.33 €€509.00

CRANIOTOMIES PRE- PARTICIPATING STANDARD PARTICIPATING STANDARD PARTICIPATING STANDARD CODE DESCRIPTION APPROVAL PAYMENT PAYMENT RULES CONSULTANT CONSULTANT ANAESTHETIST ANAESTHETIST RADIOLOGIST RADIOLOGIST REQUIRED INDICATORS RATE RATE RATE RATE RATE RATE

5376 Craniotomy for excision epileptic focus No €€1,454.48 €€728.00 €€757.48 €€283.00

Craniotomy for lobectomy (epilepsy) with electrocorticography during surgery 5377 (includes removal of electrode array) No €€2,466.15 €€921.00 €€1,266.90 €€283.00

Craniotomy with elevation of bone flap (for intractable epileptic seizures); for 5378 lobectomy, temporal, temporal lobe, without electrocorticography during surgery No €€2,521.50 €€1,399.00 €€1,498.55 €€876.00

Craniotomy with elevation of bone flap (to treat intractable mesial temporal lobe 5379 epilepsy); for selective No €€2,244.75 €€1,244.00 €€1,332.50 €€779.00

Craniotomy with elevation of bone flap; for subdural implantation of an electrode 5764 array, for long term seizure monitoring No €€1,365.30 €€728.00 €€713.40 €€418.00

Craniotomy with elevation of bone flap; for removal of epidural or subdural 5766 electrode array, without excision of cerebral tissue No €€806.68 €€430.00 €€420.25 €€247.00

5767 Craniotomy for transection of corpus callosum No €€2,000.80 €€1,066.00 €€1,045.50 €€609.00

5769 Craniotomy for excision of craniopharyngioma (complete removal) No €€3,041.18 €€1,618.00 €€1,559.03 €€910.00

Craniofacial approach to anterior cranial fossa; intradural, including unilateral or 5776 bifrontal craniotomy, elevation or resection of frontal lobe, osteotomy of base of No €€2,510.23 €€1,337.00 €€1,288.43 €€752.00 anterior cranial fossa

SHUNTS

PRE- PAYMENT PARTICIPATING STANDARD PARTICIPATING STANDARD PARTICIPATING STANDARD CODE DESCRIPTION APPROVAL PAYMENT RULES CONSULTANT CONSULTANT ANAESTHETIST ANAESTHETIST RADIOLOGIST RADIOLOGIST REQUIRED INDICATORS RATE RATE RATE RATE RATE RATE

5520 Shunt insertion No €€895.85 €€364.00 €€458.18 €€117.00

5525 Shunt revision No €€730.83 €€364.00 €€376.18 €€117.00

5796 Shunt removal No €€458.18 €€244.00 €€231.65 €€139.00 SYMPATHECTOMIES PRE- PARTICIPATING STANDARD PARTICIPATING STANDARD PARTICIPATING STANDARD CODE DESCRIPTION APPROVAL PAYMENT PAYMENT RULES CONSULTANT CONSULTANT ANAESTHETIST ANAESTHETIST RADIOLOGIST RADIOLOGIST REQUIRED INDICATORS RATE RATE RATE RATE RATE RATE

5761 Cervical sympathectomy, unilateral No €€889.70 €€409.00 €€525.83 €€117.00

5762 Cervical sympathectomy, bilateral No €€1,040.38 €€477.00 €€785.15 €€117.00

5765 Lumbar sympathectomy, unilateral No €€889.70 €€409.00 €€447.93 €€88.00

5770 Lumbar sympathectomy, bilateral No €€1,040.38 €€477.00 €€465.35 €€117.00

OTHER NEUROSURGICAL PROCEDURES PRE- PARTICIPATING STANDARD PARTICIPATING STANDARD PARTICIPATING STANDARD CODE DESCRIPTION APPROVAL PAYMENT PAYMENT RULES CONSULTANT CONSULTANT ANAESTHETIST ANAESTHETIST RADIOLOGIST RADIOLOGIST REQUIRED INDICATORS RATE RATE RATE RATE RATE RATE

5325 Penetrating brain injury with removal foreign body No €€1,829.63 €€592.00 €€939.93 €€225.00

5370 CSF leak repair via craniectomy or nasal endoscopy (I.P.) No Independent Procedure €€1,526.23 €€592.00 €€785.15 €€117.00

5400 No €€2,151.48 €€728.00 €€1,122.38 €€283.00

5484 Stereotactic computer assisted volumetric intracranial procedure No Payable in full with main benefit €€281.88 €€113.00

5590 Intracranial sensory root division (trigeminal) No €€1,194.13 €€546.00 €€730.83 €€283.00

5665 Elevation depressed skull fracture No €€1,122.38 €€364.00 €€586.30 €€166.00

5690 Excision of osteoma calvarium No Day Care €€989.13 €€455.00 €€525.83 €€117.00

5693 Skull bone grafting to facial skeleton No €€939.93 €€432.00 €€525.83 €€117.00

5695 Repair of platybasia No €€2,034.63 €€455.00 €€978.88 €€570.00

5708 Revision or removal of intracranial neurostimulator electrodes No €€436.65 €€231.00 €€265.48 €€155.00

Percutaneous transcatheter occlusion or embolisation of tumour, acute haemorrhage, vascular malformation or aneurysm includes angioplasty, stenting 5711 or clot extraction from any vessel(s) external or internal carotid or vertebral No Code 5711 is not claimable with Code 5712 €€2,466.15 €€1,035.00 €€1,464.73 €€621.00 €€2,460.00 €€1,035.00 arteries including distal branches; includes angiographic evaluation before, during and after the procedure, at the same session

Percutaneous transcatheter occlusion or embolisation of tumour, acute haemorrhage, vascular malformation or aneurysm includes angioplasty, stenting or clot extraction from any vessel(s) external or internal carotid or vertebral 5712 arteries including distal branches; including any combination of more than one of No Code 5712 is not claimable with Code 5711 €€3,002.23 €€1,260.00 €€1,785.55 €€756.00 €€2,995.05 €€1,260.00 the following: microcatheter, balloon catheter; stent catheter or clot retrieval device required for complex embolisation; includes angiographic evaluation before, during and after the procedure, at the same session

5725 Anomalies of cord vascular, operation for No €€2,101.25 €€773.00 €€912.25 €€225.00

Intraoperative neurophysiology testing by a consultant Neurophysiologist to 5741 monitor motor evoked potentials/ sensory evoked potentials of the No €€613.98 €€340.00 during spinal surgery

5743 Botulinum toxin injection for treatment of cervical dystonia No Side Room €€138.38 €€72.00 OTHER NEUROSURGICAL PROCEDURES PRE- PARTICIPATING STANDARD PARTICIPATING STANDARD PARTICIPATING STANDARD CODE DESCRIPTION APPROVAL PAYMENT PAYMENT RULES CONSULTANT CONSULTANT ANAESTHETIST ANAESTHETIST RADIOLOGIST RADIOLOGIST REQUIRED INDICATORS RATE RATE RATE RATE RATE RATE

5756 Intrathecal cytotoxic chemotherapy infusion No Side Room €€348.50 €€160.00 €€177.33 €€53.00

5763 Exploration of the brachial plexus with removal of tumours No €€1,293.55 €€592.00 €€652.93 €€225.00

5771 Nerve root tumours, transthoracic or abdominal removal No €€989.13 €€455.00 €€746.20 €€225.00

Single surgeon transnasal or transseptal approach to remove a pituitary tumour 5772 or resect a portion of gland (I.P.) No Independent Procedure €€1,493.43 €€796.00 €€762.60 €€449.00

5773 Repair of encephalocoele, skull vault, including No €€1,620.53 €€863.00 €€829.23 €€485.00

Infratemporal post-auricular approach to middle cranial fossa (internal auditory meatus, petrous apex, tentorium, cavernous sinus, parasellar area, infratemporal 5777 fossa) including mastoidectomy, resection of sigmoid sinus with or without No €€3,029.90 €€1,613.00 €€1,553.90 €€907.00 decompression and/ or mobilization of contents of auditory canal or petrous carotid artery

Trans cochlear approach to posterior cranial fossa, jugular foramen or midline skull 5778 base, including labyrinthectomy, decompression, with or without mobilization of No €€2,471.28 €€1,316.00 €€1,266.90 €€740.00 facial nerve and/ or petrous carotid artery

5786 Stereotactic lesioning (functional) No €€1,160.30 €€620.00 €€597.58 €€349.00

5787 Stereotactic biopsy (CT or MRI targeted) No €€1,221.80 €€650.00 €€624.23 €€366.00

5788 Cranioplasty for skull defect (I.P.) No Independent Procedure €€939.93 €€499.00 €€475.60 €€279.00

Transoral approach to skull base, brain stem or upper spinal cord for biopsy, 5789 decompression or excision of lesion (I.P.) No Independent Procedure €€2,383.13 €€1,269.00 €€1,244.35 €€727.00

Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital 5791 ridge osteotomy and elevation of frontal and/ or temporal lobe(s) (I.P.) No Independent Procedure €€2,404.65 €€1,280.00 €€1,254.60 €€734.00

Transtemporal approach to posterior cranial fossa, jugular foramen or midline 5792 skull base, including mastoidectomy, decompression of sigmoid sinus and/ or facial No Independent Procedure €€2,051.03 €€1,092.00 €€1,050.63 €€615.00 nerve (I.P.)

5797 Endoscopic third or cyst fenestration No €€1,272.03 €€677.00 €€652.93 €€380.00

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Irish Life Health dac is regulated by the Central Bank of Ireland. Terms and Conditions apply. Registered in Ireland No. 376607. Registered Office: Irish Life Centre, Lower Abbey Street, Dublin 1 Q71-3-0519