0 Certified to be a true copy of an Order of his Honour the

EXCUTVE coUNCIL Lieutenant Governor of Nova Scotia in Council made the

24th day of March A. D. 1981

NOVA scoriA N. S. Reuhton _3i/_’)

81-379 / The Governor in Council on the report and recommendation of the Minister of Health dated the 13th day of March, A... D., 1981, and pursuant to clause (a) of subection (1) of Section 11 of Chapter

8 of the Statutes of Nova Scotia, 1973, the Health Services and Insurance Act, and subsection (3) of Section 4 of Chapter 15 of the Statutes of Nova Scotia, 1973, the Regulations Act, is pleased to:

(a) approve and authorize payments by the Health Services Insurance and Commission in respect of the tariff of fees for insured medical services attached to and forming part of the report and recommendation, and marked Schedule “A”, effective for a period of one year, comrnencing.on the 1st day of April, A. D., 1980, at a rate of 85% of the fee so calculated; and

(b) order that the publication of this regulation be dispense4

with due to the length of the Schedule attached to and forming part of the report and recommendation.

1-3. H F. G. STEVEiS, Q..C., CLEKOF THE EXECUTIVE COUNCIL. 5/1

SCHEDULE “A”

TABLE OF CONTENTS

PREAMBLE 2

UNIT VALUE SYSTEM 21

MISCELLANEOUS FEES 22

FAMILY PRACTICE 24

ANAESTHESIA 26

DERMATOLOGY 29

INTERNAL MEDICINE 31

NEUROLOGY 33

PHYSICAL MEDICINE AND REHABILITATION 35

PABDIATRICS 37

PSYCHIATRY 39

DIAGNOSTIC AND THERAPEUTIC PROCEDURES 41

GENERAL SURGERY 51

NEUROSURGERY 75

OBSTETRICS AND GYNAECOLOGY 82

OPHTHALMOLOGY 87

OTOLARYNGOLOGY 92

ORTHOPAEDIC SURGERY 98

PLASTIC SURGERY 116

UROLOGY 124

RADIATION ONCOLOGY 133

PATHOLOGY CONSULTATIONS 134

INDEX 150

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PREAMBLE

INTRODUCTION

This 1980 edition of the Fee Schedule represents an updating of the 1967 (revised) Schedule. Future revision of this Schedule will be carried out on an on-going basis with major changes being promulgated annually. This Schedule of Fees is set up in Sections for each of the recognized Spe cialties together with the fees for consultations, visits, miscellaneous items, diagnostic and surgical procedures usually associated with each Section. Specific operative procedures are classified under Incision, Excision, Introduction, Repair, etc. There is a separate Section for Diagnostic and Therapeutic Procedures. 1. TARIFF

Please note that the M S I tariff is 85% of the fees negotiated between the Health Services and Insurance Commission and the Medical Society of Nova Scotia.

2. GENERAL CONSIDERATIONS

2.1 This Schedule of Fees is to be used as a guide and represents in the average case a fair return for services rendered by physicians licensed to practice in the Province of Nova Scotia. The mdi vidual physician; however, has the right to establish the value of his services at all times.

2.2 Prior discussion with the patient regarding fees is recommended.

2.3 A reduction in fee may be made at the discretion of the physician when—

(i) the suggested fee could prove a financial hardship to the patient;

(ii) services are rendered at the convenience of the physician for chronic or prolonged illness.

2.4 A fee higher than the suggested Schedule may be charged at the

discretion of the physician when -

(i) complications occur and/or circumstances exist demanding unusual skill, responsibility and time;

(ii) the patient requires or demands extra attention.

1VOTE: Under M S I, when a physiciai charges above the tariff, refer to the M S I Physicicuz’s ManuaL, for the proper procedure (page 8/1).

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Services Insurance, in the1 2.5 Fees disputed with Nova Scotia Medical of the Medical first instance should be brought to the attention solution, the Director of Maritime Medical Care and, failing M S I Physician’s Appeal Procedures out-lined in Chapter 3 of the Manual should be followed. discretion of Advice by telephone or letter may be charged at the 2.6 Medical. the physician. (Not an insured service under Nova Scotia Services Insurance). use of the 2.7 Mileage is to be charged on a ‘time basis’ by the an ‘Detention Fee’ explained on page 8 of the Preamble. (Not insured service wider Nova Scotia Medical Services Insurance). for professional 2.8 Fees listed (unless otherwise indicated) are for drugs, services only and are not intended to cover charges injectible materials, dressings or appliances used in rendering items medical care. An additional charge may be made for such where appropriate. (Not insured services wider Nova Scotia Medical Services Insurcuzce).

3. PRINCIPLES OF ETHICAL BILLING of a 3.1 Each medical practitioner who participates in the care patient is entitled to compensation commensurate with the services rendered to the patient. the 3.2 The attending physician, whenever possible, should acquaint patient or person responsible with the financial obligation in volved in his care. This applies particularly when more than one physician is involved or when the patient is referred outside the Province.

should 3.3 Each physician who participates in the care of a patient render directly to the patient, or to the financially responsible’ party, an itemized statement of charges for his professional services. This statement should clearly separate professional services from supplies.

3.4 A patient is entitled to receive a receipt for all payments made • by him or on his behalf directly to the physician.

3.5 Any statement of charges from an organized clinic or partnership should specify the fees for services rendered by each and every member of the group.

3.6 It is expected a physician will not charge for services provided to his own family.

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4. TERMS AND DEFINITIONS

4.1 Visits

Call or visit refers to services by a physician to a patient for diagnosis and/or treatment at home, office or hospital.

4.2 Emergency Visit

Emergency visit refers to a situation where the demands of the patient and/or the physician’s interpretation of the condition is such that he respond immediately at the sacrifice of regular office hours. The need for immediate response is the intended controlling feature. This would not apply for a patient attend— ing your office during regular office hours. Immediate attend ance because of personal choice or availability is not considered an emergency visit. Urgent visits for acute or chronic con ditions which do not interfere with regular hours do not consti tute emergency visits.

4.3 Urgent Care - Request by Patient

A request by a patient for urgent care (as opposed to emergency care) which is provided by a physician outside normal office hours entitles the physician to a fee for a home visit for the first patient seen.

Subsequent patients attended at this time - regular office visit fees apply.

Where office hours are maintained in the evenings, on Saturday, Swday or holidays, or where patients are seen at the convenience of the physician at these times, regular office visit fees apply.

4.4 Initial Visit

Initial visit refers to the services rendered a patient when the physician has not rendered medical care during the previous 30 days.

4.5 Subsequent Visits

Subsequent visits refer to continuing services during any illness.

4.6 Continuing Care Visits

Continuing care visits apply following a consultation at the request of the referring physician (see concurrent care 12.3.3 page 5/12.

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4.7 Directive Care Visits

Refer to concurrent care 12.3.2 page 12 for details of circuin— stances in which directive care applies.

4.8 Visits for Procedure Only

When the sole reason for a visit is the performance of a certain procedure, the listed fee for the procedure only will apply — except where otherwise specified.

4.9 Hospital Visit

Hospital visit refers to services rendered a patient formally admitted to hospital for diagnosis and/or treatment.

A physician may only charge for visits made for, or procedures performed on, those patients actually seen.

4.10 Out-Patient Department or Emergency Room Visits

When the physician is required to make a special trip to the hospital to attend a patient in the Out—Patient or Emergency Department, the visit fees to apply will be found in the mis cellaneous section of the MSI Tariff.

4.11 Emergency Care Centre Visits

Emergency Centres must meet the criteria established by the Health Services and Insurance Commission.

4.12 Home Visit

A home visit is a visit rendered to the first patient seen follow ing travel to the patient’s home. The appropriate home visit fee will apply.

4.12.1 Extra Patients at Home Visits

Extra patient refers to an additional member of the same family or person living in the same home or institution and seen or prescribed for during a visit to that home or institution.

4.12.2 Follow-Up Home Visits

When follow-up home visits are made at the convenience of the physician, the week day home visit fee will apply regardless of when the visit is made.

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4.13 ge Definitions

4.13.1 ‘Child’ refers to a person 15 years of age or younger.

4.13.2 ‘Adult’ refers to a person 16 years of age or older.

5. INSTITUTIONAL VISITS

When a visit is made to a patient in an institution on the specific request of an appropriate institutional authority, patient or patient’s family/guardian, the rules and fees for home visits shall, apply. This means that the first patient seen will be charged for at the appropriate home visit fee and additional patients at the ‘extra patient’ fee.

When pre—arranged routine visits are made to an institution, visit fees shall be claimed only for those patients where medical necessity exists. tinder these circumstances, the rules and fees for office visits shall apply.

Where unusual circumstances exist and the physician feels his services are inadequately compensated for under the institutional; visit rules, he may enter into a contractual agreement with the institution for a form of ‘retainer’ or other remuneration method to supplement his income from visit fees.

6. EXAMINATIONS

6.1 Complete History and Physicial Examination

A complete history and physical examination is a service that will vary from specialty to specialty. It shall comprise a full history, an enquiry into and an examination of all parts or sys tems, a complete record, and advice to the patient. Routine

urinalysis, hemoglobin estimation, pap smear and venipuncture if necessary, will be considered part of the examination.

In the case of regional specialties the service may comprise of only a full history of the presenting complaint, enquiry concer ning and detailed examination in keeping with the specialty involved, as needed to make a diagnosis, exclude disease and/or assess function.

A complete physical examination is only an insured service under Nova Scotia Medical Services Insurance when it is medically required.

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6.2 Regional or Partial Examination

A regional or partial examination, as in an ordinary office visit, shall include the necessary history, physical examination and routine laboratory tests as indicated to evaluate a region or system as well as a record of the findings and advice to the patient.

6.3 Health Examination

A health examination (for insurance, pre-employinent, pre—school, periodic routine examination, etc.) refers to examination of individuals at: any age who may or may not have signs or symptoms of disease or disability. The fee charged will depend upon the degree to which a regional or complete examination is necessary to fulfill the purpose of the examination. Special circumstances. may warrant an increased fee.

A health exajnination is not an insured service under Nova Scotia Medical Services Insurance.

7. CONSULTATIONS

7.2. Definition of Consultation

Consultation refers to a request by one physician for an opinion from another physician competent to furnish advice when the circumstances of th patient’s condition demand a further opinion, or if another opinion is requested by the patient or an author ized person acting on his behalf. No consultation should be charged to the patient or his agent unless it has been requested by the attending physician.

The Health Services and Insurance Act, Item 26, provides that Nova Scotia Medical Services Insurance has the right to request a copy of the consultation report.

7.2 Major Consultation

A major consultation requires that the consultant obtain a complete history and do a physical examination, review pertinent x-ray films, laboratory or other data and submit his opinion and recommendations, in writing, to the referring physician. The patient is returned to the referring physician unless other arrangements are made between that physician and the consultant; e.g., continuing or directive care.

7.3 Minor Consultation

When a physician refers a patient for consultation to obtain an

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opinion on a condition requiring a partial examination only, this shall be deemed a minor consultation. This would normally require a limited history and a regional physical examination together with a written report to the referring physician. The patient is returned to the referring doctor unless other arrange ments are made between that physician and the consultant; e.g., continuing or directive care.

7.4 Intra—Group Consultations

Physicians formally organized as a group practice, clinic, etc., are entitled to the usual fees.

The Health Services and Insurance Act, Item 26, provides that Nova Scotia Medical Services Insurance has the right to request a copy of the consultation report.

7.5 Repeat Consultation

A repeat consultation only applies where there has been a re referral by the attending physician to the same consultant for the same illness, or complication thereof, within 30 days of the initial consultation.

8. DETENTION FEE

Detention fee may be claimed only when the practitioner’s whole time is given to the patient to the exclusion of all other work. This is interpreted to mean that the physician is occupied completely with the patient. It does not cover waiting time for x-ray reports, laboratory results or administrative duties, etc.

Detention fee z,nlZ be considered for payment under Nova Scotia Medical Services Insurozce in emergency cases whether it be at the bedside1 in the car or ambulance on the way to a hospital, or at the hospital. The circumstances in each case, and the time involved, should be documented on your claim card.

See 0100 — Page 5/22.

MILEAGE

The fee for mileage shall be calculated on the following basis - the total time taken to travel from the physician’s office to the patient and back to his office, less one—half hour. The one- half hour being compensated for by the appropriate visit fee.

Mileage or travelling time is not an insured service under Nova Scotia Medical Services Insurance and should be billed directly to the patient.

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10. INDEPENDENT CONSIDERATION - I C

Independent Consideration will be given to certain procedures identified as Independent Consideration in the Schedule on which it has been difficult to establish fair average fees or for pro cedures not listed in the Schedule and in other exceptional circumstances.

In every instance where the term Independent Consideration is used, or Fee Code 0140 is indicated, complete details, adequate to explain and justify the charges, must accompany the claim. It is essential that the physician indicate what he considers to be an adequate fee for his services.

1l. !PROFESSIONAL SERVICES

.11.1 Anaesthetic Services

The fees listed are for all types of anaesthesia. Anaesthetic services includes preoperative examination, administration of • anaesthetic substances, injections, transfusions, I V’s, pro cedures such as intubation, laryngoscopy, use of monitor (E K G) and other procedures related to the anaesthetic technique used and the postoperative attendance. This latter is interpreted as that point in time when the Anaesthetist determines he can safely place the patient under the customary postoperative supervision.

11.2 The anaesthetic fees are determined by adding the Basic Units and Time Units.

11.2.1 Basic Unit

A Basic Unit is listed for most procedures. This includes the value of all anaesthetic services except the time actually spent administering the anaesthesia and any modifying factors or in unusual detention with the patient.

)11.2.2 Time Unit

The Time Units are computed by allowing one Unit for each fif teen minutes or part thereof of anaesthesia time. Anaesthesia time begins when the Anaesthetist is first in attendance with the patient for the purpose of creating the anaesthetic state and ends when he is no longer in personal attendance (when the patient may be safely placed under customary postoperative supervision).

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11.3 When special circumstances require the services of more than one Anaesthetist, in the interest of the patient, the second Anaesthetist will be entitled to a fee equivalent to 50% of the stated fee.

11.4 When multiple or bilateral surgical procedures are done during the same anaesthetic, the anaesthetic charge shall be based upon the Basic Unit for the major procedure plus Time Units. When bilateral procedures or surgical revisions are carried out at separate times with separate anaesthetics, the Anaesthetist shall be entitled to receive a full anaesthetic fee for each procedure.

11.5 I procedures where no value is listed or with I C, the basic portion of the calculated value will be the same as listed for a comparable procedure considering region and modifying con ditions or techniques.

Documentation of the modifying factors is required by M S I.

11.6 When unusual detention with the patient immediately before or after anaesthesia is essential for the safety and welfare of such patient, the necessary time will be valued on the same basis as indicated for the anaesthetic time.

11.7 Anaesthetic Stand—By Fee

This fee applies only when no anaesthesia is given or delayed for more than one hour.

11.8 Special Anaesthetic Procedures

11.8.1 Integumentary System

For anaesthesia for procedures on the integumentary system done about the head, neck or back, and those in which positioning requires intubation, add one unit to the Basic Units except for procedures specifically listed for the head and neck.

11.8.2 Cardiac By-Pass

When a pump with or without an oxygenator and with or without hypothermia is employed in conjunction with an anaesthetic, the anaesthetic Basic Unit will be 35. To compensate for variations in anaesthetic practice, special respiratory intensive care, or detention for the purpose of intensive treatment of other types, claims should be submitted separately with the

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11.8.3 Controlled Hypotension

Controlled hypotension using a specific technique to produce androgenic blockage in association with an anaesthetic, 10 Units should be added to the Basic Units for the procedure.

11.8.4 Hypothermia

When hypothermia is employed in conjunction with anaesthesia, the Basic Unit will be 25. The Fee Code for the procedure should be used.

11.8.5 Therapeutic Hypothermia

Please refer to page 5/27.

11.8.6 Intubation

For anaesthetic procedures requiring intubation (with the exception of tonsillectomy and adenoidectomy) the minimum Basic Units shall be 4.

11.9 Anaesthesia for Obstetrics

11.9.1 The Anaesthetist’s services include the usual and immediate care of the newborn. When active resuscitation is necessary, add 3 Units.

11.9. 2 Con inuous Conduction Anao Llicsia

Please refer to Fee Codes 0167 and 0168 on page 5/26.

11.9.3 Resuscitation

If resuscitation is necessary during anaesthesia, add to anaesthetic time.

11.9.4 Surgical Anaesthesia — Infants

Anaesthetic fee is increased by 5 basic units for infants under 5 kilograms.

12. REFERRED SERVICES

12.1 Transferral

A transferral, as distinguished from a referral, takes place where the responsibility for the care of the patient is completely transferred, permanently or temporarily, from one physician to another (e.g., where the first physician is

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leaving temporarily on holidays or otherwise unable to continue to treat the case). In such cases, the physician to whom the patient is transferred is not entitled to a consultation fee. 12.2 Referral

A referral takes place when one physician requests the services of another physician for the patient. The services latter of the may consist of -

(i) An opinion (i.e., a consultation).

(ii) Diagnostic tests or procedures (e.g., skin test, biopsy, etc.). NOTE: In such cases the referring physici continues to treat the case himself.

(iii) Treaiment (surgical or medical).

12.3. Concurrent Care

12.3.1 Consultation Only

Where the attending physician maintains day-to-day responsibility for care and requests only a consultation, the attending physician should charge on a per visit basis and the consultant may charge a consultation fee.

12.3.2 Directive Care by Consultant

In cases where the attending physician treats the patient on a day—to—day basis but, because of the seriousness of the condition, requests continuing directive care by a consultant, subsequent to a consultation, the attending physician should charge on a per visit basis and the consultant should claim under care codes directive to the maximum of 5 visits per week.

12.3.3 Continuing Care by Consultant

In cases of unusual severity, subsequent to a consultation, where the attending physician requests the consultant to assume the day-to-day responsibility for the care of the patient for a period of time, the consultant should charge under continuing care codes and the attending physician under the supportive care codes.

12.3.4 Care by More than One Physician

In the situation where the medical indications require the services of more than one physician for the adequate care of

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the patient, each physician should render a separate account for his services. This is interpreted to mean that the services of two physicians are required for unrelated conditions. This does not apply where a single fee for a team of physicians is listed in the Schedule.

13. OBSTETRICAL SERVICES

In the Obstetrical Care Section of the Schedule the composite fee principle applies.

13.1 Routine Obstetrical Care

Routine obstetrical care consists of prenatal care, delivery, postpartum care and postnatal visit and care for less serious obstetrical complications incidental to the pregnancy; e.g., cystitis and simple anemia. It does not include services rendered for major complications requiring hospital care, visits or services for unrelated conditions or care of the newborn.

13.2 Prenatal Care

Prenatal care includes a complete history and physical exam ination, routine prenatal visits with necessary haemoglobin estimation and urinalysis and the taking and submission of a pap smear.

13.3 Delivery

Delivery covers services rendered during labor and delivery, including medical or surgical inductions by the attending physician, suturing of minor lacerations, all obstetrical manoeuvres that may be required (e.g., use of forceps).

13.4 Postnatal Care

The postnatal period is defined as 6 weeks from the delivery date. Postnatal care includes necessary or customary postnatal visits, in or out of hospital, haemoglobin estimation and urinalysis and the taking and submission of a pap smear if indicated.

14. PAEDIATRIC SERVICES

14.1 Newborn Care

Newborn care refers to routine care of a healthy infant for the first seven days and includes complete examination and necessary parental advice. Infants born with an existing disease should be claimed for as any other hospitalized patient.

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14.2 Premature Infant

Premature infant refers to care of an infant weighing 2500 grains or less at birth.

14.3 Well Baby Care

Well baby care refers to periodic office visits of a well baby for routine supervision of growth and development and any parental instructions required to this end and includes necessary imxnuni— zations. The following schedule will be considered adequate —

- Once monthly during the first 6 months.

- Every 3 months thereafter to one year of age.

15. PSYCHIATRIC SERVICES

15.1 Psychotherapy

Psychotherapy is any form of treatment for mental illness, behavioural maladaptions and/or other problems that are assumed to be of an emotional nature in which a physician deliberately establishes a professional relationship with a patient for the purposes of removing, modifying or retarding existing symptoms, of attenuating or reversing disturbed patterns of behaviour and of promoting positive personality growth and development. Accordingly, a psychotherapeutic procedure may be charged for if one-half hour, or major part thereof, has been spent in such treatment of the patient.

16. SURGICAL SERVICES

16.1 Surgical Care

For surgical procedures the composite fee principle applies. A surgical procedure, in or out of hospital, includes pre operative consultation within 30 days prior to the surgery by the surgeon and customary preoperative, operative and post operative care. In unusually complicated cases, needing pro longed pre or postoperative care, Independent Consideration will be given.

Major surgery is defined, under Nova Scotia Medical Services Insurance, as a procedure in excess of 50 units.

Minor su.r’ery is defined, undcr Nova Scotia Medical Services Insurance, as a procedure at 50 units or Less.

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16.1.1 Postoperative Period

The postoperative period is defined as 30 days from the date of the operation.

16.1.2 Care in the Postoperative Period

Where other doctors were called in for normal treatment of the same illness in the postoperative period the following rules

will be applied —

(a) If the second doctor treated the patient within the • surgeon’s reasonable area of practice, the second doctor will be allowed an appropriate visit fee but this will be deducted from the surgeon’s fee.

(b) If the second doctor treated the patient outside the surgeon’s reasonable area of practice, the second doctor will be allowed an appropriate visit fee and this will not be deducted from the surgeon’s fee.

16.2 Surgical Rules V

These rules apply to all surgical procedures except fractures.

16.2.1 Unless otherwise specified, bilateral procedures are entitled • to an additional fee equivalent to 50% of that shown for the V unilateral procedure. When done under separate anaesthetics at an interval, the full fee should be charged for each procedure.

16.2.2 When multiple operative procedures are performed through a single incision in the course of an abdominal operation or on any one organ or cavity, the fee for the principal procedure should be charged plus 50% of the fee for the secondary procedure (secondary incidental procedures, such as appendectomy, which are. • not indicated by pathology, shall not be charged).

16.2.3 Multiple operative procedures performed simultaneously in different areas and through different incisions shall be entitled to the fee for the major procedure plus an additional 50% of fees for the lesser procedures.

16.2.4 When si±sequent related operative procedures are performed during the postoperative period the full procedural fee will apply.

16.3 perating Microscop

An additional fee of 25 units may be charged when a hospital operating microscope is used in the operating room.

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16.4 Fractures

16.4.1 Open reduction shall mean the reduction of a fracture by an operative procedure and is intended to include exposure of fracture site with fixation as indicated.

16.4.2 Closed reduction shall mean the reduction of a fracture by non— operative methods with the aid of local or general anaesthetic. 16.4.3 The stated fee is intended to cover treatment of the fracture including necessary after care up to 90 days and also includes the application of casts or traction devices.

16.4.4 No reduction shall mean treatment of a fracture by any method - other than designated in 16.4.1 or 16.4.2.

.16.4.5 The foe for a compound fracture or dislocation will be the fee for the appropriate fracture plus 50%. If open reduction is done the fee for it alone will apply unless extensive debridement has been necessary when Independent Consideration will be given.

16.4.6 Where multiple procedures are carried out by the same surgeon for multiple fractures the fee for the major procedure will apply plus 50% of the fee for the additional fractures.

16.4.7 Where multiple closed reductions are carried out for the same fracture the following rules apply -

(a) When done by the same physician, he is entitled to 50% of the listed fee for the initial reduction and 50% for the subsequent reduction.

(b) When done by different physicians, the first physician will be entitled to 50% of the listed fee and the second physician to 100%.

16.4.8 Where a closed reduction is followed by an open reduction the

following rules apply -

(a) When done by the same physician, he is entitled to 50% of the listed fee for the closed reduction and 100% for the open reduction.

(b) When done by different physicians, the first physician is entitled to 50% of the listed fee for the closed reduction and the second physician to 100% of the listed fee.

16.4.9 Re-fracture - Independent Consideration.

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16.5 Urology

The fee for an urologica). surgical procedure usual shall include the postoperative care as carried The out by the operating surgeon. surgical fee shall not include endoscopic or other gative procedures required investi to establish a diagnosis on the day of the surgery. unless done 17. ASSISTANTS’ FEES

An assistant should render a separate following account for services basis - on the

17.1 The fee for a surgical assistant shall be 25% whether the assistant of the surgical fee is certified or uncertified. should be calculated The fee to the nearest $5. with a minimum of $15. 17.2 When a second assistant is necessary he shall receive equal to 50% of the stated a fee fee paid to the first a minimum of $15. assistant to The need for a second assistant ported by report. to be sup 17.3 The assistant’s fee shall include concurrent, supportive valescent care except and con where care for a required. nonrelated condition is

17.4 Procedures which normally do not require be claimed. an assistant should not

17.5 An assistant’s fee will usually not be paid for minor procedures. In special surgical circuinsances an explanatory accompany the claim. note should 18. REFERRING PHYSICThNS’ SERVICES

18.1 For services rendered prior to surgery, should the referring physician charge on a fee for service SehedzZe basis according to the for home, office or hospital visits, detention, etc. 18.2 The referring physician may charge an assistant actually assists fee only when he at the surgical procedure. 18.3 Convalescent Care

Convalescent care may be claimed postoperatively physician when by the referring a patient, following discharge requires further from hospital, medical attention. One visit per week up to a

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— 5/18

maximwn of four weeks is considered adequate. This fee is not app licab is if the referring physician was the surgical assistant or Anaesthetist or a member of the same group or clinic as the surgeon.

18.4 Spportive Care

Supportive care may be claimed for registered in-patients where the referring physician is not responsible for the day-to-day care of the patient and is providing liaison with the family, reassurance to the patient, etc. One visit every three days to the 10th day and twice weekly thereafter is considered adequate.

This fee is not applicable if the referring physician was the surgical assistant or Anaesthetist or a member of the same group or clinic as the surgeon.

19. REPEAT HOSPITAL ADMISSION

Where a patient requires re—admission to hospital within ten days of being discharged for the same or related condition by the same physician or a member of his group, partnership or clinic, it shall be considered to be a continuation of the previous hospitalization and charges should be based on the appropriate subsequent hospital visit fees.

If the re—admission is by a physician other than above, it will be proper for the physician to charge as if it were a new illness. 20. INTENSIVE CARE

Intensive care is applicable to services rendered in all inten sive care units approved by the Health Services and Insurance Commission by physicians who by reason of special training or experience have been assigned by each hospital to the staff of the intensive care unit.

Fee Code 0175 is described simply as a rate per day. The inter pretation is that for every patient in intensive care one physician is paid the daily rate for every twenty—four hours that he is on duty. Should a procedure be performed on the patient during this time, then the physician has the option of charging for the procedure or the intensive care fee but not for both. If either Fee Codes 0176 or 0177, which are codes for sessional fees, are charged for a patient, then the per diem rate under Fee Code 0175 cannot be charged for that patient. The per diem rate for other patients may be charged.

- - - ‘s-. ;-.-. . 4. .‘_; - --.r-- - — — — — — — —. --- A. ‘ - • , - -‘.— —.: • .... . — - j — — - • — — .. - 5/19

21. SESSIONAL FEES

Sessional fees apply when the services of a physician are on a time engaged basis. Examples would be group inununization industrial clinics, or public health medicine or other professional services to a government department, agency or public body. Prior to accepting an engagement, the physician should ensure the terms of service are understood and proper payment arrange ments have been made. A half day is considered to be three hours and a full day six hours. 22. PAYMENT OF SPECIALIST FEES

Fees listed for the various specialties apply only where the patient has been properly referred to the specialist for con sultation or treatment.

23. DENTISTS AS REFERRING PHYSICIANS

Referrals from dentists to physician specialists are acceptable with the provisos that the dentist discuss the patient with the family physician before seeking such consultation and that the physician specialist send a copy of his report to the physician family as well as to the referring dentist. 24. OPHTHALMOLOGICAL SERVICES

24.1 Contact Lens Fitting

24.1.1 Hard Contact Lens

The fitting of hard contact lens by a medical doctor for kerato— conus, uniocular aphakia (occasionally binocular aphakia in children), irregular astigmatism due to corneal scarring or graft, occasionally in albinism, aniridia or nystagmus, high myopia in children or high hyperopia in children, neuroparalytic keratitis, lagophthalmos keratitis, corneal ulcers, corneal burns and prevention of symblepharon is an insured service under Nova Scotia Medical Services Insurance.

‘Marked’ anisometropia is considered to be medical justification for the fitting of contact lens in which the use of a contact lens might be expected to result in single binocular vision or improvement in the vision of an ambylopic eye. A written justif ication must accompany M S I claim cards.

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24.1.2 Soft (Hydrophilic) Contact Lens

The fitting of soft (hydrophilic) contact lens by a medical doctor for bullous keratitis, Stevens—Johnson disease, stromal herpes simplex, trichiasis, pemphigus and old trachoma, keratitis sicca and filamentous keratitis, descemetocele and uniocular aphakia is an insured service under Nova Scotia Medical Services Insurance.

Soft contact lens are deemed medically necessary for patients who, because of physical infirmity, are unable to safely remove and replace hard contact lens.

When fitting of contact lens is medically necessary, soft contact! lens will be allowed when the age of the patient is sixtcen years. or under.

25. PROCEDURE FOR AMENDMENTS TO FEE SCHEDULE

When a physician considers a fee inadequate or the procedure is not listed, the following action should be taken.

25.1 Notify the Chairman of the Fee Committee of the appropriate Section of the Medical Society of Nova Scotia, in writing, and provide substantiation gor the addition or change requested. 25.2 Following action by the Chairman, which likely will include discussion at a meeting of the Section, the Chairman may refer the request to the Officers of the Medical Scoeity of Nova Scotia. 25.3 The Officers of the Medical Society of Nova Scotia may initiate discussion with the Health Services and Insurance Commission to have the change approved as an insured service under M S I. When approved the amendments will be published in the M S I Physician’s Manual.

— - -

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t

•l — — 5/21

UNIT VALUE SYSTEM

On request of the Medical Society of Nova Scotia, the Health Services and Insurance Commission has agreed the M S I tariff should be published with the actual fee represented in units.

Two separate unit values have been established; a master unit value applicable to all insured services and a speciaj.unit value for anaesthesia services.

From April 1, 1979, the master unit had a value of $1.40 which has remained unchanged April 1, 1980.

From April 1, 1979, the anaesthesia unit had a value of $6.86 which was increased, effective April 1, 1980, to $7.67.

Claims for medical services should be prepared by applying the stated unit value to the number of units as listed in the tariff to arrive

at the dollar amount of the fee claimed.

Claims for anaesthesia services should be prepared by applying the stated unit value to the total of the basic units as listed in the tariff plus time units.

Conversion tables are provided by M S I as an aid in determining proper dollar amounts for entry on your claims.

Payment of claims under the N S I program is at 85% of the fees listed in Section 5 of this Manual.

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MISCELLANEOUS FEES

Units

0100 DETENTION FEE (see Preamble page 5/8) per 15 minutes after initial half-hour 8 In addition to appropriate visit fee (office visits excluded).

0140 INDEPENDENT CONSIDERATION I C

0104 SESSIONAL FEES, per hour 30 per half day 90 per day 180 Sessional fees apply when the services of a physician are engaged on a time basis; e.g., approved immunization and Well Women’s Clinics. A half day is considered to be 3 hours and a full day 6 hours.

0136 COUNSELLING (marriage, family, etc.), per ½ hour 17.5

0193 PSYCHOTHERAPY, per ½ hour 17.5 0183 HYPNOTHERAPY, per ½ hour 17.5

3003 OPERATING MICROSCOPE - see Preamble page 5/15 25

INTENSIVE CARE applies to services rendered in all intensive care units approved by the Health Services and Insurance Commission, by physicians who, by reason of special training or ex perience, have been assigned by each hospital to the staff of the intensive care unit.

0175 INTENSIVE CARE, per day 18

0176 - requiring detention, per hour 40

0177 — requiring detention, per ½ day 120 Code 0175 is described simply as a rate per day. For every patient in Intensive Care, one physician is paid for every 24 hours that he is on duty. Should a procedure be performed on the patient, then the physician has the option of charging for the procedure or the Intensive Care fee, but not for both. If either Code 0176 or 0177, which are Codes for sessional fees, are charged, then the per diem rate under Code 0175 cannot be charged for that pa tient.

EMERGENCY CARE CENTRES must be approved by the Health Ser vices and Insurance Commission. Fees for visits should be charged as follows

- —

- .l-.i• _.; - - - ... -. -, - — - -.- —r-1 pa___’ -

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Units

A072 EMERGENCY CARE - 8 am to 8 pm 8 A077 — 8 pm to 8am 12 A075 — Sundays and statutory holidays 12

Special Visit to Emergency or Out-Patient Department

0601 8 am to 5pm, Mon - Fri 12

0602 5 pm to midnight, Mon — Fri 17.5 0603 Midnight to 8 am, all days 21.5 0604 8 am to midnight, Sat, Sun and holidays 17.5 Extra patients at any visit

0605 8 am to 5 pm, Mon — Fri 7

0607 5 pm to midnight, Mon — Fri B 0608 Midnight to B am, all days 9 0609 8 am to midnight, Sat, Sun and holidays 8

Doctor on Duty or Already in Hospital

0606 — per patient 7

- -. .-. ...-

. • -- - 4 .— -- — - £ - ii

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5/24

FAMILY PRACTICE

These fees cannot be correctly amble. interpreted without reference to the Pre

AOOl Consultation Units A003 Repeat consultation 25 VISITS 13

A0lO Complete examination A060 Convalescent care A067 (defined pg. 5/17) 20 iergency visit (defined pg. 5/4) visit fee OFFICE 27

A025 Visit with necessary history examination and regional A030 Well baby care 8 (includes examination, health instructions regarding 8 care and necessary immunization procedures) HOSPITAL

A035 Initial visit (if no service 30 days) in previous A04l Subsequent visits 17 — to 4 weeks, A043 per visit — after 4 weeks, per visit 5.7 (maximum 25 units A050 per week) 5.7 Newborn care of healthy infant — 1st week A053 - 2nd and A054 3rd week 22 — after 3 weeks, per (Charge week 16 fee for service A058 Supportive when newborn with 11 care (defined illness). per visit pg. 5/18)

HOME 5.7

Where a call is received in one time time period, period, and made the lower fee applies. in another A092 8 am to 5 pm, A093 Mon - Fri 5 pm to midnight, A094 Mon - Fri 12.5 Midnight to 8 A095 am, all days 18 8 am to midnight, Sat, Sun and holidays 22 18

—

. .

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Anaes Units Units

Extra patient - at any visit

A065 B am to 5 pm, Mon - Fri 8 A064 5 pm to midnight, Mon - Fri 12 A063 Midnight to 8 am, all days 14 A062 8 am to midnight, Sat, Sun and holidays 12

OBSTETRICAL CARE

0286 Complete pregnancy exam 20 (one per pregnancy) 0287 Routine pre—natal visit 8 (maximum 12 visits) 0281 Obstetrical delivery only 70 3+T 0288 In hospital, post partuxfl 35 0285 Six week post natal care visit 12 (one only)

4 — -. .— - • .-.

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5/26

ANAESTHES IA

These fees cannot be correctly interpreted without reference to the Pre amble.

Anaes Units Units

BOOl Major consultation 46 B002 Minor consultation 24 B003 Repeat consultation 24

HOSPITAL VISITS

B007 Continuing care 8 B006 Directive care, per visit 10 (maximum 5 visits/week)

0139 Procedures requiring Independent Consideration (by report) I C

0101 Stand—by fee, per ½ hour 10 (refer to Preamble)

0145 Dental surgery 4+T

For cL’zaesthesia with cardiac by-pass3 hypothermia aid controlLed hypotension, refer to Preamble.

Radiotherapy Procedures

0149 Without intubation 3+T 0161 With intubation 4+T

Examination under Anaesthesia

0166 Without intubation 3+T 0165 With intubation 4+T

Obstetrics

Continuous Conduction Anaesthesia (Epidural)

0167 Introduction of catheter for relief of pain and initial management 5+T 0168 Maintenance (one unit for each subsequent injection or ½ hour of maintenance to a maximum of 6 units) Final delivery time 0169 Double set-up 4+T

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5/27

Anaes Units Units

i.e., examination for cause of bleeding with possibility of inmiediate operative delivery. NOTE: If anaesthesia is required for delivery, the anaesthetic fee is the fee for the procedure as listed, plus time units for double set-up.

0171 Postpartum haemórrhage 3+T for procedures other than those listed under Obstetrics

Resuscitation

0174 Cardio—respiratory resuscitation outside of anaesthesia including cardiac arrest 6+T (to a maximum of 15 units)

Intubation for Airway Obstruction

0181 Emergency (non-anaesthetic) 6+T

(tracheotomy - additional)

Tracheo—Bronchial Toilet

0126 To include laryngoscopy if necessary, two hours postoperative 25 (other than iumediate postoperative care)

Intensive Care Associated with Respiratory Insufficiency, etc.

0150 1st day (consultation, evaluation and institution of respiratory care) 1st hour 50 each additional hour 20 maximum 100 0151 2nd, 3rd and 4th day (re—evaluation, alteration and maintenance of respiratory care) per hour in attendance 20 maximum 50 0152 5th day on (maintenance and tapering off of respiratory care) per hour 20 maximum 30 per visit 5

• Intensive Care associated with Prolonged Hypothermia

1st day - if associated with surgery basic value is 25 units (refer to Preamble)

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——- _____

5/28

Anaes Units Units

0154 1st day — associated with medical condition as therapeutic hypothermia 1St hour 50 each additional hour 20 maximum 100 0156 2nd, 3rd day per hour 20 maxixnuxn 30 0157 4th day on per hour 20 maximum 20 per visit 5

Continuous Epidural Block (consultation additional if evaluation requested)

0167 Institution 5+T 0168 Maintenance (one unit for each subsequent injection or ½ hour of maintenance to a maximum of 6 units per day)

Surgical Anaesthesia — Infants Add 5 basic units to the anaesthesia fee for infants under 5 kilograms.

I •‘ - - - •. - - -re-- . - 5/29

DERMATOLOGY

These fees cannot be correcj.ty interpreted without reference to the Preamble.

Units

COOl Major consultation 46 C002 Minor consultation 24 C003 Repeat consultation 24 within 30 days for same illness or complication thereof.

VISITS

OFFICE

COlO Initial visit 22 with complete dermatological examination. C020 Initial visit with regional exam 12 C025 Subsequent visits 8 C004 Continuing care 8 C005 Directive care, per visit 10 (maximum 5 visits/week)

HOSPITAL

C035 Initial visit 22 with complete examination when patient is attended for the first time in the illness.

Subsequent visits — charge as A041 or A043. C007 Continuing care 8 C006 Directive care, per visit 10 (maximum 5 visits/week)

HOME

C070 Initial visit with complete examination 23

Where a call is received in one time period and made in another time period, the lower fee applies.

C092 8 am to 5 pm, Mon — Fri 12.5

C093 5 to midnight, Mon — Fri 18 C094 Midnight to 8 am, all days 22 C095 8 am to midnight, Sat, Sun and holidays 18 C009 Continuing care B C008 Directive care, per visit 10 (maximum of 5 visits/week)

———---—-—-—--——

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- - fE:;: -‘:. — .. — - ; t:: _- “‘ --- - - —. — --——•, b-.- —. --- . k - 1 -. -. “— - ---- —. .. •I. • ——:-- L .L 5/30 I

Arzaes Units Units

DERMATOLOGICAL PCEDURES

3100 Skin biopsy 20 3+T 3010 Incision and drainage of furuncle or abscess 6 3108 Carcinoma of skin, curettage and electrocautery 40 3+T 0138 Extensive and complicated lesions by ‘I C’ I C 3+T 3263 Plantar warts, application of occlusive boot 15 1106 Patch test for allergens (application and reading) per series 15 1113 Scratch or intradermal tests for allergens, per series 15 3392 Der7nabra.sion, less than ¼ face 25 4+T

3394 — ¼ to face 75 4+T

3391 — full face 150 4+T 3393 Dermabrasion of single area 35 * (e.g., trauma scar) *Head, neck, back or requiring intubation 4+T Other areas 3+T

— ,. __4. — — — — — — — I — t - ‘ -‘ r- *

—..—.‘.-. ——-—- 4 ,— .— ,i. —. — 1 - fr j — - - - .- -. i -. - .-. •. 7 - — • W , 4 -,—.,-:., b4 - ,. . r 5/31

INTERNAL MEDI CINE

These fees cannot be correctly interpreted without reference to the Preamble.

Units

EQO]. Consultation 46 complete diagnostic survey to include a review of any x—ray and laboratory data if pertinent and indicated but exclusive of specific diagnostic or therapeutic procedures arising out of or subsequent to the consul tation. E003 Repeat Consultation 24 for the same illness or complication thereof within 30 days of initial consultation. E0J.2 Prolonged Consultation, per 15 minutes 12.5 a detention fee of 12.5 units per 15 minutes, starting at the end of one hour will be applied for the time actually spent with the patient.

VISITS

OFFICE

EOlO Initial visit 22 with complete examination and diagnostic survey of a new patient not attended during the previous 30 days. E015 SubsequenL visit

— with ccinplete re—examination 12

E025 — with regional examination B E004 Continuing care 8 E005 Directive care, per visit 10 (maximum of 5 visits/week)

HOSPITAL

E035 Initial visit 22

Subsequent visits - charge as A041 or A043. E007 Continuing care 8 E006 Directive care, per visit 10 (maximum of 5 visits/week)

HOME

E070 Initial visit 23

Where a call is received in one time period and made in another time period, the lower fee applies.

E092 8 am to 5 pm, Mon - Fri 12.5

E093 5 pm to midnight, Mon — Fri 18

— ——-—

.— a-.. - a4p

-“ - — 5/32 I

Units

E094 Midnight to 8 am, all days 22 E095 8 am to midnight, Sat, Sun, and holidays 18 E009 Continuing care 8 E008 Directive care, per visit 10 (maximum of 5 visits/week)

SPECIAL PCEDURES

Submaxiinal Exercise Testing (in approved clinics) 6207 Graded testing utilizing treadmill or bicycle ergometer with continuous ECG monitoring 40

(a) If the patient has been seen in consultation by the Cardiologist performing the submaximal test within the previous 14 days,. no visit fee is applicable.

(b) If the patient has not been seen by the Cardiologist performing the test within the previous 14 days, an initial visit fee or consultation fee may be claimed.

(c) If the patient has been examined by a Cardi ologist within 14 days of the test, an initial visit fee may be claimed plus the test when performed by a different Cardiologist.

Holter Monitoring (by Cardiologist) 25 6208 (Fee for interpretation of the 12 hours of monitoring to be approved only when abncrmaZ.ities are present)

— -c e • •- .- - r- •44 — — t W — r -

:------,.-.-- T’- , - -- - - . -- • •.‘ - — --— • r ‘— •i

.,•- . if ——- - -— .••• • 5/33

NEUROLOGY

These fees cannot be correctly interpreted without reference to the Preamble.

Units

SOOl Consultation 46 complete diagnostic survey to include a review of any x—ray and laboratory data if pertinent and indicated but exclusive of specific diagnostic or therapeutic procedures arising out of or subsequent to the consul— tation. S003 Repeat consultation 24 for the same illness or complication thereof within 30 days of the initial consultation. S012 Prolonged consultation per 15 minutes 12.5 a detention fee of 12.5 units per 15 minutes, starting at the end of one hour, will be applied for the time actually spent with the patient.

VISITS

OFFICE

SOlO Initial visit 22 with complete examination and diagnostic survey of a new patient not attended during the previous 30 days. S015 Subsequent visit

— with complete re—examination 12

S025 — with regional examination 8 S004 Continuing care 8 S005 Directive care, per visit 10 (maximum of 5 visits/week)

HOSPITAL

S035 Initial visit 22

Subsequent visits - charge as A041 cr A043. S007 Continuing care 8 5006 Directive care, per visit 10 (maximum of 5 visits/week)

HCI1E

5070 Initial visit 23

Where a call is received in one time period and made in another time period, the lower fee applies.

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Units’

S092 8 am to 5 pm, Mon — Fri 12.5

S093 5 pm to midnight, Mon — Fri 18 S094 Midnight to 8 am, all days 22 S095 8 am to midnight, Sat, Sun and holidays 18 S009 Continuing care B S008 Directive care, .per visit 10 (maximum of 5 visits/week)

w-.--- —- - - - -. .- - c;; —

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5/35

PHYSICAL MEDICINE AND REHABILITATION

These fees cam-Lot be correctly interpreted without reference to the Preamble.

Units

MOOl Major consultation 46 M002 Minor consultation 24 M003 Repeat consultation 24 for the same illness or complication thereof within 30 days of the initial consultation. M012 Prolonged consultation, per 15 minutes 12.5 a detention fee of 12.5 units per 15 minutes, starting at the end of one hour, will be applied for the time actually spent with the patient.

VISITS

OFFICE

MOlO Initial visit 22 with complete examination of a new patient not attended during the previous 30 days. M020 Initial visit with regional exam 12 M025 Subsequent visits 8 M004 Continuing care 8 MOOS Directive care, per visit 10 (maximum of 5 visits/week)

HOSPITAL

M035 Initial visit 22

Subsequent visits - charge as A041 or A043. M007 Continuing care 8 M006 Directive care, per visit 10 (maximum of 5 visits/week)

HOME

14070 Initial visit 23

Where a call is received in one time period and made in another time period, the lower fee applies.

M092 8 am to 5 pm, Mon - Fri 12.5

M093 5 zn to midnight, Mon - Fri 18 14094 Midnight to 8 am, all days 22 14095 8 am to midnight, Sat, Sun and holidays 18 M009 Continuing care 8 MOOB Directive care, per visit 10 (maximum of 5 visits/week)

- - ..• . .—‘‘ _____ ‘4- — - -z,- -- -

• -

— - --- -• -‘ L U) 4-)

•0: •0 C., .0 •11) .I:. • .w o •a, CO.r4 • $4 -‘-I >.

04 01 wU) 0101 -‘-I 1 1D 4JW$4 U) r14J01 5/37

PAEDIATRI Cs

These fees cannot be correctly interpreted without reference to the Preamble.

Units

LOOl Consultation 46 L003 Repeat consultation 24 L012 Prolonged consultation, per 15 minutes 12.5 a fee of 12.5 units per 15 minutes starting at the end of one hour for consultation and at the end of 30 minutes for a repeat consultation.

VISITS

OFFICE -

LOlO Office visit with complete examination 35 L020 with regional examination 12 L0l5 Follow—up visit with complete examination 20 L025 Subsequent visits 8 L030 Well baby care 6 includes examination, instructions regarding health care and necessary immunization procedures. L004 Continuing care 8 L005 Directive care, per visit 10 (maximum of 5 visits/week)

HOSP ITAL

L035 Complete examination 35

Subsequent visits - charge as A041 or A043. L007 Continuing care 8 L006 Directive care, per visit 10 (maximum of 5 visits/week) L058 Supportive care 5 L060 Convalescent care 5

Attendcuzce by paediatricians at high risk delivery to be claimed under fee code LOOl at 46 units for the first hour. Subsequent fifteen minute periods to be charged under fee code L012 at 12. 5 units.

HOME

L070 Initial visit with complete examination 23 L07l with regional examination 10

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Units

Where a call is received in one time period and made in another time period, the lower fee applies

L092 8 am to 5 pm, Mon — Fri 12.5 L093 5 pm to midnight, Mon — Fri 18 L094 Midnight to 8 am, all days 22 L095 8 am to midnight, Sat, Sun and holidays 18 L009 Continuing care 8 LOOB Directive care, per visit 10 (maximum of 5 visits/week)

3 —.- I- K

. 5/39

PSYCHIATRY

These fees cannot be correctly interpreted without reference to the Preamble. Units

WOOl Consultation 46 to include certification if indicated. W003 Repeat consultation 24 for the same illness or complication thereof within 30 days of the initial consultation. W0l2 Prolonged Consultation, per 15 minutes 12.5 a detention fee of 12.5 units per 15 minutes, starting at the end of one hour, will be applied for the time actually spent with the patient.

VISITS

OFFICE

WOlO Initial visit 30 with complete examination including psychiatric evaluation and certification if indicated. W025 Subsequent visit 8 W004 Continuing care 8 WOOS Directive care, per visit 10 (maximum of 5 visits/weck)

HOSPITAL

W035 Initial visit 30

Subsequent vistts - charge as A041 or A043. W007 Continuing care 8 W006 Directive care, per visit 10 (maximum of 5 visits/week)

HOME

W070 Initial visit 25

Where a call is received in one time period and made in another time period, the lower fee applies.

W092 8 am to 5 pm, Mon - Fri 12.5

W093 5 pm to midnight, Mon — Fri 18 W094 Midnight to S am, all days 22 W095 8 am to midnight, Sat, Sun and holidays 18 W009 Continuing care 8 W008 Directive care, per visit 10 (maximum of 5 visits/week)

— - — -.---. •-: ,..-..-.- r —. -— — - - - ,—... rt ... .._; - -:,.:--• (..‘l! 4. ‘ — -. .—( -— . ,.-. C ‘c- . r , .. — — —. .-_-.—- 4 ‘-1 --..—,.- - h.- .ii4 —---—-—- — —— ———— — -- .

—- S. — ‘,______%_ 5/40

SPECIAL PRODURES Anaes Units Units

0180 Electro—convulsjve therapy 20 3+T 0192 Subcoma insulin visit fee 0198 Psychiatric assessment 35 of an accused person when requested by the court

Psychotherapy (referred patients) 0194 Psychotherapy, per ½ hour 24.5 including all forms of therapy or investigations 0184 Hypnotherapy, per ½ hour 24.5 0190 Group psychotherapy, per patient 6 per ½ hour (4 to 8 members) 0195 Family therapy, per family 24.5 per ½ hour (2 or more members)

Psychotherapy (unreferred patients) 0193 Psychotherapy, per ½ hour 17.5 including all forms of therapy or investigations 0183 Hypnotherapy, per ½ hour 17.5 0191 Group psychotherapy, per patient 4 per ½ hour (4 to 8 members) 0196 Family therapy, per family 22 per ½ hour (2 or more members)

Clinical Psychiatry

0185 Clinical psychiatry, per hour 43.5 by certified psychiatrist

NOTE: Psychiatrists employed on a sessional basis in the Mental Health Program of the Department of Health are normally restricted to not more thw-i fiz.’e sessions per week.

child Psychiatric Assessment (referred patients) 0200 Child psychiatric assessment 25

- first half hour

0201 Prolonged child psychiatric assessment — per 15 minutes 12.5 (a detention fee of 12.5 units per 15 mintues, starting at the end of the first half hour, will be applied for the time actually spent with the patient). 0202 Therapeutic/diagnostic interviews 25

- per half hour relating to a specific child with. allied health • professionals, education, correction and other community resources. (To apply to interviews by Psychiatrists but not to preclude resident involvement).

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— —•-—--- ..- —• - - - 1- 5/41

DIAGNOSTIC AND THERAPEUTIC PROCEDURES

These fees cannot be correctly interpreted without reference to the Pre amble.

These fees apply only when such procedures are carried out by or under the supervision of a physician. Cost of medication used in any of these procedures is additional.

MULTIPLE PROCEDURES

Where multiple procedures are performed the fee for the principal proce dure shall be charged in full plus 50% of the fee of the lesser pro cedure(s).

LIST I

No additional charge allowed if consultation or visit fees apply.

Anaes Units Units

2122 Occult blood in stool 1 1104 Nasal smear for eosinophils 2 1195 Injections 3 Intradermal, subcutaneous and/or intramuscular injections including immunizations and therapeutic injections. May include one or more injections at one visit. 1102 Hyposensitization

— initial injection and assessment 5

1103 — subsequent, per injection, including supervision 3 1197 Tine test 3 procedure and interpretation 1321 Complete Ophthalmological Examination including refraction and all necessary procedures to diagnose pathological lesions and to fully assess ocular function 18.2 1323 Eye examination under general anaesthetic 30 4+T

LIST II

Full fee allowed in addition to consultation or visit fee when applicable.

1132 BCG vaccination, including necessary Tuberculin tests 5

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Anaes Units Units

1196 Smallpox vaccination with certificate 5 1106 Patch test for allergens (application and reading)

— per series 15 1113 Scratch or interdermal tests for allergens

— per series 15 1107 Maximum for complete testing 35 1112 Skin scrapings for examination for fungi 5

1108 Anticoagulants - supervision of long-term

therapy — per month 10 (telephone advice) 1306 Proctoscopic examination 5 1100 Multiple inoculation for immunotherapy of malignant disease 15

BIOPSY PROCEDURES

Respiratory System 5092 Direct endoscopy of larynx with biopsy 40 6+T 5095 Indirect endoscopy of larynx with biopsy 20 6+T 5105 Bronchoscopy with or without biopsy or injection of contrast material 60 6+T 5107 Bronchoscopy with fiberscope for diagnostic purposes with cytology collection, bronchial brushing and biopsy 90 6+T

1136 Needle biopsy - pleura 20

Cardiovascular System 1140 Biopsy or pericardium by needle 75

Digestive System 5107 Bronchoscopy with fiberscope for diagnostic purposes with cytology collection, bronchial brushing and biopsy 90 6+T 7119 Oesophazoscopy with biopsy under direct vision 75 4+T 7205 Gastroscopy with biopsy 90 4+T 7462 Biopsy cf rectosigmoid for Hirschsprung’s

disease — through siginoidoscope 40 3+T

1135 Needle biopsy - liver 40 4+T 1154 Liver biopsy (paediatric) 50 4+T 7704 Basket extraction of retained bile duct stones 5Q 4+T 7729 Transheatic Cholangiography 35

Hematolcgic and Lymphatic Systems 1138 Splenic puncture biopsy 25 4+T

1110 Marrow biopsy - aspiration - needle or punch — procedure only 25 3+T

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Anaes Units Units

1111 Marrow biopsy - aspiration - needle orpunch — interpretation only 15 3+T 1133 Marrow aspiration — procedure and interpretation 40 3+T

Urology 1139 Biopsy of prostate, perineal needle 40 3+T 1134 Needle biopsy - kidney 40 4+T

1142 - Needle biopsy kidney (paediatric) 50 4+T

Miscellaneous 1137 Needle biopsy — synovial tissue 25 1130 Percutaneous muscle biopsy 30

CARDIOVASCULAR SYSTEM

6154 Capillaroscopy 10 6158 Arterial cannulation 25 4+T 6159 Regional isolation perfusion 100 4+T 1124 Aspiration of pericardium 50 1144 Cardioversion 50 5+T 6150 Carotid or vertebral arteriography 50 5+T 6151 Femoral arteriography,

— unilateral 15 4+T 6152 - bilateral 30 4+T 6155 Aortography — percutaneous 50 5+T 6157 — trans—lumbar 50 5+T 6156 — exposure of major artery 75 4+T 1145 Catheterization of heart

— right 75 5+T 1147 — left 100 5+T 1146 Hepatic wedge pressure 50 5+T 1148 Left ventricular puncture 50 5+T 6153 Selective coronary angiography 125 5+T 6162 Carotid, vertebral or branchial arteriography by cut-down 75 5+T 6148 Aortic arch study 75 5+T 6149 Temporary transvenous pacemaker insertion 100

Selective Abdominal Angiographic Studies

6145 — one catheter 65 5+T 6146 — two catheters 75 5+T

Venogram

6200 — peripheral 15 6201 — superior or inferior venacavogram 25 5+T 6202 — selective visceral venography 40 5+T

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Anaes Units Units Electrocardiogram 1166 — procedure and interpretation, office, home or hospital 10 1167 — before and after exercise 15 1168 — interpretation only 5 1291 — phonocardiogram — supervision and interpretation 10

Vectorcardiograrn

6205 — technical component 10 6206 — interpretation 10

CENTRAL NERVOUS SYSTEM

117]. Electroencephalogram, — interpretation only 10 1170 — insertion of subteinporal needles — add 10 1172 — with activating drugs; e.g., Metrazol, add 10 1151 Electrocorticogram — supervision and interpretation 100 1152 Depth EEG with electrical stimulation, as during thalamotomies 50 1173 Pneumoencephalogram 40 7+T 1118 Cisterna magna aspiration 15 1122 Lumbar puncture 20 1121 — with installation of chemotherapeutic agents 25 1125 Subdural puncture — first 15 1128 — each additional tap 5 1127 Ventricular puncture 20 1129 Cisternal puncture 30

Temporary Blocks1 1245 Mandibular block 25 1246 Maxil1ry block 25 1278 Subarachnoid block (diagnostic spinal) 30 1279 Epidural, single injection as with cortisone 30

Therapeutic Blocks with Alcohol or Other Scierosing Solutions 1268 Intrathecal or epidural, spinal block 60 1271 Maxillary or mandibular division of trigeminal nerve 30 1274 Superior laryngeal nerve 60

-

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Anaes Units Units

AUTONOMIC NERVOUS SYSTEM

Temporary Blocks 1259 Lumbar sympathetic block (unilatera 35 1280 Coeliac1ocç 35

Therapeutic Blocks with Alcohol or Other Scierosing Solutions 1266 Cardiac sensory nerve 60 1267 .. .\ Gasserian ganglion block 60 1270 . .\ Lumbar sympathetic block 60 1272 . ..\ Sphenopalantine ganglion blocks 30 1273 Stellate ganglion block 60

PERIPHER NERVOUS SYSTEM

Temporary Blocks 1255 Block of single somatic nerve or paravertebral Somatic nerve 17 1256 additional — nerves 7.5 1244 Cervical plexus block 30 1247 Brachiaj. plexus block 25 1248 Presacral block 25 1249 Cauda]. block 25 1250 Sciatic block 25 1264 Obturator block 25 1265 Pudendal block 20

Therapeutic Block with Alcohol or Other Sclerosing Solutions 1289 Single somatic block 25 1269 Lateral feinoral cutaneous nerve 30 1275 Paravertebral — single nerve 30 1276 — each additional nerve 15 — not to exceed 100 1277 Transverse scapular nerve 30

EYE AND EAR

Contact Lens Fitting (see Preamble re insured services) 9440 Contact lens with follow-up for 3 months, excluding cost of lens 200 9442 Contact lens (child under 16 years) 250

Audiometric Tests 9560 Pure tone audiogram, right or left or both 5 9561 Pure tone audiogram, bone conduction 10 9562 Speech reception and discrimination test 5

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Anaes Units Units

9563 Tone decay tests 5 9565 Alternate loudness balance 10 9566 Bekesy audiometry 10 9567 SISI tests 9569 Impedance audiometry, to include tympanometry, stapedial reflex and impedance/compliance, test ing and interpretation in doctor’s office 20 9570 Impedance audiometry, interpretation only of tytnpanogram, impedance/compliance and stapedial reflex tests 8

1131 Audiometric tests - interpretation 3 9568 Complete hearing test (including audiometry, tuning fork and speech test) 15 1342 Vestibular function tests 10

1161 Cerumen - removal of 6 Removal of cerwnen included in the fee for consultation or complete Otolarjngological exam. 1149 Catheterization of Eustachean tube 5 1340 .Laryngoqram 10 1330 Visual fields 14 (tangent, screen and/or perimetry) 1325 Kinetic minimum, two isoptars 20 1329 Kinetic, with static cuts 25 1331 Tonometry 1332 Gonioscopy 7 Visual fields, Tonometry and Gonioscopy are included in the fee for a consultation or a complete ( exajtrL.nation.

Electronic Tonography

1334 - professional component 10 1335 - technical component 10

E1ectronystagtnograpy

1337 — complete test 35 1338 - interpretation only 15 1339 Ophthalmodynamometry 10 1105 Ophthalmic tests — direct, each 1 - to a maximum of 5

9377 Retina — intravenous fluorscein testing 25 9371 Orbital pneumonography 20

HEMATOLOGICAI. AND LYMPHATIC SYSTEMS

1143 Indirect transfusion 10 1159 Tissue typing and test for cytotoxic antibody (direct crossmatch) 15

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5/47

Anaes Units Units

Venipuncture Venipwzcture is not an insured service zhen the physicii operates a cZinic or office for the purpose of obtaining blood sampZes. 1198 Adult or child 4 years and older 3 1210 Infant or childunder 4 years 5 1204 Fenral vein puncture 10 1205 Jugular vein puncture 10 1206 Venesection, therapeutic 5 1207 Phelbotomy, therapeutic 5

Replacement Transfusions

1141 Initial or subsequent . 125

Upper G I Proceudres HCL drip test

1302 - professional component 5

1281 - technical component 10 Qesophageal motility study

1293 — professional component 10

1282 — technical component 25 1114 Secretin test

— professional component 5 1155 Gastric secretory studies (augmented histamine, Pentagastrin Hollander’s test medical vagotomy)

- professional component 5 1283 Gastro—oesophageal tamponade 20 4+T 5107 Bronchoscopy with fiberscope for diagnostic purposes with cytology collection, bronchial brushing and biopsy 90 6+T

7120 Oesophagoscopy - with biopsy -60 4+T

7119 — under direct vision 75 4+T

7121 - with removal of foreign body 100 4+T 7125 Gastroscopy with oesophagoscopy 110 4+T 7122 Qesophagobronchoscopy 90 6+T 7123 Oesophagogastroscopy with Elder—Palmer or similar instrument 90 4+T 7128 Esophagogastroduodenos copy with cannulation of pancreatic duct 120 4+T 7127 Gastroscopy 75 4+T 7205 - with biopsy 90 4+T

7221 - diagnostic biopsy, removal of foreign body,

- subsequent 35 4+T 1187 Gastric lavage 10 1123 Aspiration of oesophagus or stomach and preparation of material for cytological examination 10

— VI — V — — — —

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1 = .- ._ _ _J . - - - JL -.-- 5/48

Anae S Units Units Lower G I Procedures 1326 Sigmoidoscopic examination 15 3+T (with or without biopsy of rectum or sigmoid) 1328 Sigmoidoscopic examination 25 3+T (under 16 years of age) 7520 Injection of haemorrhoids — initial 10 7521 — subsequent 5 7522 Injection for pruritus ani or fissure 10 7516 Colonoscopy of descending colon 50 4+T • 7517 Colonoscopy of descending and transverse colon 75 4+T 7518 Colonoscopy of descending, transverse and ascending colon 100 4+T 7513 Colonoscopy as above with one or more biopsies - add 10 7514 Polypectomy via colonoscopy each — add 25

Abdominal Paracentesis 1286 Aspiration for diagnostic sample 10 1287 Therapeutic aspiration including diagnostic sample 25 1288 Administration of chemotherapy including therapeutic aspiration and sample 25 1290 Pen—renal insufflation of air 25

INTEGtJMENTARY SYSTEM

1701 Superficial x—ray therapy (or Grenz raysY to single area 6 3010 Incision of abscess, subcutaneous — boil, carbuncle, infected cyst, superficial lymphadenitis, paronychia, etc. local anaesthetic 6

MUSCULOSKELETAL SYSTEM

1295 Electrcxnyography, major, with muscles of more than one region examined 31 • 1296 Electromyography, minor, examination of a specific muscle or region 16 1298 Nerve conduction studies, per nerve studies (in addition to electromyographic examination fee if done at the same time) 11 1299 Faradic and galvanic testing, strength duration and chronaxie 10 1297 Major testing or innervation of more than 3 muscles 15 3000 Minor testing of innervation 7.5

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Anaes Units Units

Injection of Medication 1203 Bursa, ganglion, joint or tendon, including preliminary aspiration if necessary 11 — additional injections or aspirations at same visit fee 1199 Intravenous 5 1201 — by cut—down 10 1200 — by scalp vein 10 1303 Discogram 30 4+T

OBSTETRICS AND GYNAECOLOGY

8863 Pap smear Vaginal insufflation visit fee 8865 Artificial insemination, operation only 15 8844 Fitting of passary (to include examination and insertion of pessary and one follow-up visit> 25

RESPIRATORY SYSTEM

5105 Bronchoscopy with or without biopsy or injection of contrast material 60 6+T 5106 Bronchoscopy for foreign body removal 100 6+T 5107 Bronchoscopy with fiberscope for diagnostic purposes with cytology collection, bronchial brushing and biopsy 90 6+T 5136 Mediastinoscopy 120 6+T 5134 Bronchoscopy and Mediastinoscopy 150 6+T 5110 Bronchogram 25 6+T 7122 Oesophagobronchoscopy 90 6+T 5091 Direct endoscopy of larynx — without biopsy 25 6+T 5092 — with biopsy 40 6+T 5095 Indirect endoscopy with biopsy 20 6+T

Thoracentesis 1294 Aspiration for diagnostic sample 20 1287 Therapeutic aspiration including diagnostic sample 25 1288 Administration of chemotherapy including therapeutic aspiration and sample 25

UROLOGY

1115 Aspiration of bladder 10 1120 Aspiration of hydrocoele 10 1162 cystometrogram 15 Prostatic massage visit fee 1150 Urinary bladder - acute retention or change of catheter

. I

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5/50

Anaes Units Units

MISCELLANEOUS

1116 Breast cyst aspiration 10 1180 Galactography 10 1126 Thyroid cyst aspiration 10

Endocrinology and Metabolism 1181 Antidiuretjc hormone response test 15 1182 Hypertonic saline infusion test 25 1183 Vasopressor or depressor test; e.g., Rogitine, Benzodioxine, Histamine 15 1184 Water tolerance test 10 1186 Fluoroscopy and/or orthodiagram 5

1253 Nitrogen Mustard or analogous therapy — per treatment 10 1101 Each subsequent drug administered on same occasion 5

Sterility Investigation 1327 Male, sperm count and morphology 5

Dialysis for Renal Failure 1163 Dye dilution densitometry curve

- initial - including procedure and interpretation (from the ear) 15

1164 — repeat

1165 — initial (from an artery) 25

1160 — repeat 10 1191 Insertion of venovenous catheters by Seldinger technique for acute hemodialysis 25 1190 Acute renal failure and chemical intoxications, including diagnosis, management, supervisIon of first hemodialysis and aftercare until the next hemodialysis 300 1194 Each succeeding hemodialysis and supervision and care associated therewith 100 1192 For the same condition treated with peritonea]. dialysis, first dialysis 150

1232 — children 7 years and under 150

1193 — each succeeding peritoneal dialysis 100

1233 — children 7 years and under 100 1189 For the treatment of chronic renal failure by ANY dialytic method including management during dialysis 50

Medical Certificate for Observation 1156 1st doctor 15 1157 2nd doctor 15 (Consultation fees not payable in addition).

p, :.:

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GENERAL SURGERY

These fees cannot be correctly interpreted without reference to the Preamble.

Units DOOl Major Consultation 28 including complete history and physical examination, re view of x-ray and laboratory findings, performance of haemoglobin and routine urine examination, if required, and a written report. D002 Minor Consultation 18 when dealing with one particular problem not requiring complete history and physical examination, to include written report. D003 Repeat Consultation 18 within 30 days for same illness or complication thereof.

VISITS

OFFICE

DOlO Initial visit 20 new condition seen for the first time in office to include complete history and physical examination. 0020 Initial visit 12 with regional examination. 0025 Subsequent visit 8 0004 Continuing care 8 0005 Directive care, per visit 10 (maximum of 5 visits/week)

HOSPITAL

0035 Initial visit 17

Subsequent tisits — charge as A041 or A043. 0007 Continuing care 8 0006 Directive care, per visit 10 maximum of 5 visits/week)

HOME

0070 Initial visit 23

Where a call is received in one time period and made in another time period, the lower fee. applies. 0092 Bamto5pm,Mon-Fri 12.5

0093 5 pm to midnight, Mon — Fri 18 0094 Midnight to 8 am, all days 22 0095 am o midnight, Sat, Sun and holidays 18 0009 Continuing care 8 0008 Direcive care, per visit 10 (maxinum of 5 visits/week)

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Anaes Units Units

OPERATIONS ON THE INTEGUMENTARY SYSTEM

Incision

Abscess, subcutaneous — boil, carbuncle, infected cyst, superficial lymphadenitis, paronychia, felon, etc.

3011 — general anaesthetic 20 3+T (pre and postoperative care at visit fees)

Local anaesthetic - see page 5/48.

3014 Perianal or pilonidal — local anaesthetic 12 3015 — general anaesthetic, complete care 30 3+T

3016 Ischiorcctal — simple incision

— local anaesthetic 12 3017 Unroof ing — complete care 60 3+T

3018 Palntar and plantar space - infections,

tenosynovitis, general or regional — full care 80 3+T 3030 Hematoma, local anaesthetic 13 3031 — general anaesthetic 35 3+T depending on size and other complicating factors. (pre and postoperative care at visit fees) 3036 Tongue tie, release of

— child, local anaesthetic 6 3037 — child, general anaesthetic 20 3+T Infant Visit fee 3050 Removal of foreign body or fibroma — local anaesthetic 10 3051 — general anaesthetic 20 3+T

Excision 3100 Biopsy of skin or mucosa 20 3+T 3120 Cyst, pilonidal, simple excision or marsupialization 100 3+T 3121 Sebaceous — on face or neck 20 4+T 3122 — on other area 16 3+T

3150 Finger or toenail - simple, complete, partial or wedge 20 3+T 3151 — radical, to include destruction of nail bed and shortening of phalanx, if necessary 40 3+T 3220 Lipoma

— simple removal, local anaesthetic 20 3221 — complicated, large and involving deeper structures 65 3+T 3230 Neuroma, simple, subcutaneous, local anaesthetic 20

-

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Anaes Units Units

Warts, including papillomata, Keratoses, Nevi.,

Moles, Pyogenic Granulomata, etc., removal by -

(a) Medical Methods 3241 Cryotherapy, initial treatment, — 5 or less procedures 12 - each additional group of 5 procedures or less 6 3242 Cryotherapy, subsequent visits, each group of 5 procedures or less 6

(b) Surgical Methods 3245 Curettage, 5 or less procedures 12 3+T — each additional yrou of 5 procedures or less 6 T 3246 Simple excision, 5 or less excisions 20 3+T — each additional group of 5 excisions or less 10 T 3247 Electrocautery 5 or less procedures 12 3+T — each additional group of 5 procedures or less 6 T 3248 Subsequent cauterization, each group of 5 or less 6 Plantar Warts and Junctional 4Vevi 3260 Curettage, 5 or less procedures 14 3+T — each additional group of 5 procedures or less 6 T 3261 Simple excision, 5 or less procedures 30 3+T - each additional group of 5 procedures or less 15 T 3262 Radical excision, 5 or less procedures 50 3+T — each additional 5 procedures or less 25 T

Carcinoma of Skin 3110 Local excision, primary closure 50 3+T 3111 Local excision plus skin graft, full or split thickness graft 80 3+T 3112 Local excision plus skin graft larger than 5 square inches 100 3+T 3113 Local excision with rotation flaps 250 3+T

Introduction 3290 Implantation of hormone pellets 10 3+T

Suture of Simple Wounds or Lacerations

3302 — child’s face 17 4+T 3300 — other ages and areas 11 (local anaesthetic) The above fees are in addition to the appropriate

visit fee. Complicated, extensive lacerations — refer to Section for Plastic Surgery.

Repair

Thermal burns - simple small burns, office dressing visit foe

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Anaes Units Units

Extensive burns - refer to Section for Plastic Surgery.

Destruction 3393 Single area; e.g., trauma scar 35 3+T

OPERATIONS ON THE BREAST

Incision 3400 Drainage of intramaixunary abscess, single or

multiloculated - including pre and postoperative care 40 3+T 3401 Repeat incision 40 3+T

Excision 3410 Excisional biopsy 60 3+T

3415 Mastectomy — simple 130 3+T 3416 Radical or modified radical 275 5+T

3419 — where skin graft necessary with either of above, add 50

3418 — male — simple 120 3+T

Repair

3420 Mainmoplasty — reduction — unilateral 170 5+T

3421 — augmentation — by prothesis - bilateral 200 5+T

OPERATIONS ON THE RESPIRATORY SYSTEM

TRACHEA AND BRONCHI

Incision 5100 Tracheotomy 120 5+T

Repair 5101 Tracheal splint, transthoracic 400 13+T 5102 Tracheal reconstruction 400 13+T 5103 Revision of tracheotomy 120 6+T 5104 Closure of tracheotomy 120 6+T

CHEST WALL AND MEDIASTINUM

Reconstruction

4381 Pectus excavatum - infant 240 4+T

4382 — other than infant 240 1l+T

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-. — — - . —______5/55

Anaes Units Units Excision 5130 Chest wall tumor involving ribs or cartilage and reconstruction of chest wall 240 9+T 5135 Mediastinal tumor 300 13+T 5138 Cervical mediastinal exploration 150 6+T 5137 First rib resection 250 9+T

5143 — with thoracotomy 250 13+T

Surgical Collapse

5140 Thoracoplasty - one stage 200 10+T

5141 Multi—stage — each 120 9+T 5142 Schede’s operation 240 10+T

5145 Pneumolysis - intra-pleural 90 5+T

5146 — extra—pleural 150 5+T

5147 Apicolysis — extra—fascial (Seinbs) 150 5+T 5148 Extra pleural 150 5+T

5150 Pneumothorax - first 15 5151 Subsequent 7.5 5154 Phrenicotomy 60 5+T

LUNGS AND PLEURA

Aspiration 5139 Aspiration of lung tumor under fluoroscopy 50

Incision Thoraco tomy 5160 Closed drainage, operation and aftercare 60 4+T 5161 Rib resection and drainage 120 l3+T 5163 Drainage of lung abscess 180 l3+T 5165 Exploratory removal of foreign body 180 13+T 5168 Biopsy of pleura or lung 180 l3+T

Excision 5170 Pneumonectomy 400 13+T 5172 Lobectomy 400 l3+T 5174 Segmental resection 350 l3+T 5175 Wedge resection 240 13+T

5180 Pleu.rectomy - pleural decortication 300 l5+T 5181 With bullous emphysema 300 13+T

Repair 5185 Bronchoplasty 400 l3+T

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Anaes Units Units

OPERATIONS ON THE CARDIOVASCULAR SYSTEM

VEINS

Repair Venous Anastamosis 6081 Lnbilical to saphenous shunt 300 lO+T 6210 Porto—caval 350 1 0+T 6211 Spleno—renal 350 lO+T 6212 Meso—caval 350 lO+T 6215 Arterio—venous fistula or aneurysm, resection and ligation or grafting depending on extent IC IC by region 6216 Arterio—venous anastamosis for artificial kidney 180 4+T

Suture Ligation 6220 Jugular 60 6±T

6221 Femoral - superficial 60 8+T

6227 — deep 60 84-T

6228 — common 60 8+T 6222 Inferior vena cava 180 lO+T 6223 Popliteal 60 8+T 6224 Saphenous 25 3+T 6225 Iliac 150 10+T

Excision, Ligation, Injection 6230 Injection, single or multiple 5

6231 Ligation, multiple - one leg 60 3+T

6232 Ligation — long saphenous - sapheno - femoral

junction — one leg 60 3+T

6233 Ligation — long saphenous - one leg with stripping 90 3+T

6234 — with multiple low ligation — ligation of perforators 100 3+T 6235 Short saphenous ligation and stripping 50 3+T

6236 Ligation and stripping - long and short saphenous

veins — one leg 125 3+T 6237 High ligation, bilateral with stripping 175 3+T

6238 — with multiple low ligations 200 3+T 6239 Bilateral long and short saphenous, high ligation and stripping 225 3+T 6240 Recurrent complicated varicose veins IC 3+T 6242. Excision of ulcer, multiple ligation and skin

graft — one leg 125 3+T 6242 Excision of ulcer, multiple ligation and skin

graft — both legs 200 3+T

6243 — above plus sympathectomy, extra 75 3+T

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Anaes Units Units

6245 Excision of stasis ulcer and skin graft —oneleg 80 3+T

6246 — both legs 120 3+T 6247 Sub—fascial ligation 150 3+T

6248 — with stripping of veins 200 3+T 6249 Thrombectomy, iliac or femoral 250 l0+T 6250 Cauterization of varicose veins 50 3+T 6251 Compression scierotherapy

(Feganization) — per leg, per year 100 6252 — after first 12 months, per treatment 15 (to a maximum of 100 units per succeeding 12 month period).

NOTE - claims must be supported by a copy of the history of the treatment for the period claimed.

ARTERIES (for Anaesthesia, see Anaesthesia for Open Heart Surgery)

Incision 6082 Aneurysm of sinus of Valsalva 500 35+T 6086 Rupture of aortic aneurysm 450 17+T Pump 35+T 6100 Arteriotomy 35 5+T 6101 Aortotomy 75 5+T 6102 Arterial puncture (independent procedure) 10

6103 Transection of artery - peripheral 75 4+T

6104 - intra—abdominal or intra-thoracic 100 I C

6105 Division of vascular ring — oesophagus 250 20+T

Procedures Requiring By-Pass 6036 (a) Complete cardiopulmonary by—pass ‘extra’ 200 6037 (b) Partial cardiopulmonary by—pass ‘extra’ 200

Excision Aneurysm 6119 Thoracic aorta 500 35+T 6111 Abdominal aorta 400 17+T

6129 — with rupture 450 17+T 6116 Splenic, hepatic 200 l0+T

6109 — with grafting 300 10+T 6117 Innominate or carotid 300 lO+T

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Anaes Units Units

612]. Femoral, popliteal, subclavian, - by excision 200 l0+T 6122 — by graft 250 l0+T 6115 Dissecting 400 17+T

Occlusive Disease

6112 Aorta - bifurcation graft 350 17+T 6113 — thromboendarterectomy 300 17+T

6114 - thromboendarterectomy and vein graft 350 17+T

Peripheral Arterial Graft 6123 Femoral graft with bypass 250 10+T 6134 Crossed femoral graft 250 10+T 6135 Axillo—femoral graft 300 l0+T 6142 Papliteal—tibial arterialgraft 250 l0+T 6079 Arterial graft-aorta to poplitcal 350 17+T 6080 Iliac artery to popliteal or femora] 300 l0+T

6124 Throznboendartcrectomy — with vein graft 275 lO+T 6136 — renal 250 l0+T 6137 — superior mesenteric 250 10+T 6138 — brachial 250 5+T 6139 — axillary 250 6+T 6140 — subclavian 300 6+T 6125 Embolectomy - aortic 250 lO+T 6126 — iliac or femoral 200 l0+T 6127 — mesenterjc 250 lO+T 6128 — renal 250 l0+T 6147 — arm 200 5+T 6120 Coarctatjon of aorta 350 20+T 6130 Carotid body tumor 250 6+T 6131 — with graft 325 10+T 6132 — with vessel bypass 350 l0+T

Repair

6160 Arterioplasty — femoral 150 lO+T 6161 — iliac 150 10+T

Suture

6175 Ligation of carotid in neck - simple 75 5+T 6176 — application of occlusion clamp 150 l0+T 6177 Ligation of anterior ethmoid artery for epistaxis 50 4+T

HEART AND PERICARDIUM

Incision 6020 Atrial or right ventricular puncture 20 5+T 6025 Biopsy of pericardium by thoracotomy 150 13+T

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Anaes Units Units

Cardiotomy

6027 — with removal of foreign body 250 20+T

6021 - with exploration 300 20+T

Excision

6075 Pericardectomy - partial 200 20+T

6076 - subtotal 300 20+T 6028 Ventricular diverticulum 300 3 5+T 6029 Ventricular aneurysm 500 35+T Pump 6024 Tumors of heart, e.g., myxoma 450 35+T Pump 6071 Resection of myocardial fibrosis 500 35+T Puxnp 6072 Resection of myocardiurn 500 35+T Pump 6088 Pulmonary embolectomy 300 20+T

Introduction 6073 Battery change of pacemaker 125 9+T* 6089 Insertion of permanent pacemaker 200 * (*) NOTE: - by thoracotomy 2 O+T

- by external method 9+T

- with monitoring by Anaesthetist add extra 5(3

Repair 6090 Patent ductus arteriosus 250 20+T 6032 Closure atrial septal defect 350 20+T 6034 Closure of septum primuni with or without valve repair 500 35+T Pump 6031 Anomalous pulmonary venous drainage 350 20+T 6040 Repair of ventricular septal defect 450 35+T

6035 - with removal of banding 500 2 0+T Pump 35+T 6041 Banding of pulmonary artery 300 3 5+T

6042 Pulmonary - aortic anastomosis

— Potts 350 20+T

6043 Pulmonary - subclavian -Blalock 350 20+T 6045 Waterston shunt 350 20+T Pump 35+T 6055 Total repair of Tetralogy 500 35+T 6083 Total repair of Tetralogy of Fallot with previous systemic pulmonary shunt 600 35+T 6092 Repair of double outlet right ventricle 500 35+T 6087 Reclosure of sternal wound 150 9+T

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Anaes Units Units

Transposition of Great Vessels 6051 Creation of atrial septal defect (Blalock Hanlon, Sterling-Edwards) 350 20+T 6054 - total repair (Mustard procedure) 500 35+T Pump Tricuspid Valve 6056 Tricuspid atresia - Glenn procedure 350 20+T 6058 — Ebstein’s procedure 500 20+T Pump 35+T 6098 Tricuspid annuloplasty 300 35+T

Pulmonary Valve 6059 Pulmonary stenosis - Brock procedure 300 20+T 6063 Pulmonary valvotomy with inflow occlusion 350 20+T 6064 Pulmonary valvotomy 400 35+T

Mitral Valve 6066 Valvotomy - transatrial 300 20+T 6067 — transventrjcular 325 20+T 6097 Valvotomy for re—stenosis 400 20+T Pump 35+T 6068 Open mitral coinmisurotomy 400 35+T 6099 Mitral anriuloplasty 400 35+T 6062 Valve replacement 500 35+T 6074 — double 600 35+T 6077 - triple 1,000 35+T

Aortic Valve 6065 Aortic valvotomy or valvuloplasty 400 35+T 6061 Valve replacement 500 35+T

Coronary Arteries 6069 Pericardial insufflation with powder 150 20+T 6046 Vineberg procedure 350 20+T 6070 Double Vineberg 450 20+T 6047 Open repair of artery 350 20+T 6049 Aneurysm of sinus of Valsalva 400 35+T 6078 Coronary endarterectomy (by—pass graft) 500 20+T

6106 Aorto—coronary by—pass - single 500 20+T

6107 - double 650 20+T 6108 — triple 775 20+T 6110 Each additional by—pass 75

Suture 6093 Suture of wound 250 20+T

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Anaes Units Units

Manipulation Cardiac Massage 6095 Opening and closing chest and massage in addition to fee for operation during which arrest occurred 100 6096 Assisted circulation for cardiac or respiratory failure 400 35+T

OPERATIONS ON THE HAEMIC AND LYMPHATIC SYSTEMS

SPLEEN AND MARROW

6501 Splenic puncture for injection of contrast substance 30 4-4-T

Excision 6510 Splenectomy 200 7+T 6521 Bone button 30 4+T

LYMPH CHANNELS

6523 Lymphangiogram 90 5+T

Excision 6525 Cystic hygroma 180 6+T

Lmphoedema 6526 Kondolean 180 5+T 6527 Radical sleeve excision 300 6+T 6529 Lympho—venous anastomosis 250 4+T

Excision 6575 Cervical gland biopsy 30 4+T 6578 Inguinal gland biopsy 30 3+T 6579 Axillary gland biopsy 30 3+T 6576 Scalene node biopsy 60 4+T

- 150 6+T 6550 Tumor — suprahyoid unilateral 6+T 6551 — bilateral 200 6555 Radical neck dissection 300 8+T 6577 Axillary glands, radical dissection 180 4+T 6553 Inguinal lymphadenectomy,

superficial — unilateral 100 6+T 6+T 6554 — bilateral 150 6557 Inguinal and iliac nodes, radical dissection 200 6+T - unilateral

6558 - bilateral 300 6+T 6559 Retro—peritoneal lymph node dissection 300 6+T

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Anaes Units Units

6560 Staging operation for Hodgkins disease 300 7+T 6563. Deep pelvic lymphadenectomy,

— unilateral 100 6+T 6562 Para-aortic lymphadenectomy 150 6+T

6563 Pelvic exenteration - anterior 600 8+T

6564 - posterior 600 8+T

6565 — total 750 8+T

OPERATIONS ON THE DIGESTIVE SYSTEM

MOUTH

Incision 7000 Drainage of Ludwig’s angina, complete care 40 5+T

Excision 7005 Biopsy 20 4+T 7006 Excision of leukoplakia,

— simple lesion 20 4+T

7007 — limited 30 4+T

7008 — extensive 120 4+T 7011 Excision of ranula or derrnoid cyst 60 4+T 7012 Local excision for carcinoma of floor of mouth, mandible, alveolar margin or buccal mucosa 90 6+T

7013 - with hemimandibulectomy 180 8+T

7014 — either of above canbined with unilateral neck dissection 325 8+T 7010 Maxillectomy for carcinoma 300 10+T

Destruction 7015 Cauterization of leukoplakia 30 4+T

LIPS

7020 Biopsy 20 4+T 7021 Lip shave 60 4+T 7022 Excision of simple lesion 35 4+T 7023 V—excision for carcinoma 90 4+T

7024 — plus radical neck dissection 325 8+T

7025 One half lip - plus reconstruction 150 4+T

7026 — plus radical neck dissection 350 8+T 7027 Total excision of lip plus reconstruction 200 4+T

7028 - plus radical neck dissection 350 8+T

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Anaes - Units Units

TONGUE

Excision 7030 Biopsy 20 4+T 7031 Local excision of simple tumor 60 4+T 7032 Heniiglossectomy 150 8+T 7033 — plus radical neck dissection 350 8+T 7034 Total glossectomy 180 8+T 7035 — plus radical neck dissection 350 8+T

Repair 7038 Suture of extensive laceration I C 4+T

TEETH AND GUMS

Incision 7040 Drainage of alveolar abscess - general anaesthetic 20 4+T

Excision 7041 Biopsy of gum 20 4+T 7049 Dentigerous cyst 120 4+T 7050 Mucus cyst 20 4+T

Suture .7051 Suture of gum, secondary 20 4+T

PALATE AND UVULA

Incision 7052 Palate abscess 20 4+T

Excision 7053 Uvulectorny — independent procedure 20 4+T 7054 Biopsy 20 4+T 7055 Excision of simple lesion 30 4+T 7056 Excision of malignant lesion with reconstruction 140 8+T

HEAD AND NECK

SALIVARY GLANDS AND DUCTS

Incision

7060 Sialolithotomy, under general anaesthesia — simple 30 4+T

7061 — complicated 90 4+T

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- 5/64

Anaes Units Units

Excision 7062 Submandibular gland 120 4+T

7063 Parotid gland — excision of tumor only 180 5+T 7064 Total removal 240 5+T

7065 — plus unilateral radical neck dissection 350 8+T 7071 Biopsy of parotid tumor 15 4+T

Repair 7067 Plastic repair of duct 120 5+T 7068 Dilation of duct as independent procedure 10 7069 Probing of duct 5 7070 Catheterization for sialogram 10

OESOPHAGUS

NOTE: (*) for procedures on the oesophagus the following basic fees for anaesthesia will apply:

- — cervical 6+T

— thoracic 13+T

- abdominal 7+T

Incision

7100 Oesophagotomy — cervical 120 6+T

7101 — thoracic 180 13+T 7102 Oesophagomyotomy 300 (*) 7103 Oesophagomyotoiny and valvuloplasty 350 (*)

Excision 7105 Intrathoracic diverticulum 240 (*)

7106 Extrathoracjc diverticuluxn - one stage 180 (*)

7108 Resection of oesophagus - one stage 400 (*)

7109 — with replacement by jejunum or colon (*) — 1st surgeon 400 (*) 7110 — 2nd surgeon 100 (*) 7111 — 2nd surgical assistant 85 7115 Oesophago—gastrectomy 400 (*) 7116 Oesophageal bypass with colon or jejunum 350 (*)

Endoscopy 7124 Introduction of Souter tube 75 4+T

Repair (*) 7130 Oesophagoplasty — repair of stricture 250 7131 Repair of ocsophageal stricture, (*) — Thai procedure 350

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5/65

Anaes Units Units

7135 Oesophageaj. hiatus hernia,

- abdominal approach 300 7+T

7136 — transthoracic approach 300 13+T 7137 Nissen procedure with or without splenectomy 275 (*) Note: when hiatus hernia and the Nissen procedure are done at the same time, the fee for hiatus hernia only shall be claimed. 7140 Ruptured oesophagus 240 (*) (*) 7141 — cervical drainage 175 7143 Oesophago-gastrostomy 300 (*) 7146 Oesophago—duodenostomy or jejunostomy 300 (*) 7150 Closure of oesophageal-tracheal fistula 350 (*) 7155 Oesophagotomy with ligation of varices 240 (*) 7156 Injection, oesophageal varices with

oesophagoscopy — initial 120 4+T 7158 Introduction of Mousseau-Barbin tube 150 4+T

7160 Dilation - indirect — active, with or without guiding string 30 4+T

7161 — passive, using mercury filled tubes 10 4+T 7162 Pneumatic dilator 30 4+T 7163 Retrograde dilation 10 4+T

7164 Dilation of oesophagus with oesophagoscopy - initial 120 4+T

7165 Dilation of oesophagus with oesophagoscopy - repeat 50 4+T 7166 Dilation of oesophagus under fluoroscopic control 35 4+T

STOMACH

Incision 7200 Gastrotomy with removal of foreign body 150 7+T 7201 Pylormyotomy (Ramstedt’s) 150 l0+T 7202 Simple tube gastrostomy 150 7+T 7203 Living tissue gastrostomy (Janeway, etc.) 200 7+T

Excision 7207 Biopsy of stomach by intubation 20 4+T

Gastr e ctomy 7210 Wedge resection for ulcer 180 7+T 7211 Partial or subtotal 300 7+T

7212 — plus cholecystectomy at same time 350 7+T 7213 — plus repair of hiatus hernia 350 7+T

7214 — after previous gastroenterostomy or partial gastrectomy 350 7+T

7209 Antrectorny or sub—total - plus vagotomy 300 7+T 7215 Total gastrectomy 350 7+T

I

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Anaes Units Units

7216 Excision of gastroduodenal lesion (recurrent ulcer) 350 7+T

7219 — plus vagotomy 400 7+T 7217 Excision of gastro—jejunal lesion (recurrent ulcer) 350 7+T 7218 — plus vagotomy 400 7+T

Repair 7225 Pyloroplasty 180 7+T 7226 Pyloroplasty and vagotomy 240 7+T 7227 Gastroduodonostomy, gastrojojunostomy or gastro— gastrostomy 180 7÷’r

7228 — either of above plus vagotomy 240 7+T 7229 Pyloroplasty or gastroenterostomy with vagotomy and hiatal hernia 300 7+T 7230 Vagotomy — abdominal 180 7+T 7231 Vagotomy — thoracic route 240 7+T

Suture 7240 Closure of gastrostomy or other external fistula of stomach 120 5+T 7241 Closure of perforated ulcer or wound of stomach 180 7+T 7245 Closure of gastrocolic or gastro—jejuno—colic

fistula - one stage 350 7+T 7246 — two stages, including colostomy 350 7+T 7247 Gastric cooling 60

INTESTINES (Except Rectum)

Incision Enterotomy or Enterostomy 7300 Ileostomy for ulcerative colitis 180 6+T 7301 Ileostomy or jejunostomy with tube 120 6+T

Exteriorization of Intestine 7310 First stage Mickulicz 180 6+T 7315 Colostomy 150 6+T

7316 — within one month of definitive procedure 60 6+T 7317 Revision of colostomy or ileostomy 60 6+T 7320 Caecostomy, as single procedure 120 6+T 7318 Enterotomy or colotomy - single 180 6+T 7319 Multiple colotomy with operative sigmoidoscopy 240 6+T

Revision for Stenosis or Obstruction

7324 — more than 4 weeks after original operation 60 6+T

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Anaes Units Units

7328 inLero—ontcrosLoiny 180 6+1 7329 Duodenal atresia - duodeno—jejunostomy 200 6+T

Excision 7330 Biopsy by intubation 50 7331 Local excision of lesion of intestine including diverticulum of duodenum 180 6+T

Enterectomy with Anastomosis Small Intestine 7335 Duodenectomy 200 6+T 7336 Other 200 6+T

Small and Large Intestine 7340 Terminal ileuxn and caecum 250 6+T 7341 Terminal ileum, caecum and ascending colon 250 6+T

Large Intestine 7345 Segmental 250 6+T 7346 Hemicolectomy, right or left 250 7+T 7350 Total colectomy without perineal resection 350 8+T Enterectotny with colostomy, caecostoxny or ileostomy, resection of colon, total colectomy with ileostorny and abdomino—pcrineal resection 7739 Single team 400 8+T 7361 Two team — 1st surgeon 350 8+T 7362 — 1st surgical assistant 120 7363 — 2nd surgical assistant 90 7375 Intestinal obstruction — without resection 250 8+T 7376 — with resection 300 8+T 7378 — two stage with enterostomy, resection and subsequent closure 300 8+1 7379 Reduction of volvulus or intussusception, etc 180 6+T

Repair 7384 Revision of ileostomy or colostomy 60 6+T 7382 Faecal fistula, radical with resection 240 6+T 7386 Closure of perforation 150 6+T 7387 Closure of perforation with colostomy 180 6+T

Suture 7390 Suture of intestine 150 6+T 7391 Closure of enterostomy plus resection 180 6+T 7392 Closure of colostomy 120 5+T 7393 Plication of small intestine for adhesions 240 6+T

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5/68

Anae S Units Units

- 7395 Manipulation, dilation of enterostomy, colostomy, etc.

— with anaesthetic 20 3+T

— without anaesthetic visit fee 7397 Intubatjon of small intestine 20 4+T

MECKEL’ S DIVERTICULUM AND THE MESENTERY

Excision 7400 Meckel’s diverticulum 150 6+T 7402 Local excision of lesion 150 6+T 7406 Resection of mesentery 150 6+T

APPENDIX

Incision 7410 Drainage of abscess, complete care 120 5+T

Excision 7411 Appendectomy 175 6+T

7412 - with removal of Meckel’s diverticulum 150 6+T

PECUM

4+T 7420 Proctotomy - with exploration 60

7421 — with decompression (imperforate anus) 60 4+T 60 4+T 7422 — with drainage (perirectal abscess) 75 4+T 7423 — Pelvic abscess — drainage

Excision Practectomy 7430 Anterior resection of recti.un 350 6+T 7431 Perineal resection of rectum 240 6+T 7360 Abdominal perineal resection plus colostomy 450 8+T — single team 2o team approach 7436 Abdominal surgeon 350 8+T 7435 Perineal surqcon 200 7437 Abdominal surgeon assistant 100 7438 Perineal surgeon assistant 80 7439 Hartman procedure 200 6+T

7450 Abdominal - perineal pull through for Hirsch— sprung’s Disease or imperforate anus 450 8+T — single team Tho team approach 7451 Abdominal surgeon 350 8+T 7454 Perineal surgeon 200 7452 Abdominal surgeon assistant 100

— —‘I - -- - 7T

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Anaes Units Units

7453 Perineal surgeon assistant 80 7455 Proctosigmoidectomy for prolapse 300 6+T

7458 Rectal or sigtnoid polyp - low 30) 7459 Upper rectum and sigmoid 60) 7460 Electrocoagulation of polyp 30) **6+T 7463 Cauterization of small rectal carcinoma 75 3+T 7464 Follow-up cautherization of rectal carcinoma subsequent to 30 days after initial procedure 30

Repair 7466 Proctostomy 150 4+T

7467 Proctopexy - abdominal route 180 6+T

Rectal Prolapse 7470 Excision of mucous membrane 90 3+T 7471 Perineal repair, major 180 4+T 7472 Abdominal approach 240 6+T 7473 Thiersch wire procedure 60 4+T

Suture of Rectum

7475 — external approach 120 4+T

7476 — intraperitoneal approach 200 6+T

* through scope ** by laparotomy

Closure of Fistula 7480 Recto-vaginal 200 4+T 7482 Recto—vesicaj 200 4+T

7484 - including colostomy and closing of colostomy 300 6+T 1185 Injection of sinus or fistula with dye or contrast media 10

Manipulation 7490 Dilation, under general anaesthetic 20 3+T 7491 Removal of foreign body, depending on nature I C I C

OPERATIONS OF THE ANUS

Incision

7500 Thrombosed haemorrhoid — local anaesthetic 10

7501 — general anaesthetic 25 3+T

Excision 7502 Local excision of lesion (fissure) 60 3+T

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Anae S Units Units

7503 Haemorrhoidectomy with siginoidoscopy and excision of fissure 90 3+T 7508 Local excision for malignancy 30 3+T 7510 Anal polyp, haemorrhoidal tags 30 3+T

7511 Fistuj.a — in—ano, low level 90 3+T

7512 — high level with division of internal sphincter 180 3+T 7515 Biopsy, independent operation, general anaesthesia 20 3+T

Repair 7525 Excision of scar, for stenosis 60 3+T 7527 Anoplasty, for stenosis 120 4+T 7530 Repair of anal sphincter 150 4+T 7531 Repair of anal sphincter and anorectal ring 150 4+T

Repair of Ixnperforate Anus 7550 Membranous obstruction of anus 60 4+T

Rectal Atresia 7551 Perineal repair 240 4+T 7552 Abdominal — perineal repair

— single surgeon 450 8+T flo team approach 7553 Abdominal surgeon 350 8+T 7543 Perineal surgeon 200 7554 Abdominal surgeon assistant 100 7555 Perineal surgeon assistant 80

With Normal Anal Canal

7556 Abdominal - perineal repair

— single surgeon 450 8+T

2o team approach 7557 Abdominal surgeon 350 8+T 7567 Perineal surgeon 200 7558 Abdominal surgeon assistant 100 7559 Perineal surgeon assistant 80

Destrtion 7560 Cauterization of fissure 10 3+T 7562 Electro—dessication of condylomata 20 3+T 7565 Dilation of anal sphincter 5 3+T

LIVER

Incision (Hepatotomy) 7600 Exploratory 180 7+T 7601 Drainage of abscess or cyst 180 7+T

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Anae S Units Units

7602 Removal of foreign body 180 7+T 7603 Incision and packing of wound 180 7+T

Excision (Hepatectomy) 7605 Local excision of lesion 180 7+T

7606 Resection of liver — partial hepatectomy or lobectomy 400 12+T

Repair

7610 Marsupialization of cyst or abscess ... 180 7+T

Suture 7614 Rupture or wound 180 8+T

BILIARY TRACI’

Incision 7726 Cholecystostomy 150 7+T 7727 Cholecystenterostomy 180 7+T 7725 Cholecystenterostomy plus enteroenterostomy 200 7+T 7728 Cholecystogastrostomy 180 7+T 7724 Choledochoduodenostomy 240 7+T 7715 Common duct exploration 240 7+T 7723 Common duct exploration with duodenotomy, sphincterotomy, removal of stone 300 7+T

Excision 7730 Lesion of hepatic ducts 275 7+T 7731 Choledochectomy 300 7+T 7735 Excision of inpulla of Vater 275 7+T 7740 Cholecystectomy 250 7+T

7742 — with operative cholangiogram 275 7+T 7741 Cholecystectomy and exploration of bile duct 275 7+T

7743 — with operative cholangiogram 300 7+T 7744 Cholecystectomy and exploration of bile ducts plus duodenostomy 300 7+T

Repair 7751 Surgical reconstruction of common bile duct 400 7+T

Suture 7752 Closure of fistula 275 7+T

PANCREAS

Incision 7800 Pancreatotomy 180 7+T 7810 Pancreatic abscess or cyst 180 7+T

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Anaes Units Units

Excision 7820 Complete pancreatectomy 400 7+T 7821 Local excision of lesion 240 7+T 7822 Islet cell ti.mor 240 7+T 7823 Partial resection of tail 240 7+T 7824 Pancreatjco—duodenal resection (Whipple type operation) 400 7+T 7827 Excision of pancreatic cyst 240 7+T

Repair 7830 Pancreaticogastrostomy 240 7+T 240 7+T 7832 — duodenostomy 240 7+T 7834 - jejunostomy 7840 Marsupialization of cyst 200 7 +T

ABDOMEN, PERITONEtJM AND OMENTUM

Incision 7900 Laparotomy, with or without biopsy ... 125 6+T

Peritoneal Abscess 7910 Drainage of subphzenic abscess 180 7+T 7914 Abdominal 120 6+T 7916 Drainage of abdominal wall

abscess — general anaesthetic — complete care 30 4+T

Removal Foreign Body, Abdominal Wall 7920 Gunshot IC IC

Excision 7930 Denoid tumor, depending on extent IC 4+T 60 4+T 7932 Umbilectomy — plastic 7935 Lipectomy 120 4+T 7940 Retroperitoneal tumor 240 7+T 7939 Mesenteric cyst 150 6+T 7942 Injection of air 20

7045 Peritoneoscopy or laparoscopy 100 4+T

Repair Herniotoimj and Herniorrhaphy 120 4+T 7950 Inguinal or femoral — single 150 4+T 7951 Inguinal — single with hydrocoele 7954 Inguinal and femoral — same side 150 4+T 7962 Sliding hernia 150 4+T 7949 Inguinal or femoral repair by prothesis or graft 150 4÷r

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Anae S Units Units

7961 Recurrent hernia 180 4+T 7969 Recurrent hernia repair by prosthesis or graft 200 4+T 7955 Umbilical hernia — adult 150 4+T 7956 Umbilical hernia — child 90 4+T 7957 Enterecoele, infant 120 7+T 7958 cmphalocoele, infant 180 7+T 7959 Diaphragmatic hernia 240 * 7965 — with prosthesis 275 * 7960 Incisional - postoperative repair by suture 180 6+T 7966 — repair by prosthesis 200 6+T 7968 Epigastric 120 4+T

*dominaj 9+T Thoracic 13+T

StrcmguZated or Incarcerated 7952 — without resection 150 8+T 7953 — with resection 240 8+T

Suture 7963 Secondary closure for evisceration 100 6+T

THYROID GLAND

Incision 8900 Aiscess, complete care 60 4+T

Excision 8905 Needle biopsy of thyroid gland 40 6+T 8906 Surgical biopsy 120 6+T Thyroidectorny 8910 Bilateral total thyroidectomy 275 6+T 8911 Total lobectomy 200 6+T 8912 Sub—total bilateral thyroidectomy 200 6+T 8914 Partial lobectomy 180 6+T 8913 Excision of solitary nodule 120 6+T If one of the following procedures is carried out

with any of the above add - 8915 Unilateral limited node dissection 60 6+T 8916 Bilateral limited node dissection 120 8+T 8917 Radical neck dissection — unilateral 120 8+T

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NEUROSURGERY

These fees cannot be correctly interpreted without reference to the Preamble. Units

FOOl Major Consultation 28 including complete history and physical examination, review of x—ray and laboratory findings and a written report. P002 Minor Consultation 18 when dealing with one particular problem not requiring complete history ‘and physical examination, to include written report. P003 Repeat Consultation 18 within 30 days for same illness or complication thereof.

VISITS

OFFICE

FOlO Initial visit 20 new condition seen for the first time in office, to include complete history and physical examination. F020 Initial visit 12 with regional examination. F025 Subsequent visit B P004 Continuing care 8 F005 Directive care, per visit 10 (maximum of 5 visits/week)

HOSPITAL P035 Initial visit 17

Subseqent Visits - charge as A041 or lO43. P007 Continuing care 8 P006 Directive care, per visit 10 (maximum of 5 visits/week)

HOME

FO7O Initial visit 23

Where a call is received in one time period and made in another time period, the lower fee applies.

P092 8 am to 5 pm, Mon — Fri 12.5

F093 5 pm to midnight, Mon - Fri 18 P094 Midnight to 8 am, all days 22 F095 8 am to midnight, Sat, Sun and holidays 18 P009 Continuing care 8 P008 Directive care, per visit 10 (maximum of 5 visits/week)

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Anaes Units Units

CRANIAL TRAUMA

Closed Head Injur 9190 Initial examination and recommendation re further management 30 9191 Daily management in hospital, perday

Scalp Laceration 3300 Simple uncomplicated 11 3304 Extensive, multiple or complicated I C 4+T

Skull (1) Fractures (a) Non—operative same as in closed head

- injury (b) Operative Treatment Simple depressed fracture 9193 Dura intact 150 7+T 9192 Dura lacerated 200 11+T 9197 Serious brain damage 300 ll+T Corrrpcund depressed fracture 9194 Dura intact 200 ll+T 9195 Dura lacerated 250 11+T 9196 Sinus involvement or serious brain damage (foreign body, hematoma, etc.) 300 ll+T

(2) Decompressive Craniectomy 9004 Subtemporal 150 11+T 9005 Suboccipital 250 l1+T 9003 Craniotomy for orbital decompression 250 l1+T 9020 Cranioplasty 200 1l+T

Meningos Surgical management of oxtradural hcmatoma, or sub— dural heinatoma, hygroma, effusion. 9034 Extradural with craniotomy 250 11+T 9033 Extradural with burr holes 250 7+T 9035 Subdural with burr holes 250 7+T 9036 Subdural with craniotomy 250 1l+T 9039 Chjid, subdural by repeated aspiration 150 7+T

SPINAL TRAL71A

4407 Fracture of spinous process (surgical removal) 75 5-fT

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Anaes Units Units

Vertebral fracture, fracture dislocation, dislocation or subluxation (a) Without Cord Injury Supervision0 bed rest only visit fees 9161 Minerva plaster jacket 40 9162 Plaster collar 15 9163 Body plaster 25 9167 Open reduction 200 * 9168 Open reduction with internal fixation 300 * 9170 Open reduction and fusion in conjunction with Orthopedic Surgeon (neurosurgical fee) 200 * 9164 Cranio—skeletal traction tongs 100 (Closed reduction under general anaesthetic add 25 units) (b) With Co pd Trzjur;j Supervision, bed rest only visit fees 9179 Antero—lateral decompression of thoracic spinal cord 450 7+T 9182 Open reduction 300 * 9183 Open reduction with internal fixation 300 * 9184 Open reduction and fusion in conjunction with Orthopedic Surgeon (neurosurgical fee) 200 * 9181 Cranio—skeletal traction tongs 100 5+T (Closed reduction under general anaesthetic add 25 units)

*Note — for operations on the spinal cord and nerve roots, the Anaesthetist’s Basic Fee will depend on the surgical approach:

Cervical 8+T Dorsal or lumbar 7+T

SKULL LESIONS

Linear craniectomy for craniosynostosis 9030 One suture 200 l1+T 9031 More than one suture 350 ll+T 9002 Excision of skull tumor 200 ll+T 9001 Craniectomy for osteomyelitis I C ll+T

BRAIN

Burr holes 9010 Diagnostic, initial 50 7+T

9011 - each additional 25

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Anaes Units Units

9108 Trephine or burr hole with cerebral needling for aspiration or injection or biopsy 165 7+T

Craniotomy

9110 — for removal of cyst, tumor, pituitary tumor, iritracerobral hematoma, lobectomy 360 1 1+T

9109 — for removal of acoustic neuroma 550 11 +T

9101 — for removal of foreign body 400 1 1+T

9111 — for excision of cortical scar for epilepsy 400 1l+T

9118 — for hcmi.sphorcctomy 400 11 1-T

9142 — for arteriovenous malformation 450 11+T 9143 — with clipping of internal carotid intracranially or of feeding blood vessel to arteriovenous malformation 375 1l+T

9114 - for hypophysectomy 365 11+T

9116 — for section of pituitary stalk 365 11+T 9117 — for excisional brain biopsy 300 11+T

9140 — for obliteration of cerebral aneurysm 440 11+T

9141 — for medullary or mesencephalic t.ractotomy 450 11+T

9223 — for carotid — cavernous fistula 550 11+T 9224 By direct attack 800 11+T 9225 By embolization 400 ll+T 9100 Surgical management of brain abscess 425

— by burr hole, to include multiple taps or procedures 7+T - by craniotomy ll+T

Shunts for treatment of hydrocephalu $ 9133 Ventriculoatrial shunt (Holter or Pudenz valve) . - 250 ll+T 9131 Lumboperitoneal shunt 225 ll+T 9130 Ventriculoperitoneal shunt 225 ll+T Ventriculocisternostomy (Torkildsen’ s)

9135 — unilateral 250 ll+T

9136 — bilateral 300 ll+T 9137 Ventricular drainage (continuous) 100 ll+T 9138 Lumbouroteral shunt 300 l1+T 9134 Revision of shunt 165 ll+T 9151 Stereotactic thalainotomy, pallidotomy, cingulotomy, with depth recording and stimulation 400 1l+T

9104 Lobotomy — unilateral 200 ll+T

9106 — bilateral 300 ll+T

VASCULAR P CEDLJRES

9144 Silverstone clamp 150 10+T

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Anaes Units Units

9147 Ligation of caroLid 150 5+’p 9148 Carotid endarterectomy 250 10+T 9150 — with patch graft 300 l0+T 9149 - with graft and by-pass shunt 350 10+T

Cerebral Artificial nbolization 9050 - extracranial 250 10+T 9154 — intracranial 350 ll+T 9057 Vertebral endarterectomy with patch graft 300 ll+T 9058 Intz-acranjal arterial reconstructive surgery 400 ll+T

SPINAL CORD

Laxninectomy 9235 — for excision of neoplasm, hematoma, vascular anomaly, constrictive pachymeningitis of spinal cord or nerve roots 375 * 9228 - for opening of dura and exploration or biopsy of cord or nerve roots or section of dentate ligaments 330 * 9205 — for decompression of spinal cord, anterior or posterior approach — cervical 300 8+T 9206 — dorsal or lumbar 250 7+T 9210 — for treatment of epidural abscess 300 * 9215 — for exploration of syringomyelic cavity 365 * 9221 — for spinothalainic tractotomy (cordotomy) - unilateral 265 * 9222 — bilateral 350 * 9226 - for anterior or posterior rhizotomy 315 * 9227 - for rhizotomy for spasmodic torticollis including spinal accessory nerve 350 6+T 9152 Excision of meningocoele 250 * *Note — anaesthetic basic units will vary according to approach - cervical 8+T dorsal or lumbar 7+T

Excision of myelomeningocele or encephalocele 9171 - cervical, dorsal or lumbar 265 8+T 9173 Rickam reservoir 150 ll+T 9174 Bischoff’s tractotomy. or modifications 400 7+T

CRANIAL NERVES

Posterior fossa craniectomy and 9122 rhizotomy, including MacKenzie procedure 400 ll+T 9123 grafting of VII nerve 350 ll+T

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Anaes Units Units

Nerve anastomosis 9124 Facial - hypoglossal or

facial - accessory nerve anastomosis 250 6+T

Subtemporal craniectomy and 9125 rhizotomy of V nerve 250 ll+T 9126 decompression of Gasserian ganglion 250 l1+T 9127 extracranial section of spinal accessory nerve and/or other peripheral nerves for treatment of spasmodic torticollis 150 6+T 9128 avulsion of mandibular, supraorbital, infraortibal, occipital nerves 50 4+T 9129 chemical destruction 35

DISCS

Cervical

4630 Removal of protruded disc — unilateral 250 8+T 4631 — bilateral or multiple 300 8+T 4652 Anterior disc and fusion — one space 300 8+T 4653 — two spaces 350 8+T

Dorsal 4629 Removal of protruded disc 300 7+T

Lumbar 4627 — unilateral 200 7+T 4628 — bilateral, multiple or recurrent 250 7+T 4633 Removal of disc or laminectomy in conjunction with Orthopedic Surgeon for fusion - unilateral 200 7+T 4654 — bilateral, multiple or recurrent 250 7+T

PERIPHERAL NERVES

9262 Primary suture, major nerve 100 4+T 9237 Exploration and neurolysis or transposition,

major nerve . 100 4+T 9054 Neurectomy, major nerve 100 4+T 9055 Secondary suture, major nerve 150 4+T 9159 Exploration of brachial plexus 250 6+T 9160 Sciatic nerve exploration and neurolysis 200 4+T 9180 Entrapment syndrome 75 3+T 9243 Excision of nerve tumor 165 4+T 9244 Morton’s neuroma 80 4+T

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5/81

Anacs Units Units

VEGETATIVE NERVOUS SYSTEM

S yxupathectomy 9265 Cervical 200 6+T

9264 Cervical-dorsal - unilateral 150 10+T

9266 — bilateral 200 lO+T

9267 Dorsal — unilateral 150 l0+T

9268 Thoracoluxnbar - complete (Smithwick) 400 13+T

9269 Lunbar — unilateral 200 6+T

MYELOGRAM

1251 Cisternal 40 5+T 1252 Luxnbar 30 4+T

VENTRI CULOG RAM

9120 Percutaneous 75 7+T 9121 By drill or burr hole 100 7+T

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5/82

OBSTETRICS AND GYNALCOLOGY

These fees cannot be correctly interpreted without reference to the Preamble.

Units

GOOl Major Consultation 28 G002 Minor Consultation 18 G003 Repeat Consultation 18 within 30 days for same illness or complication thereof.

VISITS

OFFICE

GOlO Initial visit

- with complete examination 20

G020 — with regional examination 12 G025 Subsequent visits 8 G004 Continuing care 8 G005 Directive care, per visit 10 (maximum of 5 visits/week)

HOSPITAL

G035 Initial visit 17

Subsequent visits - charge as A041 or A043. G007 Continuing care 8 G006 Directive care, per visit 10 (maximum of 5 visits/week)

HOME

G070 Initial visit 23

Where a call is received in one time period and made in another

time period, the lower fee applies. -

G092 8 am to 5 pm, Mon - Fri 12.5

G093 5 pm to midnight, Mon - Fri 18 G094 Midnight to 8 am, all days 22 G095 8 am to midnight, Sat, Sun and holidays 18 G009 Continuing care 8 0008 Directive care, per visit 10 (maximum of 5 visits/week)

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Anaes Units Units

OBSTETRICAL PROCEDURES

2400 Abortion — incomplete, examination of the uterus without 0 & C or anaesthcsia (in—hospital procedure only) 25 Abortion - complete visit fees

2403 Abortion — incomplete including 0 & C (prenatal visits extra according to office fee schedule) 60 3+T 2407 Abortion - therapeutic 75 3+T

0380 Obstetrical care — referred case including necessary prenatal and postnatal care 255 3+T

0381 Obstetrical delivery only - no prenatal or postnatal care (to be in addition to full Family Practice fee where applicable) 100 3+T 0382 Obstetrical delivery and postpartum care 125 3+T 0383 Prenatal care only visit fees 0384 Prenatal visits, postpartum care and postnatal Visit 100

OPERATIVE DELIVERY

2421 Caesarean Section, including pre and postnatal care 220 6+T 2424 Caesarean Section, consultation and surgical procedure 165 6+T 2422 Caesarean hysterectomy, sub—total or total 245 6+T

2426 Repair of third degree laceration — consultation and procedure 50 3+T

2427 Retained placenta removal — consultation and procedure 50 3+T

2428 Surgical induction of labor — consultation and procedure 25 3+T 2441 Suture of incompetent cervix during pregnancy 75 3+T 2442 Intra—uterine transfusion 125 1292 mniocentesis for hydramnios 15

1285 — for erythroblastosis 25

GYNAECOLOGICAL PROCEDURES

VULVA

Incision

8600 Hymenectomy - local anaesthesia 15

8601 — general anaesthesia 25 3+T

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Anaes Units Units

8602 Abscess of vulva, Bartholin’s or Skene’s gland - complete care — local anaesthesia 25 8603 — general anaesthesia 25 3+T 8604 Marsupialization or cautery 25 3+T

Excision 8610 Vulvectomy

— simple 120 4+T 8611 - radical without gland dissection 175 6+T 8612 — radical with complete bilateral gland dissection 300 6+T 8613 — radical with inguinal and deep pelvic lymphadenectomy 400 6+T 8615 Cyst of Bartholin’s gland 60 3+T 8617 Cliteroplasty 100 3+T 8618 Clitoris — amputation 60 6+T 8619 Condylomata 50 3+T

VAGINA

Incision 8700 Colpotomy, posterior, drainage or needling 40 3+T

Excision

8701 Biopsy — general anaesthetic 25 3+T 8702 — local anaesthetic 15 8705 Local excision of cyst 70 3+T 8706 Vaginectomy 200 4+T

Repair 8720 Cystocoele or rectocoele 100 3+T 8721 Cystocoele and rectocoele 180 3+T 8722 Cystococle, rectocoele and prolapse (Fothergill) 200 3+T 8723 Cystocoele, rectocoele and excision of cervical stump 200 3+T 8725 Vaginal vault prolapse (post-hysterectomy, vaginal or abdominal) 200 3+T 8727 Rectocoele and repair of anal sphincter 180 3+T 8730 Perineorrhaphy 60 3+T 8732 Colpocleisis (LeFort) 180 5+T 8731 Vaginoplasty — low perineal construction 240 5+T

8733 - high perineal construction 350 8+T 8734 Operation for artificial vagina 200 4+T 8735 Repair of double vagina 90 3+T 8736 Closure of fistula, — vesico—vaginal 200 4+T

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Anaes Units Units

8739 — urotero—vaginal 240 6+T 8741 Urethral caruncle or prolapse of mucosa 40 3+T 8743 Enterocoele 180 3+T 8744 Retropubic incontinence repair, (Birch sling or Marchetti) 180 5+T

Manipulation 8745 Examination and/or dilation, general anaesthetic, independent operation 20 3+T

FALLOPIAN TUBES

Endoscopy 8750 Culdoscopy 50 3+T

Excision 8755 Salpingectomy and salpingo-oophorectomy 150 6+T

Repair 8760 Tubal plastic operation 150 6+T

Suture 8762 Ligation of tubes — vaginal or abdominal 125 6+T 8764 Tubal ligation by laparoscope 125 6+T

OVARY

Excision 8770 Ovarian cyst 150 6+T 8772 Paraovarian cyst 150 6+T

UTERUS AND CERVIX UTERI

Incision 8800 Hysterotomy 150 6+T

Excision 8807 Division of utero—sacral ligaments 75 6+T 8805 Diagnostic curretage 50 3+T 8810 Mycmectomy 180 6+T

8809 Hysterectomy - total 200 6+T 8812 — total, abdominal or vaginal with rectocoele and/or cystocoele repair 250 6+T

8813 — subtotal, with or without adnexae 150 6+T

8814 — subtotal with rectocoele and/or cystocoele repair 200 6+T

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Anaes Units Units

8815 - with retropubic incontinence repair (Birch sling or Marchetti) 250 6+T 350 8+T 8816 — radical (Wertheim) 8817 — modified radical 300 8+T

8818 - radical with pelvic para-aortic lytuphadenectomy 425 8+T 8820 Septate uterus 200 4+T 8822 Cervical polyp, without D & C 15 3+T 8823 Amputation of cervix 90 4+T 8824 Cervical stump — vaginal 120 4+T 150 6+T 8825 — abdominal

8830 Biopsy of cervix — indepondont operation with general anaesthetic 25 3+T 15 8864 — office procedure 8835 Hydrocoele of canal of Nuck 60 3+T 9271 Presacral neurectomy 180 6+T

Introduction 8840 Insufflation, Rubin’s test 20 3+T

8841 - with endometrial biopsy 30 3+T 8842 Hysterosalpingograxn 30 3+T 8843 IUCD (complete care) 25 8845 Fitting for contraceptive diaphragm visit fee

Repair 8850 Hysteropexy (uterine suspension) l25 6+T 180 6+T 8852 — with D & C 200 6+T 8851 - with rectocoele and cystocoele 8859 Cervix, with or without biopsy 90 3+T 8855 Incompetent cervix, any suture repair 75 3+T 8861 Electrocautery of cervix, 25 3+T — under general anaesthetic 15 8862 — office procedure 8858 Repair of inversion of uterus, 180 4+T — operative 75 4+T 8857 — manual 8856 Interposition operation 200 5+T 1785 Insertion of radium (per application) 90 3+T 8806 Conization of cervix 60 3+T 8860 Cryosurgery of cervix 15

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OPHTHALMOLOGY

Those fees cannot be correctly intorprotaod without refcrnnce to tht Preamble;

Units

11001 Major Consultation 28 H002 Minor Consultation 18 H003 Repeat Consultation 18 within 30 days for same illness or complication thereof.

VISITS

0FFI

HOlO Initial visit 20 with complete ophthalznological examination including refraction and all procedures necessary to diagnose pathology and to fully assess ocular function. H020 Initial visit 12 not requiring complete examination. H025 Subsequent visits 8 11004 Continuing care 8 H005 Directive care, per visit 10 (maximum of 5 visits/week)

[lOS? ITAL

11035 Initial visit 17 when patient is attended for the first time in the illness.

Szthseuent visits - charge as A041 or A043. H007 Continuing care B 11006 Directive care, per visit 10 (maximum of 5 visits/week)

HOME -

H070 Initial visit 23

Where a call is received in one time period and made in another time period, the lower fee applies.

11092 8 am to 5 pm, Mon — Fri 12.5

11093 5 pm t.o midnight, Mon — Fri 18 H094 Midni;ht to 8 am, all days 22 H095 8 am to midnight, Sat, Sun and holidays 18 H009 Continuing care B H008 Directive care, per visit 10 (maxinum of 5 visits/week)

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Ariae S Units Units

OPERATIONS ON THE EYE

EYEBALL

Incision 9301 Goniotomy and/or goniopuncture 160 4+T

Excision 9305 Enucleation 130 4+T 9306 — with prosthesis or implant 150 4+T 9307 Secondary operation after enucleation to replace implant 100 4+T 9310 Evisceration 130 4+T 9311 - with implant 150 4+T

Repair 9315 foreign body, anterior route 125 4+T 9316 foreign body, posterior route 200 4+T 9317 non—magnetic, anterior route 125 4+T 9318 non—magnetic, posterior route 250 4+T

CORNEA

Incision 9320 Paracentesis 30 4+T 9322 Removal embedded foreign body 10 9323 — with general anaesthetic 25 4+T

Excision 9325 Excision of dermoid 75 4+T 9326 Malignant tumor of cornea 150 4+T

Destruction 9328 Cauterization of ulcer 10 4+T

Repair

9330 Corneal transplant — penetrating 325 8+T 9331 — lamellar 250 8+T

Suture 9333 — with excision of iris 160 6+T 9334 — without excision of iris 120 6+T 9335 Corneal measurement for congenital glaucoma 20 4+T

SCLERA

Excision 9336 Sclerotomy, posterior 75 4+T

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Anae s Units Units

Suture 9338 Uncomplicated wound, no prolapse 110 6+T 9339 Complicated wound, prolapse 170 6+T

IRIS AND CILIARY BODY

Incision 9340 Iridotomy or iridectomy 125 4+T

Destruction 9342 Diathermy of ciliary body 100 4+T 9343 Cyclodialysis 100 4+T 9344 Cyclocryosurgery 80 4+T

LINBUS

9346 Corneo—scleral filtering 160 4+T 9348 Trabeculectomy 250 6+T 9349 Trabeculotomy 250 6+T

CRYSTALLINE LENS

Incision 9350 Needling 100 5+T 9354 Capsulotomy 100 4+T

Excision 9356 Senile or others 250 6+T

RETINA

Re—attachment of retina and choroid by photocoagulation 9363 Retinal disease 175 6+T 9393 Repeat, same eye, within 30 days 80 6+T 9364 Vascular 125 6+T 9394 Repeat, same eye, within 30 days 65 6+T 9395 Laser photocoagulation, retinal or vascular 175 6+T 9396 Repeat, same eye, within 30 days 90 6+T 9360 Electrocoagulation or cryosurgical repair 200 6+T 9365 Coagulation with scieral flap 250 6+T 9361 Scieral resection 250 6+T 9362 — with vitreous implant 275 6+T

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5/90

Anaes Units Units

9366 Non-circling tube or buckle procedures, including that group of operations in which silicone is implanted to produce a non permanent choroidal elevation 250 6+T 9367 For circling tube, as a first operation 300 6+T 9368 For circling tube as a second or subsequent operation; i.e., after an unsuccessful operation or for a fresh detachment after a previous suc cessful operation 400 6+T 9372 Diathermy or electrocoagulation repair of retina 200 6+T 9373 Cryosurgical repair of retina without scieral resection 200 6+T 9374 Scieral resection with cryosurgery or electro— coagulation 250 6+T 9376 Scleraj. resection with vitreous injection or implant 275 6+T 9378 Superficial keratectomy 200 6+T

OCULAR MUSCLES

9370 Strabismus repair, one or two muscles one or both eyes 155 5+T 9369 Each additional muscle at same operation 30

ORBIT

Incision 9375 Drainage of abscess 100 6+T

Excision 9380 Tumor—Kronlein procedure 300 6+T 9381 — removal by anterior route 250 6+T 9382 - removal by intracranial route 250 6+T 9383 Extenteration and skin graft 200 6+T 9347 Repair of orbital floor 225 6+T 9385 Retrobulbar injection 15 9386 — with alcohol 25 9387 Orbital exploration for foreign body 100 6+T 9388 — and decompression 225 6+T

CONJUNCTIVA

Excision 9389 Removal of foreign body 7 9399 — under general anaesthetic 25 4+T 9400 Ptorygium 55 4+’j 9401 Biopsy 15 4+T

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Anae s Units Units

9403 Tumor malignant, excision 50 4+T

9404 — with plastic repair 125 4+T 9406 Tumor requiring graft 150 4+T

Repair 9407 Plastic repair (suturing) 20 4+T

EYE-LIDS AND LACRIMAL TRACT

Incision

9410 Dacryocystotomy — general anaesthetic 25 4+T

Excision

9412 Chalazion or tarsal cyst - single or multiple — complete care (one lid), local 25

9409 — with general anaesthetic 30 4+T 9413 Gland 100 4+T 9415 Sac 125 4+T 9416 Malignant lesion of eyelids with reconstruction 175 4+T

Repair 9420 Wounds involving canaliculi 100 4+T 9421 Ptosis 165 4+T 9423 Ectropion 150 4+T 9424 Skin or mucous membrane grafts 100 4+T 9425 Tarsorrhaphy 60 4+T 9426 Dacryocystorhinostomy 210 4+T 9427 Zeigler puncture for correction of entropion or ectropion 15 4+T

9433 Xanthelasma — single 15 4+T

9434 — multiple 25 4+T 9430 Plastic repair (without skin graft) 75 4+T 9451 Plastic repair with graft 85 4+T

Manipulation Dilation of punctum visit fee 9432 Intubatjon of nasolacrimal duct 35 3+T

9435 Probing and dilation of duct - local — initial examination and probing or dilation of duct, unilateral 15

9436 — repeat probing or dilation 5

9437 Probing and dilation of duct — general anaesthetic — initial or repeat, unilateral or bilateral procedure only 20 4+T

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OTOLARYNGOLOGY

These fees cannot be correctly interpreted without reference to the Preamble.

Units

JOOl Major Consultation 28 J002 Minor ConsulLat.LQn LH J003 Repeat ConsultaLion 18

within 30 days for same illness or complication thereof.

VISITS

OFFICE

JOlO Initial visit 20 with complete otolaryngological examination. J020 Initial visit 12 not requiring a complete examination. J025 Subsequent visits 8 J004 Continuing care B J005 Directive care, per visit 10 (maximum of 5 visits/week)

HOSP ITAL

J035 Initial visit 17 when patient is attended for the first time in the illness. Subsequent visits - charge as A041 or A043. J007 Continuing care 8 J006 Directive care, per visit 10 (maximum of 5 visits/week)

HONE

J070 Initial visit 23

Where a call is received in one time period and made in another time period, the lower fee applies.

J092 8 am to 5 pm, Mon — Fri 12.5 J093 5 pm to midnight, Mon — Fri 18 J094 Midnight to 8 am, all days 22 J095 8 am to midnight, Sat, Sun and holidays 18 J009 Continuing care 8 J008 Directive care, per visit 10 (maximum of 5 visits/week)

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5/93

Anaes Units Units

OTOLARYNGOLOGICAI. OPERATIONS

• Incision 5000 Drainage of abscess or hematoma of septn, complete care 25 4+T 5003 Excision of nasal polyp — unilateral 25 4+T 5005 — bilateral 50 4+T 5006 Single choanal polyp 40 4+T Septw 5009 Septal reconstruction 200 4+T 5010 Submucous resection 125 4+T 501]. SMR including submucous resection of inferior turbinates 150 4+T 5014 Excision of choanal atresia— membranous 200 4+T 5013 Excision of choanal atresia— bonY 200 4+T 5015 Biopsy of nasal septum — local 15 5016 Biopsy of nasal septum — general anaesthetic 30 4+T Repair

5020 Choanal - atresia dilation 25 4+T

5021 Choanaj. atresia - dilation - repeat 10 4+T

kz: 5025 Grafting for nasal deformity — partial 75 7+T 5026 — complete 200 7+T 5030 Reconstruction without skin graft but including SMR if necessary 250 7+T 5035 Rhinorrhoea — C S F leak 300 7+T 5040 Removal of foreign body - simple 10 5041 — complicated or involving general anaesthesia 30 4+T 5046 Destruction cauterization of turbinates or septum, single or bilateral — local anaesthetic 10 5047 — general anaesthetic 30 4+T 5050 Treatment of epistaxis — anterior packing 20

5051 — posterior packing 30 4+T — subsequent care visit fee 5052 Ligation internal maxillary artery 200 7+T

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Macs Units Units

ACCESSORY NASAL SINUSES

5060 Maxillary, intranasal — unilateral 60 4÷T

5062 — bilateral 100 4+T

5061 — radical, CaJ.dwell Luc — unilateral 150 4+T

5065 Frontal - trephine and sinusectomy 75 4+T

5066 - radical 250 4+T

5069 — external fronto—ethmoida]. with sphenoid if necessary 250 4+T

5070 Etlmtoidal — intranasal — unilateral 75 4+T 5072 Sphenoidal — intranasal 100 4+T 5074 Introduction - radium application to nasopharynx 10 5+T

5075 Lavage - maxillary antrum (as independent procedure) — unilateral 10 4+T

5076 Antral puncture — office 25 4+T 5077 — hospital 35 5078 Proetz displacement lavage 5 4+T

Suture 5080 Closure of antro-oral fistula 150 4+T

LARYNX

Excision 5084 Supra glottic laryngectomy 350 6+T 5085 Laryngectomy — total 300 6+T 5086 Laryngofissure 200 6+T 6+T 5087 — with block dissection 400 5088 Arytenoidectomy 200 6+T 5089 Excision of benign growth or growths 100 6+T

5093 Endoscopy — with removal of foreign body 75 6+T 6+T 5094 — with removal of benign growth 100 5090 Intubation of larynx 25

Repair 5098 Laryngoplasty I C 6+T 5099 Arytenoidopexy 200 6+T

TRACHEA AND BRONCHI

Incision 5100 Tracheotomy for laryngeal obstruction 120 5+T

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5/95

Ariaes Units Units

PHARYNX, ADENOIDS & TONSILS

Incision 7075 Drainage of retropharyngeal abscess

— intra oral, complete care 30 4+ 7076 - lateral pharyngeal 75 4+T 7078 Peritonsjllar abscess

— anaesthetic, operation only 30 4+T

7079 - no anaesthetic, operation only 5

Excision 7080 Branchial - cyst 150 4+T 7081 — sinus 200 4+T 7085 Excision of tumor of nasopharynx 200 4+T 7083 Thyroglossa]. duct - cyst 120 4+T 7084 — cyst and sinus 180 4+T

Tonsillectomy only or Tonsillectomy and Adenoidectorny 7086 Child under 16 55 4+T 7087 Adult — general anaesthetic 70 4+T 7088 Adult — local anaesthetic 85 7089 Postoperative hemorrhage - T & A referred (consultation and procedure) 50 4+T 7091 - by same surgeon 25 4 +T 7090 Child or adult, adenoidectorny only 30 4+T 7095 Pharyngo—laryngectomy 300 8+T 7096 Biopsy of pharynx 30 4+T 7098 Foreign body — removal 30 4+T

OESOPHAGUS

Inj ection 7156 Oesophageal varices with oesophagoscopy 120 4+T

Operations on the Ear

EXTERNAL EAR

9499 Cleaning mastoid cavity 10

Excision 9500 Excision of polyp — local anaesthetic 20 9501 — general anaesthetic 25 3+T 9502 Partial excision of ear 75 3+T 9503 Total excision of ear 125 5+T

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Anaes Units Units

9504 Removal of ear canal exostosis (under microscope), V — single 150 5+T

9533 — multiple 225 5+T

9534 - with skin graft 300 5+T 9505 Endoscopy, removal of foreign body

— simple 5

9506 — complicated — general anaesthetic 25 3+T 9510 Debridement of ear requiring general anaesthetic 25 4+T

Repair 9508 Otoplasty, exclusive of simple lacerations

— minor 50 5+T

9509 — major 125 5+T

9514 Plastic repair of outstanding ear — child unilateral 100 5+T 9515 Total reconstruction of ear 125 5+T 9516 Congenital atresia of canal (including necessary mastoid surgery) 300 5+’!’ 9511 Applying plastic plate for perforated ear drum 10 4+T 9512 Cauterization of perforated ear drum

— local anaesthetic 15

9519 - general anaesthetic 20 4+T

MIDDLE EAR

Incision

9520 Myringotoiny - local anaesthetic 20

9521 — general anaesthetic — complete care 30 3+T 9525 Aspiration for serous otitis 10 3+T 9526 With insertion of drainage tube under microscopy 50 3+T

9527 Removal of drainage tube — off ice procedure 5

9528 — under general anaesthetic 20 3+T

Excision

9530 Mastoidectomy — adult or child - simple 125 4+T

9531 — radical 250 4+T 9532 Intratympanic microscopic excision of aural polyp or granuloma 100 4+T

Repair 9539 Exploration middle ear, microscope 75 4+T 9540 Facial nerve decanpression 250 6+T

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F - 5/97

Anae s Units Units

9541 - with graft 300 6+T 9544 Fenestratjon of semicircular canals 300 6+T 9546 Mastoid fistula, closure 125 4+T 9547 Myringoplasty 150 4*T 9548 Stapes mobilization — unilateral 200 6+T 9549 Stapedectomy with prosthesis 350 6+T 9550 Tympanoplasty 350 6+T

INNER EAR

Incision 9553 Labyrinthotomy for Meniere’s disease 150 6+T 9555 Labyrinthectomy for suppuration 250 6+T 9556 Endolyxnphatic decompression 350 6+T

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ORTHOPAEDIC SURGERY

These fees cannot be correctly interpreted without reference to the Preamble.

Units

X00]. Major Consultation 28 X002 Minor Consultation 18 X003 Repeat Consultation 18 within 30 days for same illness or complication thereof.

VISITS

OFFICE

X0lO Initial visit

— with complete examination 20 X020 — with regional examination 12 X025 Subsequent visits 8 X004 Continuing care 8 X005 Directive care, per visit 10 (maximum of 5 visits/week)

HOSPITAL

X035 Initial visit 17 when patient is attended for the first time in the illness.

Subsequent uis’zts - charge as A042 or A043. X007 Continuing care 8 X006 Directive care, per visit 10 (maximum of 5 visits/week)

HOME

X070 Initial visit 23

Where a call is received in one time period and made in another time period, the lower fee applies.

X092 8 am to 5 pm, Mon — Fri 12.5

X093 5 n to midnight, Mon — Fri 18 X094 Midnight to 8 am, all days 22 X095 8 am to midnight, Sat, Sun and holidays 18 X009 Continuing care 8 X008 Directive care, per visit 10 (maximum of 5 visits/week)

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5/99

Anaes Units Units

BONES

Incision 4020 Punch biopsy of vertebra 75 4+T 4021 Punch biopsy of other bones — without x—ray.control 40 4+T 4022 — with x—ray control 65 4+T

Drainage of Bone-Osteomyelitis Sm,.ZZ. bones 4058 Incision and drainage 25 3+T 4091 Saucerization 100 3+T 4093 Saucerization and bone graft 200 3+T 4094 Sequestrectomy 150 3+T 4098 Secondary closure 75 3+T Major bones 4084 Incision and drainage 25 3+T 4090 Saucerization 150 3+T 4085 Saucerization and bone graft 200 3+T 4088 Sequestrectomy 150 3+T 4089 Secondary closure 100 3+T

NOTE: The following exceptions are made for anaesthetic fees for the preceding

procedures —

- humerus 4+T

- femur, shaft 4+T - femur, head and neck 5+T

4076 Pelvis 25 4+T 4079 Skull and facial bones 25 7+T Vertebrae 4099 Incision and drainage 250 4+T 4100 Saucerization (costotransversectomy) with graft as necessary 250 7+T 4101 Sequestrectomy, simple 200 4+T

Osteotomy — With or Without Internal Fixation 4050 Phalanx, single 75 3+T - each additional, add 25 4048 Metacarpal or metatarsal,

— single 100 3+T — each additional, add 25 4034 Radius — 150 3+T 4036 Ulna — 150 3+T 4038 Radius and ulna - adult 200 3+T 4032 Humerus — 150 4+T 4030 Clavicle — . 125 4-i-T

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5/100

Anaes Units Units

4040 Femur, neck, intertrochanteric or shaft — 200 5+T 4044 Femur, supracondylar,

bilateral — 300 5+T 4046 Tibia (with or without fibula) 200 3+T 4052 Femur, supracondylar and tibia, fibula 300 5+T 4059 Os calcis 150 3+T

4063 Pelvis — innorninate osteotomy 200 3+T

4107 — with iliopsoas transfer 250 7+T 4055 Spine I C 7+T 4025 Removal of internal fixation — metal plate, band, screw or nail (independent procedure) 75 3+T 4026 Stimulation of epiphysis I C 3+T

Excision (excluding amputations).

Bone Tumors Excision of bone cyct, esostosis, etc. 4080 Major bone 125 * * 4081 — with bone graft 175 4082 Minor bone 100 * * 4083 — with bone graft 125 Radical excision and reconstruction * 4096 — major bone, by report I C * 4097 - minor bone, by report I C 4029 Vertebral column I C *

*NE: Independent Consideration, according to region. For Code 4029, the following will apply:

8+T — cervical

- dorsal or lumbar 7+T

Biopsy of bone 4060 Superficial 75 4+T 7+T 4062 Vertebra - open 150

4061 Other bones - open 100 4+T

Ostectomy - Upper extremity 4069 Metacarpal 125 3+T 4070 Carpectomy 125 3+T

— each additional, add 25 Radius 3+T 4072 — styloid 100

4068 — head 100 3+T 3+T 4073 — head, with prosthetic replacement 150 UZna

4086 — excision of distal end (independent procedure) 100 3+T

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5/101

Anaes Units Units

4087 - excision of distal end in combination with other procedure 50 4074 - olecranon and repair 125 3+T Hwnerus

4023 — head 175 4+T 4024 — head, with replacement 250 4+T 4077 - head, with extensive reconstruction I C 4+T 4065 Acromion or outer end of clavicle 100 4+T

4066 Claviculectomy - total 150 4+T

Qstectomy - Lower ExtremitV 4687 Phalanx 75 3+T — each additional, add 15 4622 Sesamoids, one or more, unilateral 100 3+T 4692 Bunion — exostectomy 100 3+T

4665 Bunion — Kellar’s procedure 100 3+T 4102 Scaphoid, accessory 100 3+T 4105 Tarsal bar 100 3+T 4067 Talus 150 3+T 4103 Metatarsal head 75 3+T

— each additional, add 25

4078 Patella — total or partial 150 3+T

4095 Femur - head and neck 200 5+1’ 4075 Coccygectomy 75 4+T

Ostectomy — Spine 4634 Neural arch with nerve exploration 250 *

- cervical 8+T

- dorsal or lumbar 7+T

Repair and Reconstruction Osteop lasty 4115 Shortening of femur, tibia, humerus with or without bone graft 250 4+T 4116 Shortening of radius and ulna 150 4+T 4117 Metatarsal, single 125 4+T

4118 — more than one 175 4+T 4119 Lengthening of major bone 300 4+T 4120 Tibia 250 4+T Bone Graft 4126 Metacarpal or metatarsal 100 3+T 4127 Phalanx 75 3+T More than one metacarpal, metatarsal or phalanx, add for each 25 4125 Scaphoid 175 3+T 4122 Radius or ulna 175 3+T 4123 Radius and ulna 200 3+T 4121 Humerus 200 4+T

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Anaes Units Units

4124 Tibia 200 4+T 4131 Femur, neck or shaft 200 5+T 4132 Clavicle 175 4+T 4133 Pelvis I C 7+T

NOTE: For primary bone graft in a fresh fracture, add 50% of above to the primary procedure. Epiphysiodesis 4157 Tibia or femur 150 4+T 4158 Tibia and femur 200 4+T E’piphyseal stapling 4143 Tibia or femur 150 4+T 4144 Tibia and femur 200 4+T Spinal fusion 4136 One space 200 7+T 4141 Two spaces 300 7+T 4142 Three spaces 300 7+T 4146 From four to seven spaces 300 7+T 4138 From eight to fifteen spaces 350 7+T 4139 Spinal fusion for scoliosis

— Harrington procedure 400 8+T

4145 — with spinal osteotomy I C 8+T 4150 Scapulopexy 175 6+T 4667 Foot. rcconstruct.ion

- Joplin, Lapidus, etc 150 3+T

FRACTURES

Upper Extremity Phalanx, teininal: 20 4516 — no reduction 35 3+T 4519 — closed reduction

4520 — open reduction 75 4+T Phalanx, middle or promal:

4560 — no reduction 20 35 3+T 4563 — closed reduction 75 4+T 4549 - open reduction

- each additional, add 50% Metacarpal:

4511 — no reduction 30

4513 — closed reduction 50 4+T 4+T 4515 - open reduction 100

Bennet’s fracture - dislocation:

4522 - no reduction 30 4+T 4523 — closed reduction 50

4524 - open reduction 100 4+T

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Anaes Units Units

Carpus (excluding scaphoid):

4509 — closed reduction 50 4+T 4510 — open reduction 100 4+T Scaphoid: 4518 — no reduction visit or procedural fee 4525 — open reduction 100 4+T 4527 — excision — partial or complete 125 4+T 4125 - bone graft or replacement 175 4+T Colle’s or Smith’s fracture: 4483 — immobilization 35 4486 — closed reduction 60 3+T 4484 — open reduction 75 4+T external skeletal pin fixation 4489 — adult 100 4+T 4488 — child 75 4+T

Radius or ulna - shaft: 4475 — no reduction 25 4478 — closed reduction 75 3+T 4480 - open reduction 125 4+T Radius and una - shaft: 4501 — no reduction 35 4505 — closed reduction 100 3+T 4507 — open reduction 150 4+T Monteggia or Gczlleazzi fracture: 4494 — closed reduction 100 3+T 4500 — open reduction 175 4+T

Radius - head or neck: 4470 — no reduction 35 4471 - closed reduction 50 3+T 4472 - open reduction 100 4+T Ole cranon: 4463 — no reduction 35 4464 — closed reduction 50 3+T 4469 - open reduction 125 4+T h’wnerus - epicondy le: 4452 — medial — closed reduction 75 3+T 4453 — medial — open reduction 100 4+T 4454 — lateral — closed reduction 75 3+T 4455 - lateral - open reduction 125 4+T

Humerus - supra - or trans-condylar: 4462 — no reduction 50 4465 — closed reduction 100 3+T 4473 - open reduction 125 4+T

Humerus — shaft: 4439 — no reduction 50 4443 — closed reduction 100 3+T 4445 — open reduction 175 4+T

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5/104

Anaes Units Units

Humerus - Duberosjty:

4456 — no reduction 50 4457 — closed reduction 75 3+T 4458 - open reduction 150 4+T Humerus - neck - without dislocation of head:

4440 - no reduction 50 4441 — closed reduction 100 3+T 4442 — open reduction 175 4+T Humerus - neck with dislccition of head:

4459 - no reduction 50 4460 — closed reduction 100 3+T 4461 - open reduction 175 4+T Lower Extremity Phalanx:

4595 - no reduction 15 4591 — open reduction 35 4+T - each additional, add 50% Metatarsal:

4590 — no reduction 35 4589 - closed reduction 35 3+T 4592 — open reduction 100 4+T — each additional, add 50% Tarsus, except as calcis:

4588 - no reduction 50 4580 — closed reduction 50 3+T 458). — open reduction 150 4+T Os calcis:

4585 - closed reduction 75 3+T 4587 — closed reduction with external pin fixation 100 3+T 4586 — open reduction 150 4+T 4570 — open reduction and primary arthrodesis 200 4+T Talus:

4583 - closed reduction 50 3+T 4584 - open reduction 150 4+T 4564 — excision 150 4+T

Ankle fracture or fracture - dis location:

4561 — medial malleolus — closed reduction 75 3+T 4567 - lateral malleolus — closed reduction 50 3+T 4562 - single malleolus - open reduction 100 4+T 4571 — bimalleolar (including Pott’s) closed reduction 100 3+T 4573 — trimalleolar — closed reduction 100 3+T 4572 — bi or trimalleolar - open reduction 150 4+T Tibia, with or without fibula:

4550 — no reduction 75

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Anaes Units Units

4553 — closed reduction 125 3+T

4555 — shaft — open reduction 175 4+T 4559 — plateau - open reduction 150 4+T Fibula only: — no reduction visit or procedural fee 4565 — closed reduction 35 3+T 4566 — open reduction 75 4+T Pate ha: 4545 — no reduction 35 4535 — closed reduction 35 3+T 4531 — excision and simple repair 150 4-I-T 4546 — excision and fascial repair 175 4+T

Femur - shaft or transcondylar: 4487 — no reduction 75 4538 — closed reduction, with or without anaesthetic 150 6+T

4540 — open reduction 200 6+T Femur - pertrochanteric: 4537 — no reduction 75 4530 — closed reduction with external fixation 150 6+T

4533 - open reduction 200 6+T

Femur - neck: 4558 — no reduction 75 4526 — closed reduction with external fixation 150 6+T 4528 — open reduction with internal fixation 200 6+T 4548 — prosthetic replacement 250 6+T Femur - slipped upPer femoral epiphysis: 4534 — closed reduction 150 6+T 4536 — open reduction 200 6+T

Spine Spinous process or transverse process fracture visit fee Fracture or fracture - dislocation: 4400 — closed reduction with cast, frame or brace 150 5+T

4111 — skull caliper — visit fees plus 50 5+T 9188 — open reduction 200 7+T 9187 — open reduction and fusion 300 7+T

9186 — open reduction with decompression of cord or nerve roots 300 7+T 9169 — anterior cervical decompression and/or fusion 300 7+T Sacrum visit fee Coccyx — no reduction visit fee

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Anne s Units Units

Trunk Clavicle: 4411 — no reduction 35 4412 — closed reduction 50 3+T

4414 - open reduction 100 4+T

Scapula - body3 neck or glenoid: — no reduction visit fee 4415 — closed reduction 75 3+T 4416 - open reduction 150 4+T Sternum:

4418 — closed reduction I C * 4419 — open reduction I C * Ribs

— uncomplicated visit fee

4425 — complicated I C *

*N1$E. - with pleura closed 4+T - with pleura opened 9+T Pelvis: — no reduction visit foe

— 4431 closed reduction — manipulation with x—ray control 150 3+T

4432 — open reduction I C 4+T Acetabulum, with or without pelvic fracture:

4435 - closed reduction 75 3+T

4434 - open reduction 250 4+T

Central fracture - dislocation: 4437 — closed reduction 150 3+T

4438 — open reduction 250 4+T

JOINTS

Introduction 4625 Punch biopsy of synovial membrane 25 3+T 4621 Arthrogram 15 4623 Arthrogram, double contrast 25 4624 Arthroscopy 100 *

*NO: anaesthesia for arthroscopy:

- knees 3+T - hips, shoulders 4+T

Incision Arthrotomy (exploration, removal of loose body, etc.) 4609 Interphalangeal joint, single 50 3+T

- each additional, add 25

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Anaes Units Units

4607 Metacarpophalangeal joint, — single 75 3+T — each additional, add 25 4602 Wrist 100 3+T 4601 Elbow 100 3+T 4600 Shoulder 150 4+T 4606 Ankle 100 3+T 4605 Knee 100 3+T 4604 Hip 175 5+T 4618 Texnporomandibular joint 125 5+T

Excision Capsulectomy, syntvectorny, debridement: 4640 Iriterphalangeal joint, single 100 3+T — each additional finger, add 25

— each additional toe, add 15 4638 Metacarpophalangeal joint,

— single 100 3+T

— each additional, add 25 4637 Wrist 150 3+T 4636 Elbow 175 3+T 4669 Shoulder 175 4+T 4648 Ankle 150 3+T 4647 Knee 200 3+T 4646 Hip 250 5+T Menicectomy: 4697 Wrist 125 3+T 4635 Knee 125 3+T 4626 Temporomandibular joint 150 5+T Neurectormj: 4704 Elbow or knee 150 3+T 4706 Hip 175 5+T Discectomy: 4707 Cervical or dorsal, posterior approach 250 * 4629 Cervical or dorsal, anterior approach 300 * 4627 Lumbar, anterior or posterior approach 200 7+T 4628 Recurrent or multiple levels 250 * 4631 Two levels 300 *

*NE: anaesthesia fees

— cervical B+T — dorsal or lumbar 7+T

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Anaes Units Units

Repair

Arthroplasty - plastic or reconstructive procedure. 4658 Interphalangeal or metacarpophalanageal - single 100 3+T 4659 — multiple 200 3+T

4832 Hand - reconstruction of rheumatoid joints

— multiple 250 3+T 4657 Wrist or ankle 200 3+T 4655 Shoulder, elbow or knee 200 4+T 4723 Acromjo or sternocj.avicular 125 4+T 4660 Hip — simple prosthesis or excision of head and neck 250 5+T 4668 Hip — cup or total arthroplasty 350 6+T 4678 Total knee replacement 350 4+T 4679 Hoffman procedure — reconstruction of rheumatic foot 250 3+T

4692 Foot - great toe — exostectomy 100 3+T 4666 Exostectomy with metatarsal osteotomy 150 3+T 4662 Toe (except great toe) — single 75 3+T

- each additional, add 15

Arthrodesis 4673 Finger or thumb 100 3+T 4672 Wrist 200 3+T 4671 Elbow 200 3+T 4670 Shoulder 250 4+T 4677 Toe - one joint 75 3+T - each additional, add 15

4681 Foot - midtarsal, subtalar, triple arthrodesis, etc 200 3+T 4694 Foot — pantalar 250 3+T 4676 Ankle 200 3+T 4675 Knee 200 3+T 4674 nip 300 5+T

4685 Bone block stabilization - wrist or ankle 150 5+T 4686 Sacroiliac or symphysis pubis 200 5+T

Manipulation Manipulation under general anaesthesia, including application of casts or traction, performed as an independent procedure: 4709 Wrist 25 3+T 4708 Elbow 25 3+T 4705 Shoulder 25 3+T 4712 Ankle 25 3+T 4711 Knee 25 3+T

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Anaes Units Units

4710 Hip 25 4+T 4713 Vertebral column 25 5+T 4714 Turnbuckle jacket for scoliosis or localizer 50 3+T Congenital foot deformity (cLub foot, etc.):

(a) Non—operative - Denis Brown splints, etc visit fee (b) Manipulation and casts

4715 — initial — unilateral 25 4718 — bilateral 35

4717 — subsequent — unilateral 15 4720 — bilateral 25

4753 — with anaesthetic — unilateral 25 3+T 4754 — bilateral 35 3+T (c) Operative — 4763 Medial release and tendon lengthening 150 4+T 4683 Arthrodesis and tendon transfer 250 4+T

Dislocation (including reduction, reconstruction, etc., with internal fixation as necessary)

Upper extremity Interpha langea 1 joint:

4747 — closed reduction 15 3+T

4748 - open reduction 50 3+T Metacarpophalwzgeal joint: 4743 — closed reduction 25 3+T 4744 — open reduction 75 3+T - each additional, add 25 4752 — open reduction of thumb 75 3+T Wrist and carpal bones: 4740 — closed reduction 50 3+T 4742 - open reduction 150 3+T

4737 — closed reduction 50 3+T 4738 - open reduction 150 3+T 4739 - repair of recurrent dislocation I C 3+T ShouLder: 4734 — closed reduction (with or without anaesthetic) 50 3+T 4735 — open reduction 175 4+T

4690 - recurrent dislocation repair — all types 200 4+T Acromioc l.auicu icr: 4732 — closed reduction 25 3+T 4733 — open reduction 125 4+T Sternociavicular:

4730 — closed reduction 25 3+T 4731 — open reduction 100 4+T

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Lower extremity Interphal.angeal joint:

4780 — closed reduction 10 3+T 4781 — open reduction 50 4+T Metatarsophalangeal joint: 4775 — closed reduction 25 3+T

4776 — open reduction 75 4+T Tarsal..:

4771 — closed reduction 50 3+T

4772 — open reduction 125 4+T Ankle:

4768 — closed reduction with or without anaesthetic 75 3+T

4769 — open reduction 125 4+T

4700 — repair of recurrent subluxation 175 4+T Knee:

4761 - closed reduction, with or without anaesthetic 75 3+T

4762 — open reduction 175 4+T Pate ha:

4765 — closed reduction, with or without anaesthetic 25 3+T

4766 — open reduction 100 4+T

4767 — repair of recurrent dislocation 150 4+T Hip: Anterior or posterior dislocation:

4755 - closed reduction with or without anaesthetic 75 4+T

4756 — open reduction 175 7+T Central dislocation:

4779 — closed reduction, with or without anaesthetic 150 4+T

4757 — open reduction 200 7+T Congenital dislocation:

4758 — closed reduction with or without anaesthetic 100 4+T

4783 — repeat manipulation and plaster 35 4+T

4759 — open reduction - simple 175 7+T

4784 - open reduction with limbectomy or derotation osteotomy 175 7+T

4760 — open reduction with acetabuloplasty 200 7+T

4785 — open reduction with innominate osteotomy 350 7+T

Spine Intervertebral:

4727 — closed reduction, manipulation, traction, etc 150 5+T * 4728 - open reduction 200 * 4729 — open reduction and fusion 300

*NOTE: — cervical 8+T

- other 7+T

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Anae S Units Units Sacroi liczc: 4786 — closed reduction, traction, etc 75 5+T 4787 open — reduction 150 5+T Sacrococcygea 1: Non—operative visit fee 4075 open - reduction (coccygectomy) 75 5+T Temporoma’idibulap joint: 4725 — closed reduction without anaesthetic 15 4726 — closed reduction with anaesthetic 25 3+T 4741 — open reduction 125 5+T

TENDONS, TENDON SHEATHS, LIGANENTS PND FASCIA

Incision 4862 Tendon or tendon sheath - exploration 75 3+T 4830 Tendon sheath - drainage 75 3+T 4835 Tendon sheath — release, finger — 60 3+T 4836 — wrist 60 3+T 4848 Ulnar or radial bursa - drainage 60 3+T 4915 Tenotorny — too 25 3+T 4913 Plantar fascia 35 3+T 4845 Hip adductors — closed 25 3+T 4844 — open 75 4+T 4846 - with peripheral obturator neurectomy 100 4+T 4847 Sever’s procedure 150 4+T 4839 Tenotorrty, including heel cord lengthening and lengthening or section of tendon of hand or foot 75 3+T 4843 — with capsulotomy 100 3+T - each additional, add 15

Excision

4850 Tendon sheath — simple; e.g., DeQuervaine’s, ganglion, etc 60 3+T 4852 Tendon sheath — radical e.g., tuberculosis, etc 150 3+T 4916 Biopsy through incision 75 3+T 4856 Fascia — Dupuytren’s, - partial 100 3+T 4857 — complex 150 3+T 4860 Decompression of carpal tunnel 75 3+T 4853 Excision of Baker’s cyst of knee 100 4+T

Repair 4879 Tenoplasty - shortening, lengthening of any tendon, any location 100 3+T

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Anaes Units Units

4693 Suture of torn, ruptured or severed collateral ligaments 150 4+T 4695 Suture of torn, ruptured or severed cruciate ligaments (fresh) 150 4+T Fasciotomy and fasciectomy: 4833 Simple lengthening 100 3+T 4837 Ober or Yount and spica, skeletal pins, etc 150 3+T 4854 Fasciotomy, single, palm or sole, subcutaneous, blind, independent procedure 60 3+T 4855 Plantar fasciotomy at multiple levels 75 3+T 4858 Plantar fasciectomy (open),

— independent procedure 100 3+T

4859 — with other procedure, add to procedure 25 Tendon transplant: 4866 Hand and forearm,

— single 100 3+T

4867 — multiple 175 3+T

4880 — opponens transfer 125 3+T 4868 Foot and ankle,

— single 100 3+T

4869 — multiple 175 3+T

4870 Shoulder - pectoralis minor 100 4+T

4871 — trapezius 175 4+T

4872 Hip - abdomen 200 5+T

4873 — iliopsoas 250 5+T

4874 Knee - single or multiple 150 3+T

4875 Foot — tendodesis 100 3+T

4888 Mallet finger repair — closed, with or without anaesthetic 25 3+T

4887 — open 75 3+T 4884 Patellar advancement 150 3+T 4885 Achilles or bisceps repair 100 4+T 4886 Quadriceps, muscle or tendon 125 3+T 4892 Fascial repair or tendon graft for rupture 150 4+T 4889 Flexorplasty of elbow 150 3+T

Reconstruct ion 4701 Both interphalangeal or metacarpophalangeal ligaments 125 3+T

4918 Wrist or elbow — late 100 3+T

4891 Shoulder — rotator cuff tear I C 4+T

4919 Acromio — or sterno — clavicular - early or late 125 4+T

4696 Knee — early 175 3+T

4698 — late 175 3+T

4699 Ankle - early 125 3+T

4700 — late 175 4+T

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Anae s Units Units

BURSAE

Incision 4790 Drainage of infected bursa 25 3+T 4791 Removal of subtrochanteric calcium 125 3+T 4792 Removal of subdeltoid calcium 100 3+T

Excision 4794 Olecranon or prepatellar 75 3+T 4798 Ischial or subtrochanteric 125 4+T 4795 Radical excision of bursa in forearm and hand; e.g., for tuberculosis 150 3+T

MUSCLES

Incision 4935 Intramuscular abscess 25 3+T 4936 Removal of foreign body under general anaesthesia,

— simple 25 3+T

4937 — ccmtplicated 50 I C 4938 Myotomy for tennis elbow 100 4+T 4800 Scalenus anticus, without resection of cervical or first rib 100 5+T

4801 — with resection of cervical or first rib 200 5+T 4939 Cervical rib 150 10+T

4802 Sternomastoid - unipolar 70 5+T

4803 - bipolar 75 5+T 4970 Major muscle release (independent procedure) 100 5+T

Excision 9071 Biopsy of muscle 25 3+T 4971 Tumor, etc I C I C

Repair and Reconstruction 4972 Total muscle transplant; e.g., pectoralis major 200 6+T 4805 Quadricepsplasty 150 6+T

4806 Recession of muscle - (independent procedure) 100 3+T 4808 Repair of muscle laceration or rupture I C I C

EXTREMITIES

Traumatic Miputations 4973 Debridement and plastic repair of traumatically amputated extremities I C I C

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Anae S Units Units

Amputations (see note at end of this section) Upper e.rtremity 4910 Phalanx or metacarpal, — simple 30 3+T

4911 — complicated, by report I C 3+T 4908 Hand — through all metacarpals 100 3+T 4907 Wrist 100 4+T 4903 Radius and ulna 125 4+T 4979 Elbow 125 4+T 4902 Humerus 125 4+T 4901 Shoulder 175 9+T 4900 Forequarter (interscapulo— thoracic) 275 15+T Lower extremity 4933 Phalanx 30 4+T 4932 Metatarsal or metatarsophalangea). joint 75 4+T 4934 — complicated — by report I C 4+T 4930 Trannetatarsal 100 4+T 4929 Syme or tarsometatarsal 150 5+T 4926 Tibia and fibula 125 5+T 4922 Knee, including Gritti-Stokes or Callandar 125 5+T 4923 Femur 125 5+T 4021 hip 250 10T 4920 Llemipelvectomy 350 l5+T

NOTE: (a) supervision of limb fitting and six

months postoperative care - add 25%

(b) application of instant prosthesis — add 25%

PLASTER CASTS AND CORRECrIVF SPLINTS (as independent procedure not associated with fracture or dislocation)

Application of Plaster Casts 4940 Molded plaster to forearm 10 4941 Elbow to finger 10 4942 Hand to wrist 10 4943 Shoulder to hand 10 4944 Shoulder spica 25 4945 Ankle (foot to mid—leg) 10 4946 Knee (foot to thigh) 15 4947 Ambulatory leg cast 15 4948 Molded plaster to leg 15 4949 Spica (rib margin to toe) — unilateral 25 4950 — bilateral 35

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Anae S Units Units

4951 Body (shoulder to hips) 25

4952 — including head 35 4954 Neck 10 4953 Unna boot 5 4719 Bilateral wedging 15 Removal of casts visit fee

Application of corrective splints 4955 Fingers, hand, wrist 10 4956 Elbow 10 4957 Shoulder 10 4958 Below knee (including foot) 10 4959 Knee 10 4960 Whole leg (mid—thigh to toe) 10

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PLASTIC SURGERY

These fees cannot be correctly interpreted without reference to the Preamble.

Units NOOl Major Consultation 28 to include complete history and physical examination, review of x-ray and laboratory findings, performance of haemoglobin and routine urine examination, if required, and a written report. N002 Minor Consultation 18 when dealing with one particular problem not requiring complete history and physical examination. N003 Repeat Consultation 18 within 30 days for same illness or complication thereof.

VISITS

OFFICE

NOlO Initial visit 20 new condition seen for the first time in office, to include complete history and physical examination. N020 Initial visit 12 with regional examination N025 Subsequent visit 8 N004 Continuing care 8 N005 Directive care, per visit 10 (maximum of 5 visits/week)

HOSPITAL

N035 Initial visit 17 to include complete history and physical examination.

Subsequent visits - charge as A041 or A043. N007 Continuing care 8 N006 Directive care, per visit 10 (maximum of 5 visits/week)

HOME

N070 Initial visit 23 Where a call is received in one time period and made in another time period, the lower fee applies.

N092 8 am to 5 pm, Mon - Fri 12.5

N093 5 pm to midnight, Mon — Fri 18 N094 Midnight to 8 am, all days 22 N095 8 am to midnight, Sat, Sun and holidays 18 N009 Continuing care 8 N008 Directive care, per visit 10 (maximum of 5 visits/week)

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Anaes Units Units

SKIN GRAFTS (re—grafts - 50% of appropriate fee)

NOTE: for anaesthetic procedures in this section done about the head, neck and back, and those in which positioning requires intubation, add 1 unit to basic 3+T in each case.

Local Tissue Shifts Advancements, rotatwns, transpositions, “z” pLasty, etc. 3204 Single 100

3207 — with free skin graft to secondary defect 125 3208 Multiple 200

3209 — with free skin graft to secondary defect 225

3210 Eyebrow, eyelid, lip, ear, nose — single 125 200 3211 — two stages

Flaps from a Distance Direct (2 stages) 3212 Upper extremity 150 3213 - with free skin graft 3+T to secondary defect 175 3214 Lower extremity — see (plaster cast extra) 200 fee. node Further stages at 50% of appropriate uner

Indirect - tubes, jumps 150 3373 Major stage - per operation Graft 100 3371 Minor stage — per operation 3372 Delaying a tube or pedicle 30

Free Skin Grafts (including mucosa) Full Thickness Grafts 3202 Eyelid, nose, lips 150 3203 Finger tip 40 3218 Finger, more than one phalanx 125 3219 Sole or palm 125 3222 Toe pulp graft 50

Split Thickness Grafts Nôn-fzo2ct iona 1 areas: (total area treated, whether at one operation or at staged intervals) 3265 Less than 1 sq. in 25 3266 Less than 10 sq. ins 50 3267 Less than 100 sq. ins 100

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Anaes Units Units

3268 For each square inch over 100 sq. ins 1’ Functjo,rzaL areas: 3269 Regions of major joints and hands — early 150

3270 Regions of major joints and hands - 3+T late with scar excision graft 200 3271 Head and neck - less than 10 sq. ins 100 see

3273 — in excess of 10 sq. ins 150 note 3274 — in excess of 30 sq. ins 350 under 9728 Ectropion—entropion - Skin cauplicated, including neoplasms and plastic Graft repair 125

Cavity Graftipg 3280 Eye socket 200 3281 - with mucosa 250 3283 Nose 150 3293 Mouth 2O 3284 Lining pedicle flaps 100 I 3285 Bone cavity over 3 inches diameter in large bone; e.g., femur 250 4+T 3286 Bone cavity up to 3 inches in large bone 150 4+T 3287 Bone cavity in small bone; - e.g., hand or foot 75 3+T 3288 Operation for congenital absence of vagina (McIndo - total care 300 4+T

Twnors of skin (see Section on Genera?, Surgery)

INJURIES

Suture of Simple Wounds or Lacerations 3305 Minor laceration or foreign body not requiring anaesthesia,

- operation only 5 3302 — child’s face 17 4+T 3300 — other ages and areas 11 (local anaesthetic) see 3301 Minor laceration or foreign body requiring note general anaesthesia — operation only 20 under 3306 Extensive laceration or foreign body requiring Skin general anaesthesia — operation only 50 Graft Wounds - avulsed and complicated 3307 Lips and eyelids 100 4+T 3308 Nose and ear 75 4+T 3309 Complicated lacerations of the scalp, cheek and neck 100 4+T

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Anae s Units Units

Burns

Local care - wider general anaesthesia - per operation 3350 Dressing 20 4+T

3351 Surgical debridement — for each 5% of body surface 20 4+T

3352 Subsequent debrideinent - for each 5% of body surface 20 4+T 3355 Surgical excision of burned tissue prior to immediate skin grafting: — for first 5% of body surface 50 4+T 3356 — for each subsequent 5% of body surface 25 4+T

Osteomyelitis 4056 Saucerization, muscle flap or bone 3+T graft 200 see 4057 Saucerization and note sequestrectomy 150 under 4058 Incision of subperiosteal Skin abscess 25 Graft

REGIONAL

Jaws

5036 Prognathism and micrognathism — double resection of mandible 250 5+T

5037 Tumors — enucleation, partial or complete resection 150 5+T 5038 — with bone graft 225 5+T

FRACflJRE

4575 Mandible — simple - interdental and intermaxillary wiring 100 5+T

4576 — compound and comminuted - interosseous and external fixation by pinning 175 5+T 4577 Maxilia — requiring a radical antrostomy 150 5+T 4578 — compound — requiring reduction and soft tissue repair 200 5+T

4542 Malar bone — simple elevation — open or closed 50 5+T 4543 — open reduction with pinning 100 5+T

4544 — open reduction — with interosseous wiring 150 5+T 4547 Temporoniandibular arthrotomy (menisectomy or condylectomy) 150 5+T 4664 Arthroplasty of jaw 175 5+T 4215 Resection of mandible 150 7+T

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Anaes Units Units

CHEEKS

4899 Facial paralysis - fascial slings, or muscle transfer, unilateral 225 5+T

7066 Salivary fistula — plastic to Stenson’s duct 150 5+T

Abrasive Surgery 3392 — less than ½ of face 25 4+T 3394 — between ¼ and ½ face 75 4+T 3391 — full face 150 4+T

3393 — single area; e.g., trauma scar 35 4+T

NOSE

Rhinopi asty. 5027 Removal of hump 150 7+T 5028 Nasal refracture 150 7+T 5029 Reconstruction of nasal tip, ala and coluinella 175 7+T 5026 Nasal bone grafting for nasal deformity 200 7+T

5030 Complete rhinoplasty with su1nucous resection - without skin grafting 265 7+T 5031 Scalping rhinoplasty, two stages 350 7+T 5032 Composite graft 125 7+T 5033 Rhinophyma 100 4+T 4503 Fracture of nasal bones,

— simple requiring reduction 25 4+T 4504 - compound requiring reduction and internal fixation 50 4+T 4579 — ccnpound including open reduction if necessary 100 4+T 4582 Major fracture in middle third of face (leFort type III) 300 5+T

EARS

9514 Congenital deformity, — unilateral 100 5+T 9517 Loss of ear - partial,

— per stage 100 5+T 9513 Loss of ear — total,

— major stage 150 5+T 9518 Loss of ear — total, — minor stage 100 5+T (total account not to exceed 400 units)

MOUTH

7036 Abbe operation — 2 stages 250 8+T

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Anaes Units Units

7037 Full lip thickness transfer by rotation flap 200 8+T 7029 Unilateral hare lip 150 8+T 7022 Wedge resection of lip, vermilion 35 4+T

7023 — to sulcus 90 4+T 7059 Pharyngoplasty or pharyngeal flap 150 8+T 7057 Push—back of palate with pharyngeal flap or similar procedure 225 8+T 7058 Cleft palate 150 8+T

ORBIT

9411 Jaw or face—bone graft 175 5+T 9421 Ptosis — lid suspension,

- suture 165 4+T

9431 — living tissue sutures 200 4+T

9428 — levator resection 200 4+T 9429 Excision of benign tumor of lid margins of conjunctiva 25 4+T 9405 Excision of benign tumor of lids 15 4+T 9417 Direct flap to eyebrow,

— 1st stage 150 4+T

9418 — 2nd stage 75 4+T 9419 Orbital floor reconstruction with bone graft 225 4+T

NERVES

9263 Peripheral nerve - minor digital, primary suture 40 3+T 9052 Repair of palmar nerve 50 3+T 9262 Major, primary suture 100 4+T 9237 Exploration of peripheral nerve transplant and neurolysis 100 4+T 9153 Neurovascular pedicle 200 4+T

MENINGOCOELE (PLASTIC SURGEON’S PORI’IONS)

9155 Multiple flaps with or without skin grafts 175 7+T 9156 Single flap with skin graft 125 7+T 9157 Single flap without skin graft 100 7+T

9158 Direct advancement — specialist’s assistant fee 75

TRUNK

3420 Mainmoplasty for hypertrophic breast, with nipple transplantation — unilateral 170 5+T

3421 Augmentation mammoplasty - bilateral by prosthesis 200 5+T

3425 Decubitus ulcers - excision and treatment of bone, rotation flaps and skin graft to secondary defect 225 5+T

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Anaes Units Units

HAND

3426 Syndactyly — local flaps, - first cleft 100 4+T 3427 — each additional 35

3428 - with skin graft,

— first cleft 150 4+T 3429 — each additional 35 3430 Direct flap to finger for covering bare bone or

bare tendon — 2 stages 125 4+T

Suture

Tenorrhaphy, tendon suture - finger, hand, wzst, foot, ankle 4815 Extensor tendon — single 50 3+T

4816 — two 90 3+T 4817 - more than two 125 3+T 4818 Flexor tendon — single 100 3+T 4819 — two 150 3+T 4820 — more than two 200 3+T 4821 Achilles or biceps, repair of rupture 100 4+T 4877 Tenolysis — single 100 3T

4823 Tendon transfer — single 100 3+T 4824 — multiple 175 3+T 4879 Tendon lengthening or shortening 100 3+T 4802 Tenotomy for congenital torticollis 70 3+T

4804 — resection of sternomastoid total 150 5+T 4822 Distal biceps repair 150 4+T 4825 Compound ganglion, flexor or extensor sheaths of wrists 150 3+T 4826 Section of transverse carpal ligament 75 3+T 4850 DeQuervain’s disease 60 3+T 4857 Dupuytren’s contracture with dissection of palmar fascia (complex) 150 3+T

4830 Acute tenosynovitis of finger — drainage 75 3+T 4848 Acute tenosynovitis ulnar or radial bursa, incision and drainage 60 3+T 4814 Tenodesis 85 3+T 4828 Pollicization 300 3+T 4829 Digital transplant 200 3+T

4832 Reconstruction of rheumatoid joints — multiple — complete care 250 3+T Replacement of metacarpophalangeal or inter phalangeal joint of hand by silicone prosthesis

4810 — single 150 3+T 4811 - multiple 300 3+T

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Anae S Units Units

Reconstruction of flexor sheath of finger by silicone tendon graft

4807 — single 150 3+T 4809 — multiple 300 3+T 4812 Tendon graft - autogenous 200 3+T 4813 Excision of tendon of hand or finger 100 3+T LEG

6526 Lymphoedema - of limbs modified Kondoleon -

excision and grafting — per operation 180 5+T 6528 Lymphoedema — entire lower limb 250 5+T

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UROLOGY

These fees cannot be correctly interpreted without reference to the Preamble. Units ROOl Major Consultation 28 to include history arid physical examination as indicated to evaluate the genito—urinary system and, when necessary, such procedures as urinalysis, venipuncture, urethral calibration, catheterization, prostatic fluid examination, review of x-ray and laboratory findings, and a written report - but not to include endoscopic examination. R002 Minor Consultation 18 when dealing with one particular problem not requiring complete history and physical examination. R003 Repeat Consultation 18 within 30 days for same illness or complication thereof.

VISITS

OFFICE

R010 Initial visit 20 new condition seen for the first time, to include complete history and physical examination. R020 Initial visit 12 with regional examination. R025 Subsequent visits 8 R004 Continuing care 8 R005 Directive care, per visit 10 (maximum of 5 visits/week)

HOSP ITAL

R035 Initial visit 17

Subsequent vs’zts - charge as A041 or A043. R007 Continuing care 8 R006 Directive care, per visit 10 (maximum of 5 visits/week)

HOME

R070 Initial visit 23

Where a call is received in one time period and made in another time period, the lower fee applies.

R092 8 am to 5 pm, Mon — Fri 12.5

R093 5 pm to midnight, Mon — Fri 18 R094 Midnight to B am, all days 22 R095 8 am to midnight, Sat, Sun and holidays 18 R009 Continuing care 8 R008 Directive care, per visit 10 (maximum of 5 visits/week)

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Anaes Units Units

OPERATIONS ON THE UROGENITAL SYSTEM

The fee for an urological surgical procedure shall include the usual postoperative care as carried out by the operating surgeon. The surgical fee shall not include endoscopic or other investigative procedures required to establish a diagnosis unless done on the day of surgery.

KIDNEY AND PERINEPHRIUM

Incision 8000 Drainage of kidney abscess, including excision of carbuncle 150 7+T 8001 Drainage of perinephric abscess 100 7+T 8004 Adrenal exploration, unilateral 150 7+T 8005 Renal exploration 150 7+T 8006 Nephrostomy 175 74-T 8007 Nephrolithototny 200 7+T 8010 Transection of aberrant renal vessel 175 7+T

8011 Secondary operation — additional 50 7+T aol3 Pyelostomy 175 7+T 8014 Pyelolithotomy 175 7+T 8015 - with diversion of urine 200 7+T 8016 Renal biopsy — open 100 7+T

Excision 8940 Adrenalectomy, unilateral 200 l0+T 8941 Functioning tumors, (pheochromocytoma) 200 l0+T 8021 Renal cyst 175 7+T 8022 Heminephrectomy 240 7+T

8019 Secondary operation — additional 50 7+T

Nphrectomy 8023 Ectopic 200 7+T 8024 Lumbar 220 7+T 8027 Transperitoneal 200 7+T 8028 Thoraco—abdomirial 275 13+T 8029 Radical nephrectomy — lumbar or thoraco abdominal 300 13+T 8030 Nephro—ureterectomy 240 7+T 8031 Nephro—ureterectomy with resection of ureterovesical junction 300 7+T

8032 Secondary operation — additional 50 7+T

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Anae S Units Units

Repair 8045 Pye].oureteroplasty 225 7+T 8048 Nephropexy 150 7+T 8049 — with renal sympathectomy 200 7+T 8053 Symphysiotomy for horse shoe kidney with or without riephropexy and associated procedures 240 7+T 8055 Renal hypothermia — additional 25 7+T

8056 Secondary operation - additional 50 7+T

Suture 8060 Ruptured or lacerated kidney, — repair or removal 210 7+T

URETER

Incision 8100 Peri—ureteral abscess 100 6+T

Ureterotomy 8106 Upper two—thirds 200 7+T 8107 Lower one—third 230 7+T 8109 Ureterocoele 75 6+T

Excision 8110 Ureterectomy 175 7+T 8111 — including ureterovesical junction 215 7+T

Repair 8115 Ureterovesical anastomosis, - reimplantation 260 6+T 8116 — bilateral 310 6+T 8118 Uretero-ileal conduit 300 6+T 8119 — with total cystectomy 450 6+T 8121 - radical cystectomy and urethrectomy 550 6+T 8120 Uretero—colic anastomosis or transplant 225 6+T 8124 — with cystectomy, one stage 360 6+T 8125 — with cystectomy and colostomy 420 6+T 8127 Revision of uretero—intestinal anastomosis 240 6+T 8126 Ileo-ureteral substitution 300 6+T 1174 heal loopogram 15 1175 — with dilation of stoma 25 8128 uretero-ureterostcny 250 6+T

8130 Ureterostomy — cutaneous — unilateral 150 6+T 8132 Uretero—vaginal fistula 240 6fT

8135 Ureterolysis for peri—ureteral fibrosis — unilateral 240 6+T 8136 Uretorostomy with T—tube — unilateral 150 6+T

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5/127

Anaes Units Units

Spontaneous or Traumatic Rupture or Transection

8140 Immediate — upper two—thirds 175 6+T

8141 — lower one—third 200 6+T

8142 Late repair — upper two—thirds 200 6+T

8143 — lower one—third 225 6+T

Endoscopic Procedures

8150 Calibration and/or dilation — one or both sides 40 3+T 8152 Endoscopic meatotomy if required (basket extraction) 130 3-fT 8153 Manipulation only, stone not removed 60 3-fT

BLADDER

Endoscopy - Cystoscopy

8227 — diagnostic, with or without catheterization of ureters, collecting of ureteral specimens of urine, intravenous function test and retrograde injection of opaque medium for pyelography and/or ureterography, but not including subsequent hospital care 40 3+T

8229 — with bilateral sodium excretion estimation (Howard test) 50 3+T

8230 - with biopsy of bladder (transurethral) 40 3+T

8231 — with electrocoagulation of tumor — single 60 3+T

8232 — multiple 85 3+T

8234 — with urethral dilation 40 3+T

8235 — with bladder dilation 50 3+T

8236 — with electrocoagulation of Hunner’s ulcers 60 3+T

8237 — with electroexcision of tumor or tumors

including base and adjacent muscle — single 140 3+T

8233 — multiple 200 3+T

8238 — with resection of bladder neck, female or child 90 3+T

8239 — with electrosurgical ureteral meatotomy 75 3+T

8240 — with removal of foreign body or calculus 90 3+T

8241 — with insertion of radioactive substance (in addition to associated procedures) 25 3+T

8242 — with litholapaxy, visual or tactile, and removal of fragments 120 3+T

8243 — with urethral meatotomy and plastic repair 60 3+T 8228 Differential renal function test (Stanley) 100 4+T 1176 cystogram 15 3+T

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5/128

Anaes Units Units

Incision 8200 Cystotomy or cystostomy 75 5+T 8202 — with eJ.ectrocoagulation of tumor 150 5+T 8203 Cystotomy with trochar and cannual and insertion of tube 35 5+T 8205 Cystolithotomy 100 5+T 8208 Ureterocelectomy 150 6+T 8209 — with ureteral reimplantation 240 6+T

Excision

8210 Cystectomy, partial — for atony’ 200 6+T 8211 Tumor or diverticulum 240 6+T

8212 - with reimplantation of ureter 270 6+T 8215 Complete cystectomy without transplant 240 6+T 8216 — with colocystoplasty 400 8+T

8218 — second surgeon 100 8220 Excision of urachus and repair of bladder 125 6+T

8221 Extrophy — primary closure 150 6+T

8222 - urinary diversion for bladder extrophy and excision of ectopic bladder and repair of abdominal wall 400 6+T

8224 - excision of bladder and repair of abdominal wall 150 6+T

Repair 8250 Repair of ruptured bladder 180 5+T 8255 Ileocystoplasty (or colocystoplasty) 300 5+T 8260 Suprapubic resection of bladder neck 150 5+T 8262 Plastic repair of bladder neck (child or adult) 200 5+T

8263 — with unilateral ureteroneocystostomy - additional 50

8264 — with bilateral ureteroneocystostomy — additional 100

8275 Closure of fistula — external, suprapubic 120 4+T

8276 — vesicovaginal — transvesical approach 240 5+T

8277 — vesicorecta]. or vesicosigmoid 200 5+T

UREThRA

1177 Urethrogram 15 3+T 8340 Urethroscopy including biopsy 30 3+T 8341 Internal urethrotomy 60 3+T 8342 Removal of foreign body or calculus 75 3+T 8343 Meatal extraction of foreign body 15 3+T 8344 Urethroscopy 15 3+T

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5/129

Anaes Units Units

Incision 8300 Urethrotomy, external 120 3+T 8303 Meatotomy and plastic repair 35 3+T 8305 — for extravasation of urine with multiple drainage 120 3+T

8306 — with external urethrotomy or cystotomy 180 3+T 8308 Periurethral abscess 25 3+T

Excision 8310. Caruncle 35 3+T 8311 — including cystoscopy 60 3+T

8314 Urethral papilloma - single or multiple 60 3+T 8330 Prolapse 40 4+T 8331 — with cystoscopy 60 4+T 8318 Stricture — one stage with diversion 180 3+T

8319 — two stage — first stage 90 3+T 8320 — second stage 180 3+T 8324 Diverticulectomy — male or female 125 3+T 8326 Posterior urethral valve by endoscopy 50 3+T

8327 — open operation 125 4+T 8335 Biopsy of urethra 15 3+T

Repair - 8345 Urethral sling 150 3+T 8346 Urethrovesical suspension for stress incontinence 180 5+T 8347 with partial cystectomy or vesicopexy 240 5+T

Suture

8350 Rupture — anterior urethra (diversion of urine stream) 120 4+T

8351 — posterior urethra — immediate repair 210 4+T

8352 — late repair 300 4+T

8356 — membranous urethra 180 4+T 8358 Recto—urethral fistula 200 6+T

8359 — with colostomy 250 6+T

Manipulation

8360 Dilation of stricture — local anaesthetic 10

8361 — general anaesthetic 25 3+T 8362 — filiforms and followers 18 3+T

PENIS

Incision

8400 Slit of prepuce - newborn 5 3+T 8401 — child or infant 5 3+T

8402 — adult 10 3+T

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Anae S Units Units

Excision

8403 Circumcision — newborn 10 3+T 8404 — child or infant under 12 yrs 30 3+T 8405 — adult 45 3+ 8408 Condylomata 25 3÷’ 8409 Excision Peyronie’s plague 50 3+T 8410 Biopsy of penis 15 3+T

Mtputation 8412 Partial 90 4+T 8413 Partial with inguinal glands dissection — 1 or 2 stages 240 4+T

8414 Total with inguina]. and femoral glands — 1 or 2 stages 300 6+T

Repair 8420 Epispadias 150 3+T

8425 Hypospadias — including urinary diversion —

chordee repair — first stage 100 4+T

8426 — plastic reconstruction - urethra penile 175 4+T

8427 — peno—scrotal or perineal 245 4+T 8428 — closure urethrocutaneous fistula 100 4+T

TESTIS

Incision 8430 Abscess 25 3+T

Excision 8434 Orchidectorny, unilateral 90 3+T 8436 Biopsy of testis 25 3+T 8437 Biopsy of testis with vasography 50 3+T

Repair

8440 Orchidopexy or exploration - unilateral 180 4+T 8446 Reduction of torsion of testis or appendix testis and repair 90 3+T 8448 Ruptured testicle 90 3+T

EPIDIDYMIS

Incision 8450 Abscess 25 3+T

Excision 8454 Spermatocoele 90 3+T

8456 Epididymectomy — unilateral 90 3+T

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5/131

Anaes Units Units

Repair

8458 Anastomosis, epididymovasostomy — unilateral 90 3+T

TUNICA VAGINALIS

Excision

8460 Hydrocoele — unilateral 90 4-FT

SCROTUM

Incision 8464 Abscess or hematocoele 25 3+T

8465 Exploration — unilateral 60 3+T

Excision 8468 Minor lesions; e.g., sebaceous cysts, fibroma, etc 15 3+T 8469 Resection of scrotum 90 3+T

Suture

8466 Trauma — laceration — depending on extent and complications I C 3+T

VAS DEFERENS

8470 Vasography — single procedure 25 3+T

8474 Anastomosis — unilateral 75 3+T

8475 - with biopsy and vasography 100 3+T

Suture

8478 Ligation — bilateral 50 3+T

SPERMATIC CORD

Excision

8485 Varicocoele — single 90 3+T

8480 Hydrocoele — single 90 4+T

SEMINAL VESTICLES

Incision 8490 Abscess 50 3+T

Excision 8495 Vesiculectomy 300 3-FT

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Anae S Units Units

PROSTATE

Incision 8500 — with drainage of abscess 50 4+T

8505 - with removal of calculus (perineal) 175 4+T

Excision Biopsy of prostate 8510 Open biopsy of prostate 100 4+T 8511 Needle biopsy, perineal, with cystoscopy 60 3+T Prostatectomy 8515 — perineal 240 7+T

8516 — radical 300 7+T 8517 — radical with vesiculectomy 360 7+T

8520 — suprapubic - 1 stage or 2 stages 240 7+T 8521 with diverticulectomy 300 7+T 8522 - with partial cystectomy for atony of bladder 300 5+T

8530 — retropubic - simple 250 7+T 8531 - radical 300 7+T 8532 — radical with vesiculectomy 360 7+T Endoscopy 8540 Transureth.ral electro-resection 260 7+T 8541 Transurethral drainage 50 5+T 8545 Resection of bladder neck — adult male 150 5+T

8550 Kidney transplantation — complete care — Surgeon 500

8551 — Urologist 500 8555 — Anaesthetists - recipient l0+T 8556 - donor 7+T

8557 Nephrectomy - cadaver donor 158

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5/133

RADIATION ONCOLOGY

These are the fees for professional services only of a specialist in Radiation Oncology, exclusive of technical and physical aspects of treatment procedures and facilities.

CONSULTATIONS

Examination of patient and decision as to treatment:

Units

2310 Major malignancy 28 2311 Minor malignancy 18 2312 Repeat consultation 15

VISIT

1704 Treatment planning, dosage calculation and preparation of any special treatment advice. (This is to apply only to malignant conditions treated radically) 20

THERAPEUTIC PROCEDURES

1781 Gold seed implants 90 1782 Caesium needle implants 90 1783 Caesium insertions 50 3100 Biopsies 20

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PATHOLOGY

Units

2305 Initial consultation, total care 30 As requested in writing by attending physician, with visitation of patient, pertinent history, and examination by pathologist and rendition of a written consultation report recommending further diagnostic procedures and/or treatment. 2306 Initial consultation, pathology material only 20 As requested by attending physician with consultation with attending physician, procurement of additional pertinent history by pathologist and rendition of a consultation report supplementary to usual tissue or other laboratory reports, recommending or cncel1ing further diagnostic procedures and treatment. 2307 Repeat consultation 15 Repeat of 2305 or 2306 on the same patient following request by attending physician, with written report in addition to usual tissue or laboratory reports. (see page 5/8 item 7.5) 2304 Operating room consultation without frozen section 35 Attendance in operating room at request of attending surgeon with verbal consultation, followed by written report.

2

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V. - - -. —. -

.-...,....

..-‘•:.,.--. - ... INDEX 150 A PAGE Abdomen, injection of air 72 Abdomen, surgery of 72 Abdominal, angiogram 43 Abdomino—perineal 67,68,70 Abortion 83 Abscess — abdomen 72.

— abdominal wall 72.

— alveolar 63

- appendix 68

- Bartholin’s gland 84 —bone 99

— brain 78

— breast 54

— bursae 111,113

— epididymis 130

— intramuscular 113

— ischiorectal 52.

— kidney 125

— lateral pharyngeal 95

— liver 70

— Ludwig’s angina 62

— muscle 113

— nasal septum 93

— orbital 90

— palatal 63

— palmar or plantar space 52

— pancreatic 71

— perianal or pilonidal 52 perinephric 125

— perirectal 68

— peritonsillar 95

— periureteral 126

— periurethral 129

— peritoneal 72

— prostatic 132

— renal 125

— retropharyngeal 95

— scrotum 131

— seminal vesicles 131

— septum 93

— Skene’s 84

— skin 30,52

— subcutaneous 52

— subphrenic 72

— testis 130

— thyroid 73 —vulva 83 Achilles tendon, rupture 112,122 Acne, dermabrasion 30,121 Acromion 101

. . — ——--.._ a . . ..r . . . . . -. . —— I - -‘ — — - — .z. — - — —..- — —

-- ; -‘- - .—i — 4 — — — — —. a.. - ‘A

_ .3 ...... — ‘• — —— — — — — —. — a- — .-. i.- — = ...-.- .. INDEX 15]. A

PAGE Adenoidectomy 95 Adhesions, intestinal 67 Adrenal gland, surgery of 125 Adult, defined 6 Advice by telephone or letter 3 Ages, defined 6 Allergy, skin tests 30,42 Allergy injections 41 Amniocentesis 83 Amputations 113,114 — cervix 86 — penis 130 Anaesthesia, procedures 26 — I C detention 26 — time units 9 — obstetrical 26 - epidural 28 Anastomosis, epididymis 131 - vas deferens 131 Aneuryn 57 — of sinus of Valsalva 57 Angina, Ludwig’s 62 Anticoagulant control 42 Antidiuretic hormone response test 50 Aortotomy 57 Aortic valve 60 Appendectomy 68 Apicolysis 55 Arteries, surgery of 57,58 Arteriography 43 Arterioplasty 58 Arteriotomy 57 Arthrodesis 108 Arthroplasty 108,119 Arthroscopy 106 Arthrotomy 106 Artificial insemination 49 Aspirations,

— abdomen 47

— bladder 49 — breast cyst 50 — cisterna mayna 44 — hydrocoe].e 49 — marrow 42 — oesophagus or stomach 47 - pericardium 42 - thyroid cyst 50 Assistant’s fees 17 Audiometric tests 46

-.-- ...... --- -. .. — -. — — —. - .“__- .. - . •.b.

. --: - -- S - . •- . - 4 -- - _ •__ .—. 1 ... —S. ‘. 1 — .- “-‘ .. . .. — — _ S.— • - —— • - — . — — :--. - ‘‘ _ .— .- - — - - — - 5- - .‘ ___

INDEX 152 B PAGE Baker’s cyst 11]. Bartholin’s gland, cyst, abscess 84 BCG inoculation 41 Biliary tract, si.irgery of 71

Biopsy, - anus 70

- bone 100

— bone button 61

- bone, punch 99

— breast 54

— cervical gland 61

- cervix 86

— cervix cone 86

- conjunctiva 9o

— endomatrium 85,86 -gum 63

- intestine, by intubation 67

— kidney, ,wedle 43

— kidney, open 125

- larynx 42 —lip 62

— liver 42

- marrow 42

- mouth 62

- mucosa 52

— muscle 113

— nasal septum 93

— palate 63

- parotid gland 64

— penis 130

- pericardium, needle 42

- pericardium, open 58

- pharynx 95

- pleura 55

— prostate 43,132

— prostate, perineal needle 43

- rectum 42

— scalene node 61

— skin 30,52

— spleen, needle 42

- stomach, by intubation 65

- synovial membranes 106

— snyovial tissue, needle 43

- tendon 111

— testis 130

- thyroid gland 73

— tongue 63

— urethra 128,129

- uvula 63

— vagina 84 Bladder, surgery of 127

-— --—-—--_ . - : - : a.

0 :.. w :— 4 - — - —,.. ... -. .. — INDEX 153 B

PAGE Block, nerve 44 Blood, occult, stool 41 Blood transfusions 46 Body cast 115 Bone, surgery of 99 Bone tumors 100 Bowel, small, surgery of 66 Brain, surgery of 77,78,79 Branchia3. cyst, sinus 95 Breast, surgery of 54,121 Bronchogram 49 Bronchoscopy 42,47,49 Burns 53,119 Burr holes 77 Bursae 113

C

Caecostomy 66 Caesarean section 83 Calculus, ureteral (basket) 128 Caliper, skull 77 Caidwell—Luc 94 Cannulation, arterial 43 Capsulectomy 107 Carbuncle 52

Cardiac — massage 61

— pacemaker 59

— surgery 58 Cardioversion 43 Carotid artery ligation 80 Carpal tunnel decompression ill Casts, plaster 114 Cataracts 89 Catheterization,

— bladder 49

— Eustachian tube 46

— heart 43

Cervix — biopsy 86

— cautory 86

— incompetent 83,86

- surgery 85 Chalaziori 91 Chemotherapy 48 Chest wall, surgery of 55 Choanal atresia 93 Ciliary body 89 Circumcision 130 Cisterna magna 44

T: ; INDEX 154 C

PAGE Club foot 109 Colie’s fracture 103 Colon and rectum, surgery of 67 Colostomy 66 Complete examination 6,24 Concurrent care, defined 12 Condylomata 84 Conjunctiva, surgery of 90 Consultation, defined 7,8 Continuing care, defined 12 Contact lens 19,20,45 Convalescent care 18,24,37 Cornea, surgery of 88 Corneal measurement 88 Coronary arteries, surgery of 60 Counselling 22 Crycosurgery of cervix 86 Cryotherapy 53 Crystalline lens 89 Culdoscopy 85 Cysts — Bartholin’s M — chalazion 91 — dentigerous 63 — hepatic 70,71 - mucous 63 — pancreatic 71,72 — paraovarian 85 — pilonidal 52 — sebaceous 52 — tarsal 91 - vaginal 84 Cystogram 127 Cystometrograxn 49 Cystoscopy 127

D

Debridement 107 Delivery, obstetrical 25,83 Densitometry curve 50 Dermabrasion 30 Detention time, anaesthesia 10,26 Detention time 8,22 Diagnostic curettage 85 Diagnostic and Therapeutic procedures 41 Dialysis 50 Dilation and curettage (D&C), uterus 85 Directive care, defined 5,12 Digestive system, surgery of 62

- —.. -. - *_•_• ——-:i — - —./ - —

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- — ______

INDEX 155 D PAGE

Disc, excision of 80,107 Discogram 49 Dislocation

— clavicle 109 - lower limb 110

— spine 110 - temperomandibular 111

- upper limb 109 Diverticulum, Meckel’s 68 Dorsal sympathectomy 81

E

Ear — debridement 96

- surgery of 96,97 - inner, surgery of 97

- middle, surgery of 96

— removal of tubes 96

- removal of ceri.nnen 46 Electrocardiogram 44 Electrocautery 53 Electroconvulsive therapy 40 Electroencephalogram 44 Eloctrocorticogram 44 Electromyogram 48 Electronystagmygraphy 46 Emergency visit 4,5,23,24 Embolectomy 58 Encephalogram, electro 44

— pneuxno 44 Endoscopy

- bladder 127

— prostatc 132 Enterectomy 67 Epididymis, surgery of 130 Epidural, anaesthesia 28 Epiphysiodesis 102 Epiphyseal stapling 102 Epiphysis, slipped femoral 105 Epiphysis, stimulation 100 Epistaxis 58,93 Evisceration 73 Eye, complete examination 41 Eyeball, surgery of 88 Eyelid, surgery of 91,121 Examination, health 7

t I. — I— - — — :: :- ‘‘ t..

— .•...... -.‘ I ———I’. — .%%.- F — —— —— INDEX 156 F PAGE

Face, abrasive surgery of . 30 Fallopian tubes, surgery of 85 Family Practice 24 Fasciectomy (Dupuytren’s) 112 Femoral artery 58 Fibroma, removal of 52 Finger nail, excision 52’ Fistula, injection of 69 Fluoroscopy and/or orthodiagrain 50 Foreign body conjunctiva 90 cornea 88 ear 96 intramuscular 113 intraocular 88 larynx 94 nose 93 pharynx 95 rectum 69 skin 52 urethra 128 Fractures — clavicle 106

- lower limb 104

— malar bone 119 - mandible 119

- maxilla 120 — nasal bones 120

— pelvis 106

- ribs 106

— scapula 106 — skull 76

- spine 76,105

— spinous process 76

— Uj)j)C limb I uO Fusion, spine 102

G

Galactrography 50 Gastric lavage 47 Gastric cooling 66 Gastric surgery 65 Gastroscopy 42,47 Goniotomy 88 Grafts - arterial 58 —bone 101

— peripheral nerve 121

- skin 117

-j

_a. - — -. - — — — 4

— — - 1— -. g .- I — - — —.

- - . . -: -: — - . _;,• - ‘:.‘ :-,.•‘ __ — — b. — - - - — —. T •‘ —- . —_—-‘ — •q € —‘ — -_;_ - — h .a$ .r •— 4

‘

- - - - -. - . . - . --- —- - - —- - -• - - .- -. —. ‘.- I - INDEX

157 G

PAGE — tendon 122 Grenz rays 48 G UZflS 63 Gunshot wounds 72

H

Haemotoma, incision and drainage 52,93 Haemic and lymphatic systems, surgery of 61 Hanodia1ysis 50 Haexnorrhoids, surgery of 69 Hartnann procedure 68 Head injury 73,76 HCL drip test 47 Health examination 7 Hearing tests 45,46 Heart, pericardium and great vessels, surgery of 58,59 Hepatic wedge pressure 43 Hepatectomy 71 Hernia, - diaphragmatic 73 — incisional 73 — inguinal or femoral 72 — umbilical 73 Hirschsprung’s disease 68 Home visits, defined 5,25 Hospital visit, defined 5,24 Hormone pellets, implantation 53 Hydrocephalus 79 Hydrocoele 49 Hymen, surgery of 83 Hypertonic saline infusion test 50 Hysterosalpingogram 86 Hyposensitization 41 Hysterectomy 85 Hysteropexy 86 Hysterotomy 85

I

heal loopogram 126 Immunization, group 22 Implant hormone pellets 53 Independent consideration 9,10, 22,26 - defined 9 — anaesthesia 9,26 Induction of labour, surgical 83 Initial visit, defined 4 Inj ection —BCG 41

..• -.; . — - . .. — — - . — — - — — —. . . — .. _•. ,.. , ‘ ,..‘ a h — - -— c..’ v ... - - — - - ‘S • -“P’ -. - -, - .- - - - I.- - • -s’-’-- J’: ;:— -—;r . - ..

INDEX 158 I PAGE

— bursa 49

— hyposensitization 41

— intravenous 49

— joint 49

— sinus or fistula 69

- subcutaneous or intramuscular 41 Iris, surgery of 89 Insufflation, pen—renal 48

— vaginal 49,86 Insulin, subcoma 40 Integumentary system 52 Intensive care 18,22,27

- prolonged hypothermia 27

- respiratory insufficiency 27 Internal Medicine, visits 31 Intestines, surgery of 66 Intrathecal injection 44 Intubation

— for resuscitation 27

— anaesthetic services 26 IUCD 86

J

Joint surgery 106

K

Keratectomy 90 Keratosis Kidney, surgery of 125,126

L

Laceration extensive 76,118,131 — obstetrical 83 — simple 53,76,118 - tongue 63 — muscle 113 r.aminectomy Laparoscopy 72 Laryngogram 46 Laryngoscopy 42,49 Larynx, surgery of 94 Lavage, gastric Ligation— arteries 58

. .- ..—,---—— —.--‘.- •—::;‘----r * — I- — I r — - -_ - , ‘,‘; .‘— - ‘ ., . - — : . r — - .. - — ;4. - - - - - ... —- .—- - - ‘r- ‘ ‘ I — —: Y’ .‘ —-----•.— — - 0 ‘ —: — z —‘ 0 - ,- _7_ -..- - - - -

—- : . . . . -‘--•.- -. ..• —— ..• .•.r :- V — .— — — 1 — — ._ —4- -. —. — — __-_ F -_ INDEX 159 L

PAGE

— veins 56 — fallopian tube 85 — vas deferens 131 Lip, surgery of 62 Lipoma 52 Lipectoxny 72 Liver, surgery of 71 Lobectomy 78 Lower limbs, fractures 104 Lumbar puncture 44 Lungs, surgery of 55 Lungs and pleura, surgery of 55 Lymphadenitis 52 Lymphangiogram 61 Lymph glands, excision of 61,62 Lymphoedema 61,123

M

Mallet finger 112 Mammoplasty 54 Mandible, surgery of 62 Mandibular nerve 44 Manipulation

— joints 108 — lacrima.1. tract 91 — urethra 129 — vagina 85 Massage - cardiac 61 — prostatic 49 Mastectomy 54 Mastoid cavity

— cleansing of 95 — surgery of 96 Maxillary nerve block 44 Meckel’s diverticuluin 68 Mediastinum, surgery of 54,55 Medical Certificate for Observation 50 Medicine, Internal, visits 31 Meninges, surgery of 76,121 Menisectomy 107 Mesentery 68 Mesentery, cyst 72 Middle ear 96 Mileage 8 Mitral valve (,O Moles 53 Morton’s neuroma 80

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INDEX 160 M

PAGE

Mouth, surgery of 62,120 Muscle, laceration or rupture 113 Muscle, recession 113 Myelogram Myotomy 81 113 Myringotomy 96

N

Nail, finger or toe, removal 52 Nasolacrimal tract,

- probing 91 — surgery 91 Nasopharynx

— application of radium 94 - excision of tumor 94 Neck 63,74 Nephrectomy 125 Nephropexy 126 Nerve, peripheral,

— repair 80,121 — surgery of 80,121 Neurectomy 107 Neurology, visits 33,34 Neuroma — excision 52 — Morton’s 80 Neurosurgery 75 Newborn care 13,24,37 Nitrogen mustard therapy 50 Nystagmography 46

0

Obstetrical, visits 82 Obstetrics 13,25,83 Obstetrical anaesthesia 26 Ccular muscles 90 Oesophagoscopy 42,47 Ce sophagus

— dilation 65 — surgery of 64,95 cEnentum 72 Operating microscope 15,22 Ophthalmic tests 46 Ophthalmodynaxnomctry 46 Ophthalmology 87 — complete eye examination 41 — surgery of 88,91

- -.. .._-z-----_ —t — .. — .- - . % - — — IS ). k -, 4. _4 ti ‘# > ‘ --... “,-- -K - — --::_. ..—- — I - p_.(._•_ b •ii f ‘ ‘‘ ‘ .‘. , ‘

‘d’.. -. .,_:---.-..- - 4.. .-.‘.—. .- ‘,. ‘— , - -. •... .—- —. .——--—.. ‘ - .—. —.,.. -‘ t .., - — ———.———-- 5— * -*. - -.-—- -. -- — . - -- S.. -.-_.- - — INDEX 161 0 PAGE

Orbit, surgery of 90 Orchidectomy, orchidopexy 130 Orthopaedic surgery, visits 98 Ostectomy ioo,io]. Osteomyelitis 99 Osteoplasty 101 Osteotomy 99 Otolaryngology, visits 92 Ovary, surgery of 85

P

Pacemaker, cardiac 59

— permanent 59

— temporary 43,59

— transvenous 43 Paediatrics, visits 37 Palate and uvula, surgery of 63,121 Palmar abscess 52 Pancreas, surgery of 71 Pap smear 49 Papillomata 53 Paracentesis 48 Parathyroid gland, surgery of 74 Parotid gland, surgery of 64 Penis, surgery of 129 Pectus excavatum 54 Perineorrhaphy 84 Peripheral nerves 80 Peritoneoscopy 72 Peritoneum, surgery of 72 Pharynx, surgery of 95 Phlebotomy 47 Phonocardiogram 44 Phrenicotoxny 55 Physiatry, supervision and visits 35 Physical examination complete 6,24 Physiotherapeutic procedures 36,48 Placenta, removal 83 Plantar abscess, excision 53 Plaster casts and splints, application 114 Plastic surgery, visits 116 Pneumoencephalogram 44 Pneumothorax 55 Pollicization 122 70 Polyps, — anal 96 — aural 86 — cervical

- ‘ - , ‘ --E—--’ - ‘. — , --.- , ..

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_.,1;-::.3-:’-•—.—) - -- .... ‘ ‘ -, -- _:..——- —— INDEX 162 P PAGE

— nasal 93

— rectal 69 — sigmoid 69 Proctoscopy 42 Prostate, 132 — biopsy 132 — surgery Psychiatry, visits defined 22,39 Psychotherapy — definition 14

— fee codes 40 Pterygiuzn 90 Ptosis 91,121 Puncture — arterial 57 - atriaJ. or right ventricular 58 44 — cisternal — left ventricle 43 — lumbar 44 — splenic 42,61 — subdural 44,76

Q

Quadricepsplasty 113

R

Radiotherapy 26 Radium — application to nasopharynx 94 — insertion (gynaecological) 86 Ranula, excision 62 Rectal surgery 68 Respiratory system, surgery of 54,93 Resuscitation 27 Retained placenta 83 Retina, — fluorescein testing 46 89 — surgery of Retroperitoneal tumor 61,72 Rhinoplasty 93,120 Rubin’s test 86

S

Salivary glands 63 Salpingectomy, salpingo—oophorectomy 85 Saucerization of bone 99

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.“-. -. .S-. S -. . INDEX 163 S PAGE

Schede’s operation (Chest) 55 Sciera, surgery of 88 Scrotum, surgery of 131 Secretin test 47 Seminal vesicles, surgery of 131 Septal reconstruction 93 Sequestrectomy 99 Sesamoids 101 Sessional fees 19,22 Shoulder, recurrent dislocation 109 Shunt, hydrocephalus 78 Sialolithotomy 63 Sigmoidoscopy 48

Sinuses — lavage 94

— surgery of 94 Skin — grafting 117 — scrapings 42 — surgery of 53

— testing, allergy 30,41,42

— ulcers 121 Skull, surgery of 76,77 Smear, nasal, for eosinophi].s 41 Spermatic cord 131 Spinal surgery 76,79 Spinal fusion 102 Spine — dislocation 105

— fracture 105 Sphincter anal 70 Spleen, surgery of 61 Splenectomy 61 Splints 115 Sterility, investigation of 50 Sterilization 85,131 Stomach, surgery of 65 Strabismus, repair 90 Subdural tap 44 Submucous resection 93 Supportive care 24,37

— defined 18 Sympathectomy 87 Syndactyly 122 Synovectomy 107 Syringing of ears 46

T

Teeth and gums 63 Telephone advice 3 Tendolysis 122

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“-. 4 — .. —- - ,. 1 - .. — — INDEX 164 T PAGE

Tendon — surgery 111

— reconstruction 112 — transplant 112,122 Tendon sheath, excision 111 Tenodesis 122 Tenorrhaphy 122 Tenosynovitis, drainage’ 122 Tenotomy 111, 122 Testis, surgery of 130 Thermal burns 53 Thoracentesis 49 Thoracotomy 55 Thorax, surgery of 55 Thrombectomy 57 Thymus, surgery of 74 Thyroglossal duct, surgery of 74 Thyroid gland, surgery of 73 Tine test 41 Tongue, surgery of 63 Tongue—tie, release of 52 Tonography, electronic 46 Tonometry 46 Tonsillectomy 95 Tracheobronchial toilet 27 Tracheotomy 94 Traction, skull 77 Transfusion,

— indirect 46

— intrauterine 83

— replacement 47 Transplant, renal 132 Tunica vaginalis 131 Turbinates, cautery 93 Tympanoplasty 97

U

Umbilectomy 72 Upper limb fractures 102

Ureter, — dilation 127

- surgery of 126 Urethra - biopsy 129 - dilation 129

— endoscopy 127

- surgery of 128 Urethrogram 128 Urethroscopy 128 Urinary system, surgery of 125

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r

INDEX 165

U

PAGE

Urology, visits 124 Uterus and cervix, surgery of 85 Uvula, surgery of 63

V

Vaccination, —BCG 41 — smallpox 42 Vagina, surgery of 69,84 Varicocoele 131 Varicose ulcer 56 Varicose veins 56 Vas deferens, surgery of 131 Vasectomy 131 Vasography 131 Vasopressor or depressor tests 50 Vectorcardiogram 44 Vegetative nervous system 82 Veins, surgery of 56,57 Venesection, therapeutic 47 Venipuncture 47 Venogram 43 Venous anastomosis 56 Ventricle, tap 44 Ventriculocisternostomy 78 Ventriculogram 81 Visits, defined 4,5,6 Vestibular function tests 46 Visual fields 46 Vulva, surgery of 83 Vulvectomy 84

w

Warts, - plantar 30,53

— simple 53 Water tolerance test 50 Well baby care 14,24,37

X

Xanthelasma 91 X—ray, superficial 48 z 7.eigler punct.ure 91

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