MALAYSIAN MEDICAL ASSOCIATION MALAYSIAN MEDICAL ASSOCIATION MEDICAL PROCEDURES AND SERVICES NOMENCLATURE (MPSN®) AND RELATIVE VALUES GUIDELINES FOR MEDICAL PRACTITIONERS IN MALAYSIA COPY RIGHT 2020 FIRST EDITION --- 1987 SECOND EDITION --- 1992 THIRD EDITION --- 1997 FOURTH EDITION --- 2002 FIFTH EDITION Version 1.0 _ 2008 Version 1.1. _ 2019 Version 2.0. _ 2020 COPY RIGHT NOTICE WARNING: The doing of an unauthorized act in relation to copyright work may result in both a civil claim for damages and criminal prosecution The Malaysian Medical Association (hereinafter referred to as MMA) published the Schedule of Fees in 1987,1992,1997 and 2002. This 2008 Edition has been renamed as Medical Procedures and Services Nomenclature and Schedule of Relative Values (hereinafter referred to as MPSN®) and is protected by copyright and is the property of the MMA as were the previous editions of the Fee Schedule. The 2008 MPSN® is produced by kind permission of materials from the BUPA Schedule of Procedures (1995) of the British United Provident Association Ltd. London, United Kingdom. The BUPA Schedule of Procedures (1995) is based on the UK Office of Population Censuses and Surveys. Classification of Operations and Surgical Procedures 4th Edition © Crown Copyright 1987 and has been used by kind permission of the Controller of Her Majesty’s Stationery Office. In addition to the above, the MPSN® (2008) is the result of work developed by the Health Insurance Committee (HIC) of the MMA. Advice and suggestions by a large number of medical organisations and societies were taken into account. These were via discussions, consultations, written feedback and review of similar fees guidelines published by sister bodies from within and outside the country. The 5th Edition has been further revised in 2019 and as published as Version 1.1 and in 2020 as Version 2.0. These two are substantially the same as version 1.0 except that new procedures approved by the Ministry of Health have been added. ALL RIGHTS RESERVED No part of the MMA MPSN® may be reproduced or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise or stored in any retrieval system of any nature without the written permission of MMA, and a licence to use, the application for which shall be made to the MMA, in writing and addressed to:- The Honorary General Secretary Malaysian Medical Association 4th Floor, MMA House 124 Jalan Pahang 53000 Kuala Lumpur Malaysia Tel: +603 4041 1375 (Hunting Line) Fax: +603 4041 8187 Email: [email protected], [email protected] Website: www.mma.org.my I OPCS 4 CODES – DEVELOPMENT LICENCE The Grant of this license to the Malaysian Medical Association is solely for the utilization of the Data known as the Classification of Surgical Operations and Procedures (OPCS4 Codes) and that: 1. It is to be used for the production of a standard guide by the medical profession, hospitals, insurance companies, managed care organisations, third party administrators and the general public in Malaysia and 2. The publication and distribution of the data shall be limited to Malaysia The Host undertakes that the Service will carry an acknowledgement of British Crown Copyright in the form specified for this purpose below and a statement that no responsibility for the accuracy and comprehensiveness of the Data is accepted by the Data Provider or British United Provident Assurance Ltd. The notices shall be incorporated in the Services by the Host in a manner that ensures that they are displayed to every user of the Service. The Host also undertakes that any literature distributed by or on behalf of the Host which promotes the Service shall include an acknowledgement of the British Copyright in the form specified below. British Crown Copyright 1993 Published by permission of the Controller of Her Britannic Majesty’s Stationery Office INFRINGEMENT OF COPYRIGHT The Host shall report any infringement of copyright, of which it becomes aware, forthwith to the Data Provider so that it may then instruct the Controller, Her Britannic Majesty’s Stationery Office, as legal owner of the British Crown Copyright, to take any necessary infringement action to remedy this matter. II CONTENTS Page INTRODUCTION AND NOTES i-iv PART A GENERAL PRACTITIONERS Consultation Fees 1 Medical Examination Fees 1 House Calls and Medical Assistance Fees 1 Legal Reports and Court Appearances Fees 1 Common Procedures 2- 3 SPECIALISTS CONSULTATION AND FOLLOW-UP FEES Consultation Fees 4 ICU Consultation 5 Court Attendance 5 GENERAL PROCEDURES Anaesthesiology 6-8 Cardiology 9-10 Dermatology and Venereology 11-12 Gastroenterology and Hepatology 13 Haematology 14 Nephrology 15 Neurology 16 Obstetrics and Gynaecology 17 Occupational Medicine 18 Oncology 19-21 Ophthalmology 22 Paediatrics 23-26 Pathology 27-29 Psychiatry – Psychotherapy 30 Respiratory Medicine 31 Radiology 32-40 RELATIVE VALUE TABLE AND CONVERSION FACTOR 41-42 III CONTENTS Page PART B Simple Investigations and Procedures Investigations 1 Procedures 1 General Procedures 2 Brain, Cranium and other Intracranial Organs Brain 3 Cranium 4 Meninges 4 Nerves 4 Vessels 5 Others 5 Spine, Spinal Cord and Peripheral Nerves Cervical Region 6 Thoracic Region 6 Lumbar Region 7 Spinal Cord 8 Nerve Roots 8 Sympathetic Nerves 8 Peripheral Nerves 8-9 Pain Relief 9-10 Neurophysiological Procedures 10 Eye and Orbital Contents Globe and Orbit 11 Eyebrow and Lid 11-12 Lacrimal System 12 Muscles 12 Conjunctiva 13 Cornea 13 Sclera 14 Iris and Anterior Chamber 14 Lens 14-15 Vitreous 15 Retina 15 General 15 IV CONTENTS Page PART B Ear, Nose and Throat External Ear 16 Middle Ear and Mastoid 16 Inner Ear 17 Nose and Nasal Cavity 17-18 Nasal Sinuses 18 Throat 19 Larynx and Trachea 19-20 Fibreoptic Endoscopic Procedures under Topical Anaesthesia 20 Face, Mouth, Head and Neck Face and Jaws 21-22 Lips 22 Tongue 22 Palate 23 Mouth Cavity 23 Salivary Glands 23-24 Teeth 24 Neck 24 Thyroid and Parathyroid Glands 25 Breasts Breasts 26 Cardiololgy Pacing and Electrophysiological Procedures 27 Invasive Diagnostic Procedures 27-28 Interventional Cardiac Procedures 28 Interventional Peripheral Procedures 29 Coronary Care Procedures 29 Spiral Angiography Computed Tomography Procedures 30 Cardiothoracic Surgery Oesophagus 31 Chestwall 31 Trachea/Bronchus 32 Lung 32 Mediastinum 33 Heart Cardiac Surgery 33-34 Great Vessels 34-35 V CONTENTS PART B Page Vascular System Aorta 36 Arteriovenous 36 Artery 36 Carotid 36 Sympathectomy 36 Varicose veins 37 Vascular access and grafts 37 Vein 37 Lymphatic 37 Endoscopic Gastro Intestinal Procedures Oesophagus 38 Stomach 38 Duodenum 39 Small Intestine 39 Colon 39 Sigmoid Colon 40 Rectum and Anus 40 ERCP 40 Endoscopic Ultrasound Procedures 40 Ultrasound Guided Therapeutic Intervention 41 Laparoscopic Procedures 41 Abdomen (other than urinary and reproductive organs) Oesophagus 42 Stomach 42 Duodenum 43 Small Intestine 43 Large Intestine 43 Rectum/Anus 44 Other organs, mainly digestive 45 Major Vessels 46 Abdominal Wall 46 Peritoneum 46 Urinary System and Male Reproductive Organs Kidney/Renal Pelvic 47 Ureter 48 Bladder 49-50 Urethra 50-51 Prostate 51 Genitalia 51-53 Others 53 VI CONTENTS PART B Page Female Reproductive Organs Uterus/Adnexa 54 Suspension 54 Cervix Uteri 55 Vagina/Perineum 55 Vulva/Labia 55 Haemostasis 55 Pregnancy and Confinement Intrapartum 56 Postpartum 56 Contraception 56 Skin and Subcutaneous Tissue Lesions of Skin 57 Repair 57 Burns 58 Grafts 58 Flaps/Transplant 58 Bones, Joints Etc (not listed elsewhere) Connective Tissue/Tendon Muscle 59 Bone (Non-specific) 59-60 Fractures 60-61 Nerves 61 Joints (not listed elsewhere) 61 Joint Replacement/Reconstruction (not listed elsewhere) 62 Fixation/Arthrodesis 62 Hand 62 Shoulder 63 Elbow 63 Hip, Leg and Pelvis 63-64 Knee 64 Foot 64-65 Illizarov 65 External Fixation/Traction 65 Paediatric Surgery Ano-rectal 66 Bile Duct 66 Chest Wall 66 Cloaca 66 Colon 66 Liver 66 Oesophagus 66 Pancreas 66 VII CONTENTS PART B Page Paediatric Surgery Trachea 67 Tumour 67 Vagina 67 Clitoris 67 Bladder 67 Diaphragm 67 Testis 67 Abdominal Wall 67 Bronchus 68 Duodenum 68 Hernia 68 Laparotomy 68 Lung 68 Urethra 68 Spleen 68 Stomach 69 Small Bowel 69 Lymphangioma 69 Rectum 69 Testis 69 Penis 69 Others 69 Interventional Radiology Biopsies/Localisation 70 Drainages/Lysis 70 Dilatations/Stenting 70 Spinal and Pain Interventions 71-72 Hepatobiliary/Gastrointestinal Interventions and Tumour Ablations 72-73 Genitourinary Interventions 73 Revascularisations 74 Neurovascular Interventions 74 Embolisation 74-75 Vascular Access/Interventions 75 Venous Sampling 75 Others 76 Diagnostic 76-77 ADDENDUM 78-80 VIII INTRODUCTION AND NOTES INTRODUCTION AND NOTES TO THE MEDICAL PROCEDURES AND SERVICES NOMENCLATURE (MPSN ®) AND SCHEDULE OF RELATIVE VALUES FIFTH EDITION Version 2.0 (2020) GENERAL The Malaysian Medical Association (MMA) first released a Schedule of Fees in 1987. The 1. Fifth Edition, now renamed as Medical Procedures and Services Nomenclature (MPSN ®) (2008) and Schedule of Relative Values (RV). The Fifth Edition was revised in 2019 and published as Version 1.1 and further revised in 2020 and publidhed as Version 2.0 2. The previous Schedule, Fourth Edition, was published in 2002 and the changes from the Third Edition reflected a 10% increase in consultation and procedural fees as compared with the Third Schedule in 1997. 3. A major part of the Fourth Schedule was incorporated into the Thirteenth Schedule (Regulation 433) of the Private Healthcare Facilities and Services Regulations 2006. This law governs the professional fees of all medical practitioners in Malaysia. 4. This Fifth Schedule is the result of work developed by the Health Insurance Committee (HIC) of the MMA. Advice and suggestions by a large number of medical organisations and societies were taken into account. These were via discussions, consultations, written feedback and review of similar fees guidelines published by sister bodies from within and outside the country.