TELEPHONE/FACSIMILE/ COMMUNICATIONS

Transcription

1 General Schedule TELEPHONE/FACSIMILE/ COMMUNICATIONS 8000 Telephone/Facsimile/ Communications initiated by other health care providers This tariff may be claimed for the following categories of telephone, facsimile and communications: 1) Communications initiated by other health care providers, who are responsible for and/or assigned to the care of: i) a patient receiving home care; ii) a patient in a personal care home; iii) a paneled patient at home or in hospital who is awaiting placement in a personal care home; iv) a patient in a special care home, (in-patient or out-patient), e.g., St. Amant Centre, Manitoba Developmental Centre; v) a chronic care patient in an extended care facility, (in-patient or out-patient) e.g., Deer Lodge Centre Extended Treatment Unit; vi) a patient presenting at a northern nursing station; vii) a patient registered in the Manitoba Home Nutrition Program; viii) a patient registered in the Manitoba Home IV program; ix) a newborn receiving a home visit by a Public Health Nurse in a recognized RHA post-natal program; x) a patient receiving care at a Quick Care Clinic; xi) a patient receiving care at River Ridge Transitional Care, or xii) a patient registered in the Sleep Disorders Centre Program. Other health care providers includes, but is not limited to: i) Home care coordinator; ii) Nurses; iii) VON; iv) Public health nurses; v) Psychiatric nurses; vi) Mental health workers; vii) Nurses located in northern nurses stations; viii) Occupational therapists; ix) Physiotherapists; x) Respiratory therapists; xi) Ambulance paramedics; xii) Clinical Assistants. 2) Communications initiated by midwives following a Midwifery Assessment and Report by the physician. B-6 April 1, 2018

2 Musculoskeletal System 0720 Vertebra, process, one (1) or more, body, closed reduction open reduction, with or without plating or grafting PELVIS (Ilium, ischium, pubis including acetabulum) 0770 Pelvis, closed reduction, with traction open reduction Acetabular fracture, lips, open reduction... 1, one (1) pillar, open reduction... 1, two (2) pillars, open reduction... 2, UPPER EXTREMITY 0780 Humerus, neck, closed reduction open reduction shaft, closed reduction open reduction supracondylar or dicondylar, closed reduction open reduction medial or lateral condyle, closed reduction open reduction Radius, head or neck, closed reduction open reduction or excision shaft, closed reduction open reduction distal end (e.g., Colles ), closed reduction skeletal pinning, with external fixation open reduction Ulna, olecranon or shaft, closed reduction open reduction or excision with dislocation of radial head (Monteggia fracture), closed reduction open reduction Radius and ulna, closed reduction open reduction Carpal bone, open reduction with or without fixation Metacarpal, closed reduction skeletal pinning with external fixation open reduction F-10 April 1, 2018

3 Musculoskeletal System UNIT VAULE 1830 soft tissue capsular release, add radial styloidectomy, add ) Each add-on is payable at 100%. Ligament Repairs of the Wrist 2) A maximum of five (5) add-ons may be claimed for the same patient, same day. ~1840 Direct ligament repair of distal radio-ulnar joint (includes dorsal and palmar ligament) ~1841 Reconstruction of distal radio-ulnar joint, includes tendon wrap or weave ~1842 Open triangulo fibrocartilage complex repair ~1843 Total wrist arthroplasty or total distal radio-ulnar arthroplasty including soft tissue interposition using synthetic prosthesis ~1844 Acute wrist ligament direct repair (including scapholunate or lunotriquetral ligament and pinning) ~1845 Acute wrist ligament reconstruction with capsulodesis (including scapholunate or lunotriquetral ligament) ~1846 Chronic wrist ligament reconstruction (including scapholunate or lunotriquetral ligament) includes capsulotomy of wrist, ORIF carpal bones and reconstruction of wrist ligament using tendon graft (includes tendon harvest) ~1847 Posterior interosseous neurectomy, add Scaphoid Deformity ~1848 ORIF or percutaneous screw fixation of non-displaced/minimally displaced carpal fracture ~1849 Open scaphoid or lunate debridment and internal fixation for scaphoid or lunate nonunion with vascularized pedicled bone flap HIP ~1470 Diagnostic hip arthroscopy (independent procedure) ~1471 Arthroscopy, hip with therapeutic intervention, includes labral debridement, chondroplasty of acetabulum and/or femoral head ~1481 labrum repair major, (two (2) or more implants), add ~1482 femoral neck osteoplasty, add ~1483 acetabular osteoplasty major, add ~1469 microfracture, add ~1474 loose body removal, add ~1475 labral repair minor, (one (1) implant), add ~1478 trochanteric bursectomy, add ~1479 release, iliopsoas tendon or iliotibial band, add ~1484 repair of abductor, unilateral, add ) Each add-on is payable at 100%. F-14 April 1, 2018

4 Musculoskeletal System 2) A maximum of five (5) add-ons (~1469, ~1474, ~1475, ~1478, and ~1479) may be claimed for the same patient, same day. 3) ~1481, ~1482, ~1483 and ~1484 claimable in addition at 100%. UNIT VAULE KNEE 1080 Arthroscopy knee joint meniscectomy or meniscal repair, add chondral shaving of patella, add chondral shaving of the trochlea, add trimming of synovium, add osteophyte trimming, add microfracture, add additional meniscectomy or meniscal repair (one), add debride femoral condyle, add debride tibial plateau, add patellar retinacular release, add removal of loose body, add Notes: 1) Each add-on is payable at 100%. 2) A maximum of five (5) add-ons may be claimed per knee for the same patient, same day. ANKLE 1670 Peritalar arthroscopy, regardless of portals used Second peritalar joint arthroscopy, performed in conjunction to ankle arthroscopy without redraping, add Add-ons: 1672 exostectomy tibia, add exostectomy talus, add exostectomy calcaneus, add chondroplasty tibia, add chondroplasty talus, add chondroplasty calcaneus, add synovectomy minor, add synovectomy major (see Note 4), add arthrolysis, add microfracture tibia, add microfracture talus, add microfracture calcaneus, add April 1, 2018 F-15

5 Male Genital System SCROTUM 4211* Scrotum, drainage of abscess Foreign body in scrotum, removal... By Report Resection of scrotum... By Report Scrotoplasty, plastic operation on scrotum... By Report Skin lesion, scrotum, local excision Unlisted or Unusually Complicated... By Report VAS DEFERENS 4241 Vasectomy, partial or complete, unilateral or bilateral (independent procedure) See Rule of Application 1 re: counselling Vasovasostomy (anastomosis) unilateral bilateral Unlisted or Unusually Complicated... By Report SPERMATIC CORD 4271 Hydrocele of spermatic cord, excision, unilateral (independent procedure) Varicocele, excision, unilateral (independent procedure) with hernia repair and/or hydrocele and/or varicocele excision Unlisted or Unusually Complicated... By Report SEMINAL VESICLES 4291 Vesiculectomy... By Report Vesiculotomy, unilateral... By Report Unlisted or Unusually Complicated... By Report PROSTATE ~4304 Prostate biopsy, transrectal or transperineal, at the time of prostate resection, add * Core needle biopsy transrectal, systematic, image-guided (up to 5 cores), or digitally directed prostate biopsy (unlimited cores) ~4314* Core needle biopsy, transrectal, systematic, image-guided (between 6 and 11 cores) ~4315* Core needle biopsy, transrectal, systematic, image-guided (12 or more cores) Abscess, prostatic, external drainage, prostatotomy Only one (1) service, total, of tariffs ~4304, 4305, ~4314 or ~4315 is payable per sitting; these tariffs are not payable in combination of each other Prostate Cryosurgery... 1, April 1, 2018 M-3

6 Endocrine System ADRENAL RESECTION 4988 Adrenalectomy or biopsy, unilateral bilateral, one (1) stage bilateral, two (2) stages... 1, Unlisted or Unusually Complicated... By Report CAROTID BODY RESECTION 4994 Carotid body tumor, excision excision with sacrifice of the carotid artery Unlisted or Unusually Complicated... By Report ENDOCRINE AND METABOLIC TESTING 7850* Cortrosyn/ACTH stimulation test * Combined PRL/TRH * GnRH stimulation test * Insulin stimulation test * Tolbutamide tolerance test * TRH test for prolactin stimulation * Water deprivation test * Triple stimulation test * Pentagastrin stimulation test * TRh/GnRH stimulation test * Glucose growth hormone suppression test * Prolonged fast: short from variant * Glucagon stimulation test * Saline infusion test for aldosteronism * Thyroxine absorption test Growth Hormone stimulation testing per agent tested is payable at 100% for each agent tested Human Chorionic Gonadtropin (HCG) stimulation testing The fees listed above are payable only where the service is provided at Health Sciences Centre or St. Boniface General Hospital. O-2 April 1, 2018

7 Renal Transplants P RENAL TRANSPLANTS These benefits cannot be correctly interpreted without reference to the Rules of Application Renal transplant... 1, Cadaver nephrectomy single for local implant or export... 1, Cadaver nephrectomy double for local implants or export... 1, Live donor nephrectomy... 1, Laparoscopic live donor nephrectomy... 1, Rejection transplant nephrectomy... 1, Pre-transplant nephrectomy (recipient) unilateral bilateral Marsupialization of post transplant lymphocele The above fees represent the total fees of those surgeons in actual attendance and will be divided among the team in accordance with their involvement. They do not include Nephrologists fees which are listed below. NEPHROLOGISTS BENEFITS Recipient related services; including nephrological management of transplantation including examination, supervision of allocation, tissue typing and interpretation of cross-match and immunological risk, determining induction and maintenance immunosuppression and complete patient care for the first three (3) day of postoperative care. 1) One of each service may be billed per patient. 2) 5871, 5872 and 5873 are payable to the attending physician of record for the day Day Day Day Donor related services; including the nephrological management of organ procurement, management of the neurologically dead donor on life support systems, the assessment of renal functions pre-nephrectomy, immunotherapy prenephrectomy, and assessment of potential recipients, etc Subsequent postoperative routine care at daily care rates, per day Management of rejection crises, care ordinarily equivalent to that of the first three (3) postoperative days, per day Management of rejection crises requiring dialysis; as for acute renal failure (includes daily care by a Nephrologist); equivalent to repeat hemodialysis in acute renal failure, per dialysis See existing schedule April 1, 2018 P-1