Radiology ii. 2nd digit indicates the sub region within a main region or category eg. Head / Skull and Brain = 10xxx

Transcription

1 NATIONAL REFERENE PRIE LIST FOR RADIOLOGISTS, EFFETIVE FROM 1 JANUARY 2004 The following reference price list is not a set of tariffs that must be applied by medical schemes and/or providers. It is rather intended to serve as a baseline against which medical schemes can individually determine benefit levels and health service providers can individually determine fees charged to patients. Medical schemes may, for example, determine in their rules that their benefit in respect of a particular health service is equivalent to a specified percentage of the national health reference price list. It is especially intended to serve as a basis for negotiation between individual funders and individual health care providers with a view to facilitating agreements which will minimise balance billing against members of medical schemes. Should individual medical schemes wish to determine benefit structures, and individual providers determine fee structures, on some other basis without reference to this list, they may do so as well. In calculating the prices in this schedule, the following rounding method is used: Values R10 and below rounded to the nearest cent, R10+ rounded to the nearest 10cent. Modifier values are rounded to the nearest cent. When new item prices are calculated, e.g. when applying a modifier, the same rounding scheme should be followed. VAT EXLUSIVE PRIES APPEAR IN BRAKETS. This schedule is for the exclusive use of registered specialist radiology practices (Pr No "038" and nuclear medicine practices (Pr No "025". This schedule must be used in conjunction with the Radiological Society of S A Guidelines. ode Structure Framework a. The tariff code consists of 5 digits i. 1st digit indicates the main anatomical region or procedural category. 0 = General (non specific 1 = Head 2 = Neck 3 = Thorax 4 = Abdomen and Pelvis (soft tissue 5 = Spine, Pelvis and Hips 6 = Upper limbs 7 = Lower limbs 8 = Interventional 9 = Soft tissue regions (nuclear medicine eg Head = 1xxxx ii. 2nd digit indicates the sub region within a main region or category eg. Head / Skull and Brain = 10xxx iii. 3rd digit indicates modality 1 = General (Black and White x-rays 2 = Ultrasound 3 = omputed Tomography 4 = Magnetic Resonance Imaging 5 = Angiography 6 = Interventional radiology 9 = Nuclear Medicine (Isotopes eg: Head / Skull and Brain / General x-ray = 101xx iv. 4th and 5th digits are specific to a procedure / examination, eg Head / Skull and Brain / General / X-ray of the skull = Guidelines for use of coding structure The vast majority of the codes describe complete procedures / examination and their use for the appropriate studies is selfexplanatory. Some codes may have multiple applications and their use is described in notes associated with each code odes to (Angiography machine codes may only be used by owners of the equipment and who have registered such equipment with the Board of Healthcare Funders / RSSA. The machine codes 00510, 00520, 00530, 00540, 00550, may not be added to 60540, 60550, 70530, (Antegrade Venography, upper and lower limbs Where public sector hospital equipment is used for a procedure, the units will be reduced by 33.33%. onsumables 09 Sep 2004 Page 1 of 52 Version 01.11

2 ontrast Medium o Prior to the implementation of Act 90, contrast will be billed according to the official 2004 RSSA reimbursement price list, without mark up. o After the implementation of Act 90, contrast medium will be billed according to the suppliers list price, without mark up. Angiography catheters, angioplasty balloons, stents, coils and other embolisation materials, guide wires and drains are to be billed at net acquisition cost, without mark up, until the implementation of Act 90. All other consumables are to be billed at net acquisition price, until the implementation of Act 90. Thereafter Act 90 regulations apply. The cost of film is included in the comprehensive procedure codes and is not billed for separately. Appropriate codes must be provided for consumables. General omments on Procedural odes All x-ray tomography codes are stand alone studies and may be used as a unique study or in combination with the appropriate regional study if done simultaneously. May not be added to 20130, 42110, Setting of sterile tray is included in all appropriate procedure codes. Where introduction of contrast is necessary eg. sialography, arthrography, angiography, etc, the codes used for the procedures are comprehensive and include the introduction of contrast or isotopes. The use of Doppler or olour Doppler as an adjunct to a study (eg small parts thyroid is included in the code for that study. T Angiography (10330, 20330, 32300, 32310, 44300, 44310, 44320, 44330, 60310, 70310, are stand alone studies and may not be added to the regional contrasted studies (see 10335, 20340, 20350, for combined studies. Angiography and interventional procedures include selective and super selective catheterization of vessels as are necessary to perform the procedures. odes (Ultrasound guidance, (T guidance and (MR guidance are stand alone procedures that include the regional study and may not be added to any of the ultrasound, T or MR regional studies General odes Modifiers Radiology and nuclear medicine services rendered to hospital inpatients A Radiology and nuclear medicine services rendered to outpatients A A reduction of one third (33.33% will apply to radiological examinations where hospital equipment it used Equipment / Diagnostic ode Description RVU Price Status onsumables used in radiology procedures (- Appropriate code to be provided. See separate codes for contrast and isotopes X-ray skeletal survey under five years ( X-ray skeletal survey over five years ( X-ray sinogram any region ( X-ray with mobile unit in other facility (91.60 To be added to applicable procedure codes eg X-ray control view in theatre any region ( X-ray fluoroscopy any region ( May only be added to the examination when fluoroscopy is not included in the standard procedure code. May not be added to: any angiography, venography, lymphangiography or interventional codes. any contrasted fluoroscopy examination X-ray fluoroscopy guidance for biopsy, any region ( Add to the procedure eg , 80605, X-ray -Arm (equipment fee only, not procedure per half hour ( Only to be used if equipment is owned by the radiologist X-ray -arm fluoroscopy in theatre per half hour (procedure only ( A U 09 Sep 2004 Page 2 of 52 Version 01.11

3 00160 X-ray fixed theatre installation (equipment fee only ( Only to be used if equipment is owned by the radiologist X-ray examination contrast material (- Identification code for the use of contrast with a procedure. Appropriate codes to be supplied Ultrasound with mobile unit in other facility (88.70 Add to the relevant ultrasound examination codes eg Ultrasound intra-operative study ( overs all regions studied. Single code per operative procedure Ultrasound guidance ( omprehensive ultrasound code including regional study and guidance. Guided procedure code to be added eg , 80605, Ultrasound guidance for tissue ablation ( omprehensive ultrasound code including regional study and guidance. Radiologist assistance (01030 may be added if procedure is performed by a non-radiologist. Guided procedure code to be added if performed by a radiologist or Ultrasound examination contrast material (- Identification code for the use of contrast with a procedure. Appropriate codes to be supplied T planning study for radiotherapy ( To be used once per planning session for any region T guidance (separate procedure ( omprehensive T code including regional study and guidance. Guided procedure code to be added eg 80600, 80605, and T guidance, with diagnostic procedure ( To be added to the diagnostic procedure code. Guided procedure code to be added eg 80600, 80605, T guidance and monitoring for tissue ablation ( May only be used once per procedure for a region. Radiologist assistance (01030 may be added if procedure is performed by a non-radiologist. If performed by radiologist, add procedural code 80620, or T examination contrast material (- Identification code for the use of contrast with a procedure. Appropriate codes to be supplied MR study of the whole body for metastases screening ( MR Spectroscopy any region ( May be added to the regional study, once only MR guidance for needle replacement ( omprehensive MRI code including region studied and guidance. Guided procedure code to be added eg 80600, 80605, MR low field strength imaging of peripheral joint any region ( MR planning study for radiotherapy or surgical procedure ( A 09 Sep 2004 Page 3 of 52 Version 01.11

4 00455 MR planning study for radiotherapy or surgical procedure, with contrast ( MR examination contrast material (- Identification code for the use of contrast with a procedure. Appropriate codes to be supplied Analogue monoplane screening table ( A machine code may be added once per complete procedure / patient visit Analogue monoplane table with DSA attachment ( A machine code may be added once per complete procedure / patient visit Dedicated angiography suite: Analogue monoplane unit. Once off charge per patient by owner of equipment. A machine code may be added once per complete procedure / patient visit ( Digital monoplane screening table ( A machine code may be added once per complete procedure / patient visit Dedicated angiography suite: Digital monoplane unit. Once off charge per patient by owner of equipment. A machine code may be added once per complete procedure / patient visit Dedicated angiography suite: Digital bi-plane unit. Once off charge per patient by owner of equipment. A machine code may be added once per complete procedure / patient visit ( ( Angiography and interventional examination contrast material (- Identification code for the use of contrast with a procedure. Appropriate codes to be supplied Nuclear Medicine study - Bone, whole body, appendicular and axial skeleton ( Nuclear Medicine study - Bone, whole body, appendicular and axial skeleton and SPET ( Nuclear Medicine study - Venous thrombosis regional ( Nuclear Medicine study - Tumour whole body ( Nuclear Medicine study - Tumour whole body multiple studies ( Nuclear Medicine study - Tumour whole body and SPET ( Nuclear Medicine study - Tumour whole body multiple studies & SPET ( Nuclear Medicine study Infection whole body ( Nuclear Medicine study infection whole body with SPET ( Nuclear Medicine study infection whole body multiple studies ( A 09 Sep 2004 Page 4 of 52 Version 01.11

5 00930 Nuclear Medicine study infection whole body with SPET multiple studies ( Nuclear Medicine study - Bone marrow imaging limited area ( Nuclear Medicine study - Bone marrow imaging whole body ( Nuclear Medicine study - Bone marrow imaging limited area multiple studies ( Nuclear Medicine study - Bone marrow imaging whole body multiple studies ( Nuclear Medicine study - Spleen imaging only - haematopoietic ( Nuclear Medicine therapy Hyperthyroidism ( Nuclear Medicine therapy - Thyroid carcinoma and metastases ( Nuclear Medicine therapy Intra-cavity radio-active colloid therapy ( Nuclear Medicine therapy - Interstitial radio-active colloid therapy ( Nuclear Medicine therapy - Intravascular radio pharmaceutical therapy particulate ( Nuclear Medicine therapy - Intra-articular radio pharmaceutical therapy ( Nuclear Medicine Isotope (- Identification code for the use of isotope with a procedure. Appropriate codes to be supplied Nuclear Medicine Substrate (- all and assistance Emergency call out code only to be used if radiologist is called out to the rooms to report on an examination after normal working hours. May not be used for routine reporting during extended working hours. Emergency call out code only to be used when a radiologist reports on subsequent cases after having been called out to the rooms to report an initial after hours procedure. This code may also be used for home tele-radiology reporting of an emergency procedure. May not be used for routine reporting during normal or extended working hours. Radiologist assistance in theatre code only to be used if the radiologist is actively involved in assisting another radiologist or clinician with an interventional or other procedure. Radiographer assistance in theatre may not be used for procedures performed in facilities owned by the radiologist; ie only for attendance in hospital theatres etc. Does not apply to Bed Side Unit (BSU examinations. Second opinion consultations only to be used if a written report is provided as indicated in codes 01050, 01055, Not intended for ad hoc verbal consultations Emergency call out fee, first case ( Emergency call out fee, subsequent cases same trip ( Radiologist assistance in theatre, per half hour ( Radiographer attendance in theatre, per half hour ( Written report on study done elsewhere, short ( Written report on study done elsewhere, extensive ( Sep 2004 Page 5 of 52 Version 01.11

6 01060 Written report for medico legal purposes, per hour ( onsultation for pre-assessment of interventional procedure ( X-ray procedure after hours, per procedure (- U Ultrasound procedure after hours, per procedure (- U T procedure after hours, per procedure (- U MR procedure after hours, per procedure (- U Angiography procedure after hours, per procedure (- U Interventional procedure after hours, per procedure (- U onsultation for nuclear medicine study ( Monitoring EG / Pulse oximetry monitoring ( Use for monitoring patients requiring conscious sedation during imaging procedure. Not to be used as a routine EG/pulse Oximeter monitoring (96.40 Head Skull and Brain odes (skull and (tomography may be combined X-ray of the skull ( X-ray tomography of the skull ( X-ray shuntogram for VP shunt ( Ultrasound of the brain Neonatal ( Ultrasound of the brain including doppler ( Ultrasound of the intracranial vasculature, including B mode, pulse and colour doppler ( T Brain uncontrasted ( T Brain with contrast only ( T Brain pre and post contrast ( T angiography of the brain ( T of the brain pre and post contrast with angiography ( T brain for cranio-stenosis including 3D ( T Brain stereotactic localisation ( MR of the brain, limited study ( MR of the brain uncontrasted ( U A 09 Sep 2004 Page 6 of 52 Version 01.11

7 10420 MR of the brain with contrast ( MR of the brain pre and post contrast ( MR of the brain pre and post contrast, for perfusion studies ( MR of the brain plus angiography ( MR of the brain pre and post contrast plus angiography ( MR angiography of the brain uncontrasted ( MR angiography of the brain contrasted ( MR of the brain, with diffusion studies ( MR of the brain, pre and post contrast, with diffusion studies, ( MR study of the brain plus angiography plus diffusion, uncontrasted ( MR of the brain pre and post contrast plus angiography and diffusion ( Arteriography of intracranial vessels: 1-2 vessels ( Arteriography of intracranial vessels: 3-4 vessels ( Arteriography of extra-cranial (non-cervical vessels ( Arteriography of intracranial and extra-cranial (non-cervical vessels ( Arteriography of intracranial vessels (4 plus 3 D rotational angiography ( Arteriography of intracranial vessels (1 plus 3D rotational angiography ( Venography of dural sinuses ( Nuclear Medicine study Bone regional, static ( Nuclear Medicine study Bone regional, static, with flow ( Nuclear Medicine study Bone regional, static with SPET ( A 09 Sep 2004 Page 7 of 52 Version 01.11

8 10915 Nuclear Medicine study Bone regional, static, with flow, with SPET ( Nuclear Medicine study Brain, planar, complete, static ( Nuclear Medicine study Brain complete static with vascular flow ( Nuclear Medicine study Brain, planar, complete, static, with SPET ( Nuclear Medicine study Brain, planar, complete, static, with flow, with SPET ( Nuclear Medicine study - SF flow imaging cisternography ( Nuclear Medicine study Ventriculography ( Nuclear Medicine study - Shunt evaluation static, planar ( Nuclear Medicine study - FS leakage detection and localisation ( Nuclear medicine study - SF SPET ( Facial bones and nasal bones odes (facial bones and (tomography may be combined X-ray of the facial bones ( X-ray tomography of the facial bones ( X-ray of the nasal bones ( T of the facial bones ( T of the facial bones with 3D reconstructions ( T of the facial bones/soft tissue, pre and post contrast ( MR of the facial soft tissue ( MR of the facial soft tissue pre and post contrast ( MR of the facial soft tissue plus angiography, with contrast ( MR angiography of the facial soft tissue ( Orbits, lacrimal glands and tear ducts ode (tomography may be added to or or (orbits or (dacrocystography X-ray orbits less than three views ( X-ray of the orbits, three or more views, including foramina ( Sep 2004 Page 8 of 52 Version 01.11

9 12120 X-ray of the orbits for foreign body ( X-ray tomography of the orbits ( X-ray dacrocystography ( Ultrasound of the orbit/eye ( Ultrasound of the orbit/eye including doppler ( T of the orbits single plane ( T of the orbits, more than one plane ( T of the orbits pre and post contrast single plane ( T of the orbits pre and post contrast multiple planes ( MR of the orbits ( MR of the orbitae, pre and post contrast ( Nuclear Medicine study Dacrocystography ( Paranasal sinuses ode (tomography may be added to 13100, (paranasal sinuses, (nasopharyngeal X-ray of the paranasal sinuses, single view ( X-ray of the paranasal sinuses, two or more views ( X-ray tomography of the paranasal sinuses ( X-ray of the naso-pharyngeal soft tissue ( T of the paranasal sinuses single plane, limited study ( T of the paranasal sinuses, two planes, limited study ( T of the paranasal sinuses, any plane, complete study ( T of the paranasal sinuses, more than one plane, complete study ( T of the paranasal sinuses, any plane, complete study: pre and post contrast ( T of the paranasal sinuses, more than one plane, complete study; pre and post contrast ( MR of the paranasal sinuses ( Sep 2004 Page 9 of 52 Version 01.11

10 13410 MR of the paranasal sinuses, pre and post contrast ( Mandible, teeth and maxilla ode (orthopantomogram may be combined with (mandible if two separate studies are performed. ode (orthopantomogram may be combined with and / or (TM joint if complete separate studies are performed. ode (tomography may be combined with or or (teeth. ode (tomography may be combined with and / or (TM joint if complete separate studies are performed. ode and (Dental implants may be combined if mandible and maxilla are examined at the same visit X-ray of the mandible ( X-ray orthopantomogram of the jaws and teeth ( X-ray maxillofacial cephalometry ( X-ray of the teeth single quadrant ( X-ray of the teeth more than one quadrant ( X-ray of the teeth full mouth ( X-ray tomography of the teeth per side ( T of the mandible ( T of the mandible, pre and post contrast ( T mandible with 3D reconstructions ( T for dental implants in the mandible ( T for dental implants in the maxilla ( MR of the mandible/maxilla ( MR of the mandible/maxilla, pre and post contrast ( TM Joints ode (TM joint and (tomography may be combined. ode (TM joint and (tomography may be combined. ode (arthrography and (tomography may be combined. ode (arthrography and (tomographymay be combined. odes (T arthrogram and (MR arthrogram include introduction of contrast (00140 may not be added X-ray tempero-mandibular joint, left ( X-ray tempero-mandibular joint, right ( X-ray tomography tempero-mandibular joint, left ( Sep 2004 Page 10 of 52 Version 01.11

11 15130 X-ray tomography tempero-mandibular joint, right ( X-ray arthrography of the tempero-mandibular joint, left ( X-ray arthrography of the tempero-mandibular joint, right ( Ultrasound tempero-mandibular joints, one or both sides ( T of the tempero-mandibular joints ( T of the tempero-mandibular joints plus 3D reconstructions ( T arthrogram of the tempero-mandibular joints ( MR of the tempero-mandibular joints ( MR of the tempero-mandibular joints, pre and post contrast ( MR arthrogram of the tempero-mandibular joints ( Mastoids and internal auditory canal ode (mastoids and (tomography may be combined. ode (mastoids bilat and (tomography may be combined ode (IAM s and (tomography may be combined X-ray of the mastoids, unilateral ( X-ray of the mastoids, bilateral ( X-ray tomography of the petro-temporal bone, unilateral ( X-ray tomography of the petro-temporal bone, bilateral ( X-ray internal auditory canal, bilateral ( X-ray tomography of the internal auditory canal, bilateral ( T of the mastoids ( T of the internal auditory canal ( T of the internal auditory canal, pre and post contrast ( T of the ear structures, limited study ( T of the middle and inner ear structures, high definition including all reconstructions in various planes ( MR of the internal auditory canals, limited study ( MR of the internal auditory canals, pre and post contrast, limited study ( Sep 2004 Page 11 of 52 Version 01.11

12 16420 MR of the internal auditory canals, pre and post contrast, complete study ( MR of the ear structures ( MR of the ear structures, pre and post contrast ( Sella turcica ode (sella and (tomography may be combined X-ray of the sella turcica ( X-ray tomography of the sella turcica ( T of the sella turcica/hypophysis ( T of the sella turcica/hypophysis, pre and post contrast ( MR of the hypophysis ( MR of the hypophysis, pre and post contrast ( Salivary glands and floor of the mouth ode (calculus and (open mouth may be combined. odes (sialography and (T sialography include introduction of contrast and fluoroscopy (00140 may not be added X-ray of the salivary glands and ducts for calculus ( X-ray of the salivary ducts, open mouth for calculus ( X-ray sialography, per gland ( Ultrasound of the salivary glands/floor of the mouth ( T of the salivary glands, uncontrasted ( T of the salivary glands/floor of the mouth, pre and post contrast ( T sialography ( MR of the salivary glands/floor of the mouth ( MR of the salivary glands/floor of the mouth, pre and post contrast ( Nuclear Medicine study - Salivary gland imaging ( Soft Tissue Nuclear Medicine study - Tumour localisation planar, static ( Sep 2004 Page 12 of 52 Version 01.11

13 19905 Nuclear Medicine study - Tumour localisation planar, static, multiple studies ( Nuclear Medicine study - Tumour localisation planar, static and SPET ( Nuclear Medicine study - Tumour localisation planar, static, multiple studies and SPET ( Nuclear medicine study - Infection localisation planar, static ( Nuclear medicine study - Infection localisation planar, static, multiple studies ( Nuclear medicine study - Infection localisation planar, static and SPET ( Nuclear medicine study - Infection localisation planar, static, multiple studies and SPET ( Neck ode (laryngography includes fluoroscopy (00140 may not be added. ode (speech includes tomography and cinematography (00140 may not be added. ode (MR Angiography may be combined with (MR brain X-ray of soft tissue of the neck ( X-ray of the larynx including tomography ( X-ray laryngography ( X-ray evaluation of pharyngeal movement and speech by screening and / or cine with or without video recording ( Ultrasound of the thyroid ( Ultrasound of soft tissue of the neck ( Ultrasound of the carotid arteries, bilateral including B mode, pulsed and colour doppler ( Ultrasound of the entire extracranial vascular tree including carotids, vertebral and subclavian vessels with B mode, pulse and colour doppler ( T of the soft tissues of the neck ( T of the soft tissues of the neck, with contrast ( T of the soft tissues of the neck, pre and post contrast ( T angiography of the extracranial vessels in the neck ( T angiography of the extracranial vessels in the neck and intracranial vessels of the brain ( T angiography of the extracranial vessels in the neck and intracranial vessels of the brain plus a pre and post contrast study of the brain ( Mr of the soft tissue of the neck ( Sep 2004 Page 13 of 52 Version 01.11

14 20410 MR of the soft tissue of the neck, pre and post contrast ( MR of the soft tissue of the neck and uncontrasted angiography ( MR angiography of the extracranial vessels in the neck, without contrast ( MR angiography of the extracranial vessels in the neck, with contrast ( MR angiography of the extra and intracranial vessels with contrast ( MR angiography of the intra and extra cranial vessels plus brain, without contrast MR angiography of the intra and extra cranial vessels plus brain, with contrast ( Arteriography of cervical vessels: carotid 1-2 vessels ( Arteriography of cervical vessels: vertebral 1-2 vessels ( Arteriography of cervical vessels: carotid and vertebral ( Arteriography of aortic arch and cervical vessels ( Arteriography of aortic arch, cervical and intracranial vessels ( Venography of jugular and vertebral veins ( Thyroid (Nuclear Medicine Nuclear Medicine study - Thyroid, single uptake ( Nuclear medicine study - Thyroid, multiple uptake ( Nuclear medicine study - Thyroid imaging with uptake ( Nuclear medicine study - Thyroid imaging ( Nuclear medicine study - Thyroid imaging with vascular flow ( Nuclear medicine study - Thyroid suppression/stimulation ( Parathyroid (Nuclear Medicine Nuclear Medicine study - Parathyroid, planar, static ( Nuclear medicine study - Parathyroid, planar, static, multiple ( Nuclear medicine study - Parathyroid, planar, static with subtraction technique ( Nuclear medicine study - Parathyroid SPET ( A 09 Sep 2004 Page 14 of 52 Version 01.11

15 Soft Tissue Nuclear Medicine study - Tumour localisation planar, static ( Nuclear medicine study - Tumour localisation planar, static, multiple studies ( Nuclear medicine study - Tumour localisation planar, static and SPET ( Nuclear medicine study - Tumour localisation planar, static, multiple studies and SPET ( Nuclear medicine study - Tumour localisation planar, static ( Nuclear medicine study - Infection localisation planar, static, multiple studies ( Nuclear medicine study - Infection localisation planar, static and SPET ( Nuclear medicine study - Infection localisation planar, static, multiple studies and SPET ( Nuclear medicine study - Regional lymph node mapping, static, planar ( Nuclear medicine study - Regional lymph node mapping, static, planar, multiple ( Nuclear medicine study Lymph node localisation with gamma probe ( Thorax hest wall, pleura, lungs and mediastinum ode (tomography may be combined with or (chest or or (ribs or (thoracic inlet. odes (Sterno-clavicular and (tomography may be combined. ode (sternum and (tomography may be combined. ode (T limited high resolution may be combined with or or (T chest. Motivation may be required. ode (high resolution is a stand alone study. ode 30360, (T chest for pulmonary embolism is a complete examination and includes the preceding uncontrasted T scan of the chest, and may not be combined with or (T abdomen and pelvis. ode (T pulmonary embolism plus T venography may not be combined with (Doppler X-ray of the chest, single view ( X-ray of the chest two views, PA and lateral ( X-ray of the chest complete with additional views ( X-ray of the chest complete including fluoroscopy ( X-ray tomography of the chest ( X-ray of the ribs ( X-ray of the chest and ribs ( Sep 2004 Page 15 of 52 Version 01.11

16 30160 X-ray of the thoracic inlet ( X-ray of the sterno-clavicular joints ( X-ray tomography of the sterno-clavicular joint ( X-ray of the sternum ( X-ray tomography of the sternum ( Ultrasound of the chest wall, any region ( Ultrasound of the pleural space ( Ultrasound of the mediastinal structures ( T of the chest, limited study ( T of the chest uncontrasted ( T of the chest contrasted ( T of the chest, pre and post contrast ( T of the chest, limited high resolution study ( T of the chest, complete high resolution study ( T of the chest for pulmonary embolism ( T of the chest for pulmonary embolism with T venography of abdomen, pelvis and lower limbs ( MR of the chest ( MR of the chest with uncontrasted angiography ( MR of the chest, pre and post contrast ( Nuclear Medicine study - Lung perfusion ( Nuclear Medicine study - Lung ventilation, aerosol ( Nuclear Medicine study - Lung perfusion and ventilation ( Nuclear Medicine study - Lung ventilation using radio-active gas ( Nuclear Medicine study - Lung perfusion and ventilation using radio-active gas ( Oesophagus 09 Sep 2004 Page 16 of 52 Version 01.11

17 odes 31100, 31110, (swallow include fluoroscopy (00140 may not be added X-ray barium swallow ( X-ray barium swallow, double contrast ( X-ray barium swallow with cinematography ( Aorta and large vessels odes and (Ivus may be combined Ultrasound intravascular arterial or venous assessment for intervention, once per complete procedure ( Ultrasound intravascular (IVUS first vessel ( Ultrasound intravascular (IVUS subsequent vessels ( T angiography of the aorta and branches ( T angiography of the pulmonary vasculature ( MR angiography of the aorta and branches ( MR angiography of the pulmonary vasculature ( Arteriography of thoracic aorta ( Arteriography of bronchial intercostal vessels alone ( Arteriography of thoracic aorta, bronchial and intercostal vessels ( Arteriography of pulmonary vessels ( Arteriography of heart chambers, coronary arteries ( Venography of thoracic vena cava ( Venography of vena cava, azygos system ( Venography patency of A-port or other central line ( Heart odes (T anatomy / function and (T Angiography may be done as stand alone studies or as additive studies if both are performed at the same time Ultrasound study of the heart for foetal or paediatric cases including doppler ( ode is a stand alone study and may not be added to or This code is intended for paediatric and foetal cases only Ultrasound study of the heart, including Doppler ( Ultrasound study of the heart trans-oesophageal ( A 09 Sep 2004 Page 17 of 52 Version 01.11

18 33220 Ultrasound intravascular imaging to guide placement of intracoronary stent once per vessel ( T anatomical/functional study of the heart ( T angiography of heart vessels ( MR of the heart, anatomical study ( MR of the heart, anatomical and functional study ( MR of the heart, pre and post contrast ( MR angiography of the heart vessels ( MR of the heart, anatomical, functional and coronary angiography ( Nuclear Medicine study - ardiac shunt detection ( Nuclear Medicine study - ardiac blood pool imaging, ejection fraction plus wall motion single study ( Nuclear Medicine study - ardiac blood pool imaging, ejection fraction plus wall motion multiple studies ( Nuclear Medicine study - ardiac blood pool imaging, gated SPET ( Nuclear medicine study - ardiac blood pool imaging, first pass technique ( Nuclear medicine study - Myocardial perfusion, single, rest (thallium/mibi planar, non gated ( Nuclear medicine study - Myocardial perfusion, single, stress (thallium/mibi planar, non gated ( Nuclear medicine study - Myocardial perfusion, single, rest (thallium/mibi, SPET (non gated ( Nuclear medicine study - Myocardial perfusion, single, stress (thallium/mibi, SPET non gated ( Nuclear medicine study - Myocardial perfusion, single, rest (thallium/mibi, SPET (gated ( Nuclear medicine study - Myocardial perfusion, single, stress (thallium/mibi, SPET (gated ( Nuclear medicine study - Plus wall movement and ejection fraction, SPET ( Nuclear medicine study - ardiac hot spot imaging (infarction planar ( Nuclear medicine study - ardiac hot spot imaging (infarction SPET ( Nuclear Medicine study - Multi stage treadmill EG test ( Mamma 09 Sep 2004 Page 18 of 52 Version 01.11

19 odes (localization, (stereo-tactic localization and (stereo-tactic biopsy may not be combined. ode (stereo-tactic biopsy. Add procedural code (cutting needle or (mammotome ode (U/S FNA includes the procedural code (may not be combined with X-ray mammography including ultrasound ( ode may not be combined with when these two procedures are done in the same sitting. ode includes ultrasound. In this situation use code (fine needle aspiration with X-ray mammography galactography ( Once off fee per visit. May be added to X-ray mammography study for localisation ( X-ray stereotactic mammography localisation ( X-ray stereotactic mammography biopsy ( X-ray of biopsy specimen of the mamma ( X-ray Mammotome hand held biopsy apparatus ( Ultrasound study of the breast ( Ultrasound guided aspiration FNA/localisation of the breast ( omputer assisted diagnosis for mammography ( MR study of the breast ( MR study of the breast pre and post contrast ( Soft Tissue Nuclear medicine study - Tumour localisation planar, static ( Nuclear medicine study - Tumour localisation planar, static, multiple studies ( Nuclear medicine study - Tumour localisation planar, static and SPET ( Nuclear medicine study - Tumour localisation planar, static, multiple studies and SPET ( Nuclear medicine study - Infection localisation planar, static ( Nuclear medicine study - Infection localisation planar, static, multiple studies ( Nuclear medicine study - Infection localisation planar, static and SPET ( Nuclear medicine study - Infection localisation planar, static, multiple studies, SPET ( A 09 Sep 2004 Page 19 of 52 Version 01.11

20 39940 Nuclear medicine study - Regional lymph node mapping, static, planar ( Nuclear medicine study - Regional lymph node mapping, static, planar, multiple ( Nuclear medicine study Lymph node localisation with gamma probe ( Abdomen and Pelvis Abdomen/stomach/bowel ode (tomography may be combined with or or (abdomen. odes to (barium studies include fluoroscopy (00140 may not be added. ode (intussusception is a stand alone code and may not be combined with or (barium enema, (00140 may not be added X-ray of the abdomen ( X-ray of the abdomen supine and erect, or decubitus ( X-ray of the abdomen multiple views including chest ( X-ray tomography of the abdomen ( X-ray barium meal single contrast ( X-ray barium meal double contrast ( X-ray barium meal double contrast with follow through ( X-ray small bowel enteroclysis (meal ( ode includes duodenal intubation and may not be added to (Duodenal intubation X-ray small bowel meal follow through single contrast ( X-ray small bowel meal with pneumocolon ( X-ray large bowel enema single contrast ( X-ray large bowel enema double contrast ( X-ray guided gastro oesophageal intubation ( X-ray guided duodenal intubation ( X-ray defaecogram ( X-ray guided reduction of intussusception ( Ultrasound study of the abdominal wall ( Ultrasound study of the whole abdomen including the pelvis ( T study of the abdomen ( T study of the abdomen with contrast ( Sep 2004 Page 20 of 52 Version 01.11

21 40313 T study of the abdomen pre and post contrast ( T of the pelvis ( T of the pelvis with contrast ( T of the pelvis pre and post contrast ( T of the abdomen and pelvis ( T of the abdomen and pelvis with contrast ( T of the abdomen and pelvis pre and post contrast ( T triphasic study of the liver, abdomen and pelvis pre and post contrast ( T of the chest, abdomen and pelvis without contrast ( T of the chest, abdomen and pelvis with contrast ( T of the chest triphasic of the liver, abdomen and pelvis with contrast ( T of the base of skull to symphysis pubis with contrast ( T colonoscopy ( Stand alone study, may not be added to any code between and MR of the abdomen ( MR of the abdomen pre and post contrast ( MR of the pelvis, soft tissue ( MR of the pelvis, soft tissue, pre and post contrast ( Nuclear Medicine study - Gastro oesophageal reflux and emptying ( Nuclear Medicine study - Gastro oesophageal reflux and emptying multiple studies ( Nuclear Medicine study - Gastro intestinal protein loss ( A A 09 Sep 2004 Page 21 of 52 Version 01.11

22 40915 Nuclear Medicine study - Gastro intestinal protein loss multiple studies ( Nuclear Medicine study Acute GIT bleed static/dynamic ( Nuclear medicine study Acute GIT bleed multiple studies ( Nuclear medicine study - Meckel's localisation ( Nuclear medicine study - Gastric mucosa imaging ( Liver, spleen, gall bladder and pancreas ode 41110, and (cholangiography include fluoroscopy (00140 may not be added X-ray ERP including screening ( X-ray ERP reporting on images done in theatre ( X-ray cholangiography intra-operative ( X-ray T-tube cholangiography post operative ( X-ray transhepatic percutaneous cholangiography ( Ultrasound study of the upper abdomen ( Ultrasound doppler of the hepatic and splenic veins and inferior vena cava in assessment of portal venous hypertension or thrombosis ode is a stand alone study and may not be added to 40200, 40210, or ( T of the abdomen triphasic study liver ( MR study of the liver/pancreas ( MR study of the liver/pancreas pre and post contrast ( MRP ( MR study of the abdomen with MRP ( MR study of the abdomen pre and post contrast with MRP ( Nuclear Medicine study - Liver and spleen, planar views only ( Nuclear Medicine study - Liver and spleen, with flow study ( Nuclear Medicine study - Liver and spleen, planar views SPET ( A A 09 Sep 2004 Page 22 of 52 Version 01.11

23 41915 Nuclear Medicine study - Liver and spleen, with flow study and SPET ( Nuclear Medicine study - Hepatobiliary system planar static/dynamic ( Nuclear Medicine study hepatobiliary tract including flow ( Nuclear medicine study Hepatobiliary system planar, static/dynamic multiple studies ( Nuclear medicine study Hepatobiliary tract including flow multiple studies ( Nuclear medicine study - Gall bladder ejection fraction ( Nuclear medicine study Biliary gastric reflux study ( Renal tract X-ray tomography of the renal tract ( ode (tomography may not be added to or (IVP. odes (IVP, (cystography, (urethography, (MU, (retrograde, and (prograde include fluoroscopy (00140 may not be added X-ray excretory urogram including tomography ( X-ray excretory urogram including tomography with micturating study ( X-ray cystography ( X-ray urethrography ( X-ray micturating cysto-urethrography ( X-ray retrograde/prograde pyelography ( X-ray retrograde/prograde pyelography reporting on images done in theatre ( X-ray prograde pyelogram percutaneous ( Ultrasound study of the renal tract including bladder ( Ultrasound doppler for resistive index in vessels of transplanted kidney ( ode is a stand alone study and may not be added to T of the renal tract for a stone ( MR of the renal tract for obstruction ( MR of the kidneys without contrast ( U A 09 Sep 2004 Page 23 of 52 Version 01.11