PART III IN HOSPITAL ON CALL ANESTHESIA COVERAGE

Transcription

1 Anesthesia g) A consultation may not be claimed where the patient is referred to the anesthetist for the sole purpose of providing post-operative Patient Controlled Analgesia. h) Tariff 8406 may not be claimed on the same day as a consultation. 16. REQUIREMENT FOR SECOND ANESTHETIST a) Where clinical circumstances necessitate the attendance of a second anesthetist, such anesthetist shall be remunerated at seventy percent (70%) of the total anesthetic remuneration payable to the first anesthetist. b) Where one anesthetist commences an anesthetic service and is replaced by another anesthetist during the provision of the anesthetic services, the total remuneration shall not exceed the amount payable had the one anesthetist completed the anesthetic service. PART III IN HOSPITAL ON CALL ANESTHESIA COVERAGE Where an anesthetist provides In-Hospital On-Call Anesthesia Coverage remuneration shall be in accordance with this Part. 17. SITES AND SERVICES a) One anesthetist per site is required to provide twenty-four (24) hour per day In-Hospital On-Call Anesthetic Coverage at the following sites and services: Tariff Site Service Benefits [per fifteen (15) minute period or portion thereof] 8201 St. Boniface General Hospital Obstetrics Brandon Regional Health Centre Obstetrics and Emergency Surgery Health Sciences Centre Obstetrics Health Sciences Centre Emergency Surgery b) Where an anesthetist is required to provide In-Hospital On-Call Anesthetic Coverage at the following site and service. Tariff Site Service Benefits [per fifteen (15) minute period or portion thereof] 8205 St. Boniface General Hospital Emergency Surgery Grace Hospital Emergency Surgery ANESTHETIC SERVICES a) In-Hospital On-Call Anesthesia Coverage is time based and shall be calculated in fifteen (15) minute periods or portion thereof. b) Where an anesthetist providing coverage under Part III at Brandon Regional Health Centre, Grace Hospital, Health Sciences Centre or St. Boniface General Hospital is required to provide anesthetic services other than obstetrical procedures listed in Rule of Application for Anesthesia 19 a), such anesthetist shall be remunerated in accordance with Rule of Application for Anesthesia Services 20. C-10 April 1, 2012

2 SPINE ANTERIOR AND POSTERIOR PROCEDURES When anterior and posterior spinal procedures are performed on the same day, same anesthetic, the higher fee is payable at 100% and the lesser fee is payable at 85%. Notwithstanding that the lesser fee is payable at 85%, all procedures that include the word add are to be paid at 100%. SPINE APPROACH 1230 Trans abdominal or retroperitoneal approach to spine Benefit payable when spinal surgical service(s) is performed by a different surgeon. ANTERIOR INSTRUMENTATION Cervical C2-C two (2) vertebrae... 1, add on per additional vertebra Cervico-Thoracic C7-T two (2) vertebrae... 1, add on per additional vertebra Dorsal 0645 Anterior Instrumentation of Spine and/or Osteotomy, via chest via abdomen... 1, via chest and abdomen... 1, DECOMPRESSION Cervical-Thoracic-Lumbar 5203 Intervertebral discs, excision anterior approach, cervical... 1, Laminectomy laminae only for decompression of the spinal cord and nerve roots unilateral first level ~5200 bilateral, first level Laminectomy for lesion, laminae only for decompression of spinal cord or meninges unilateral first level ~5204 bilateral, first level... 1, each additional vertebral level (unilateral or bilateral) add to 5205, ~5200, 5207 or ~ Laminotomy, cervical F-6 April 1, 2012

3 1074 Excision of lumbar intervertebral disc, one (1), all methods, any approach e.g. minimally invasive, includes all associated bone and soft tissue procedures e.g. laminotomy, foraminotomy, laminectomy, facetectomy, fat graft, microscope, fluoroscopy more than one (1)... 1, Vertebrectomy including disc and adjacent end plates, add... 1, per additional vertebra, add Total disc excision with end plates for fusion or disc replacement, add per additional vertebra, add Partial vertebrectomy, add Posteriolateral decompressions of the vertebral body must include lamina, and complete laminectomy and a portion of facets, pedicles, unilateral first level, add bilateral, first level, add... 1, ~1220 each additional vertebral level unilateral or bilateral, add to 1114 or FUSION-CERVICAL POSTERIOR FUSION 1116 Occipito-cervical fusion (includes wires, screws and graft when necessary)... 1, add on per vertebra below C C1-C2 fusion wires and graft C1-C2 fusion including transarticular screws and wires... 1, add on flat bone graft CERVICO-THORACIC-LUMBAR 0636 Spine, two (2) vertebrae, (e.g. lumbo-sacral) three (3) to five (5) vertebrae More than five (5) vertebrae... 1, Posterior or Posteriolateral fusion with instrumentation including pedicle screws, two (2) vertebrae... 1, add on per additional vertebra add on per Sacral vertebra (maximum per patient $3,000.00) ALIF OR PLIF Alif-(anteriorlumbar interbody fusion) Plif-(posteriorlumbar interbody fusion) 1124 Vertebra Replacement with autogenous or allograft bone, cement, tri-cortical bone and/or cage per vertebra, add ~1219 Partial vertebral replacement with autogenous or allograft bone, cement, tricortical bone and/or cage per vertebra, add April 1, 2012 F-7

4 1126 Intervertebral disc replacement any type for radical disc excision tricortical strut graft, autograft, allograft, bone cement prosthetic with or without cage, per vertebra, add Artificial disc insertion each additional level replaced, add Anterior Release includes discectomy and section of longitudinal ligament including open or thoroscopic approach, through posterior or posteriolateral approach 1128 one (1) intervertebral disc space two (2) three (3) intervertebral disc spaces... 1, four (4) six (6) intervertebral disc spaces... 2, Greater than six (6) intervertebral disc spaces (per disc space) (maximum per patient including fusion $3,000.00), add Fusion with anterior release with morsellized non-structural bone graft per intervertebral disc space, add BONE GRAFT Procurement and application of graft from remote site ~1100 Morsellized bone graft (allograft, not synthetic bone graft), to one or more sites, add Onlay graft for posterior lateral fusion, add MISCELLANEOUS 1134 Laminoplasty add on per additional vertebra Odontoidectomy, transoral with microscope... 1, Open Vertebroplasty, posterior approach with augmentation of bone with autograft, bone cement or bone substitute... 1, Odontoid fracture open reduction and interior fixation with screw... 1, Multi vertebral level saucerization of spinal wound with re-opening of the initial incision down to the spine for major infection, drainage of hematoma, including debridement, add ) Where required, re-instrumentation may be claimed in addition to Tariff ) Payable in the post operative period Intra-operative ultrasound, add MEP/SSEP electro-physiological monitoring, primary spine surgeon, add MEP/SSEP electro-physiological monitoring, non-operating physician per hour or major portion F-8 April 1, 2012

5 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 Cadaver nephrectomy double for local implants or export Live donor nephrectomy ~5881 Laparoscopic live donor nephrectomy... 1, Rejection transplant nephrectomy 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 5898 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 Recipient related services; including nephrological management of transplantation including examination. Supervision of osmotic loading, tissue typing, and interpretation of cytotoxicity tests, timing of initial suppression and detention in the operative theatre and complete patient care for the first three (3) days 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 Dialysis without rejection crises, care equivalent to that for chronic renal failure on repeat hemodialysis, per dialysis See existing schedule The above fees represent the total fees for those Nephrologists directly involved with the transplant and will be divided amongst them according to the involvement of each. April 1, 2012 P-1