Emergency Level Services
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- Rolf Washington
- 6 years ago
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1 Emergency Level Services <----- This set of figures is for emergency level services. DESCRIPTION OF SERVICES ABBREV.DESC. CPT RVS Suggtd RCC Code Price CF Medical And Related Services - FACILITY $110 ER VISIT, NEW OR EST. STRAIGHTFWD PER VISIT,STRT.FWD $ ER VISIT, LOW COMPLEXITY ER VISIT, LOW COMP $ ER VISIT, MODERATE COMPLEXITY, EXPAER VISIT, MOD COMP $ ER VISITMODERATE COMPLEXITY, DETA ER VISIT, MOD.COMP,DET $ ER VISIT, HIGH COMPLEXITY, MED. EMERER VISIT, HIGH COMP.,ME $ PHYSICIAN DIRECTION OF EMS SERVICEPHYS.DIR. EMS SERV CRITICAL CARE BY PHYSICIAN, 1ST HR. CRIT.CARE,1ST HR $ CRITICAL CARE BY PHYSICIAN, EA.ADDL CRIT.CARE,EA.30 MIN $ IV,INFUSION-THROMBOLYSIS, (ADD DRUGIV, THROMBOLYSIS $ INTESTINAL BLEEDING TUBE, INSERTIONINSERT. BLDG. TUBE $ GASTRIC INTUBATION, ASP/LAVAGE(POISGASTRIC. INTUB $ CONSCIOUS SEDATION, IV,IM,OR INHAL. CONSC.SED.IV,IM,INHAL $ CONSCIOUS SEDATION, ORAL RECTAL/INCONSC.SED.OS,REC.INHAL $ CARDIOPULMONARY RESUSCITATION CPR $ CARDIOVERSION CARDIOVERSION $ Abbey & Abbey, Consultants, Inc. Page 1 4/20/99
2 EKG INTERP. EKG INTERP $ RHYTHM EKG INTERP RHYTHM EKG INTERP $ VENTILATION MANAGEMENT VENT.MGMT $ PULSE OXIMETRY PULSE OX $ IPECAC ADMINISTRATION IMPECAC ADMIN $ Sugical - FACILITY INCISION&DRAINAGE ABSCESS,CYST I&D ABS,CYST $ INCISION&DRAINAGE PILONIDAL CYST,SII&D PIL.CYST,SIM $ INCISION&REMOVAL FB,SUBQ,SIMPLE I&D,REM.FB.SIMP $ INCISION&DRAINAGE,HEMATOMA,SEROMI&D,HEM,SER $ PUNCTURE ASP.ABS,HEMATOMA,CYST I&D,ABS.CYST $ DEBRIDEMENT INFECTED SKIN, 10% DEBRID,INF,SK 10% $ DEBRIDEMENT INFECTED SKIN, EA.10% DEBRID.INF,SK,EA 10% $ DEBRIDEMENT SKIN PARTIAL THICKNESSDEBRID,SK,PT $ DEBRIDEMENT SKIN FULL THICKNESS DEBRID,SK,FT $ REMOVAL SKIN TAGS UP TO 15 REM.S/TAG $ REMOVAL SKIN TAGS EA.ADDL 10 REM.S/TAG E $ EXCISION BENIGN,LES.TR.EXT. <0.5CM EXC.LES.TR.EXT.<0.5CM $ EXCISION BENIGN,LES.TR.EXT EXC.LES.TR.EXT $ EXCISION BENIGN,LES.SCH&F <0.5CM EXC.LES.SC.NK.H&F<0.5CM $ EXCISION BENIGN,LES.SC.NK.H&F EXC.LES.SC.NK.H&F $ EXCISION BENIGN,LES.SC.NK.H&F EXC.LES.SC.NK.H&F $ Abbey & Abbey, Consultants, Inc. Page 2 4/20/99
3 EXCISION BENIGN,LES.FACE <0.5 CM. EXC.LES.FACE< $ EXCISION BENIGN,LES.FACE EXC.LES.FACE $ AVULSION NAIL PLATE,PARTORCOMP S/SAVULS,NP,PT/COMP $ AVULSION NAIL PLATE,PARTORCOMP 2NAVULS,NP,PT/COMP 2ND $ AVULSION NAIL PLATE,PARTORCOMP,EAAVULS,NP,PT/COMP.EA ADDL $ EVACUATION OFSUBUNGUAL HEMATOMAEVAC.SU.HEM $ EXCISION NAIL&MATRAIX,PART OR COMPEXC.NAIL/MAT./PTORCOMP $ REPAIR OF NAIL BED RPR.NAIL BED $ WEDGE EXCISION SKIN,NAIL WEDGE EXC. SK,NAIL $ SIMPLE LAC RPR. SCALP,NK,GEN.TR.H&FS/LAC.SC.NK.GEN.TR.H&F $ SIMPLE LAC.RPR. SCALP,NK,GEN.TR.H&FS/LAC.SC.NK.EXT $ SIMPLE LAC.RPR. SCALP,NK,GEN.TR.H&FS/LAC.SC.NK,EXT $ SIMPLE LAC.RPR.FACE <2.5 CM. S/LAC FACE < $ SIMPLE LAC.RPR.FACE S/LAC.FACE $ TREATMENT OF SUPERFICIAL WOUND D TX.WD.DEHIS $ TREATMENT OF SUPERFICIAL WO EHIS.WTS.WD.DEHIS.W/P $ INT.RPR.SCALP,AX,TRUNK,EXT.2.5 CM. INT.RPR.SC.AX,TR,EXT $ INT.RPR.SCALP,AX,TRUNKT. INT.RPR.SC.AX,TR.EXT $ INT.RPR.SCALP,AX,TRUNK,EXT INT.RPR.SC.AX,TR.EXT $ INT.RPR.NK,H&F,EXT.GENITALIA <2.5 CM.INT.RPR.NK,H&F,GEN < $ INT.RPR.FACE,<2.5 CM. INT.RPR.FACE < $ Abbey & Abbey, Consultants, Inc. Page 3 4/20/99
4 INIT.TX.FIRST DEGREE BURN,LOC.TX. INIT.TX.1ST DEG.BURN $ DRESSINGS/DEBRID. INIT/SUBS.ANES.SMDR/DEB.INIT/SUBS,ANES.SM $ DRESSINGS/DEBRID.INIT/SUBS.MED.LG. DR/DEB.INIT/SUBS,MED.LG $ DRESSINGS/DEBRID.INIT/SUBS.W/O ANESDR/DEB.INIT/SUBS.W/OANES.SM $ DRESSINGS/DEBRID.INIT/SUBS.W/O ANESDR/DEB.INIT/SUBS.W/OANES.SM $ DRESSINGS/DEBRID.INIT/SUBS.W/O ANESDR/DEB.INIT/SUBS.W/OANES.SM $ DESTRUCTION LESION ANY METHOD 1STDEST.LES,1ST $ DESTRUCTION LESION ANY METHOD 2-1DEST.LES, $ DESTRUCITON LESION ANY METHOD 15 DEST.LES, > $ DESTRUC.M/LES ANY METHOD, <0TR,EXTDEST.M/LES TR,EXT,< $ DESTRUC.M/LES ANY METHOD, 0.6TR,EXTDEST.M/LES TR.EXT $ DESTRUC.M/LES SCALP,H&F <0.5CM DEST.M/LES SC.H&F < $ DESTRUC.M/LES SCALP,H&F DEST.M/LES SC.H&F $ DESTRUC.M/LES FACE <0.5 CM DEST.M/LES FACE,< $ INCISION OF SOFT TISSUE ABSCESS,SUPINC.ST ABS.,SF $ EXPLORATION OF PENETRATING WD,NECEXP.WD.NECK $ EXPLORATION OF PENETRATING WOUNDEXP.WD.CHEST $ EXPLORATION OF PENET NG WOUD.FL,BEXP.WD.TRUNK $ EXPLORATION OF PENETRATING WOUNDEXP.WD.EXT $ INJECTION TRIGGER PT.GANGLION CYSTINJ.TR.PT.GANG.CYST $ ARTHROCENTESIS ASP/INJ.SM. JOINT ASP/INJ SM.JT $ ARTHROCENTESIS ASP/INJ.MED.JOINT ASP/INJ.MED JT $ ARTHROCENTESIS ASP/INJ.LG.JOINT ASP/INJ.LG.JT $ Abbey & Abbey, Consultants, Inc. Page 4 4/20/99
5 CLOSED TX.NASAL BONE FX.W/O STAB. CL.TX.NOSE FX $ REMOVAL FB SHOULDER, SQ REM.FB.SHOUL.SQ $ CLOSED TX.CLAVICULAR FX.W/O MANIP. CL.TX.CLAV.FX $ CLOSED TX.ACROMIOCLAVICULAR FX.W CL.TX.AC JT.W/MANIP $ CLOSED TX. HUMERAL SHAFT FX.W/O MACL.TX.HUM FX $ CLOSED TX. RADIAL SHAFT FX.W/O MAN CL. RADIAL SHAFT FX W/O MAN $ CLOSED TX. RADIAL SHAFT FX.W MANIPUCL. RADIAL SHAFT FX W MAN $ CLOSED TX.ULNAR SHAFT FX. W/O MAN CL. ULNAR SHAFT FX W/O MAN $ CLOSED TX.ULNAR SHAFT FX. W MAN CL. ULNAR SHAFT FX W MAN $ CLOSED TX.FINGER/THUMB FX.W/O MANCL.TX.FING/THUM.W/O MAN $ CLOSED TX.DISTAL FINGER/THUMB FX.WCL.TX.DISTAL FING/THUM W/O MA $ CLOSED TX. TIBIAL SHAFT FX. W/O MAN CL. TX.TIBIAL SHAFT FX W/O MAN $ REMOVAL FB. FOOT, SUBCUTANEOUS REM.FB.FOOT, SQ $ CLOSED TX FX. GREAT TOE, W/O MANIP.CLSD.FX.GR.TOE W/O MAN $ CLOSED TX.FX.OTHER TOES, W/O MANIPCLSD.FX.OTHER TOES,W/O MAN $ APPLICATION OF LONG ARM SPLINT APPL.L/ARM SPL $ APPLICATION OF SHORT ARM SPLINT,STAPPL.S/ARM SPL.ST $ APPLICATION OF SHORT ARM SPLYNAMIAPPL.S/ARM SPL.DY $ APPLICATION OF FINGER SPLINT, STATICAPPL.FINGLSPL.ST $ APLICATION OF FINGER SPLINT,DYNAMICAPPL.FING.SPL.DYN $ Abbey & Abbey, Consultants, Inc. Page 5 4/20/99
6 STRAPPING,THORAX STR.THORAX $ STRAPPING,LOWBACK STR.LOWBACK $ STRAPPING SHOULDER STR.SHOULDER $ APPLICATION OF LONG LEG CAST APPL.L/LEG CAST $ APPLICATION OFSHORT LCAST APPL.S/LEG CAST $ APPLICATION OF LONG LEG SPLINT APPL.L/LEG SPL $ APPLICATION OF SHORT LEG SPLINT APPL.S/LEG SPL $ APPLICATION OF UNNA BOOT APPL.UNNA BOOT $ REMOVAL BIVALVING FULL ARMOR LEG CREM.BIVALV.ARM/LEG CAST $ WINDOWING OF CAST WINDOW CAST $ WEDGING OF CAST WEDGE CAST $ INTUBATION, ENDOTRACHEAL INTUB. ET $ LARYNGOSCOPY, INDIRECT LARYNGOSCOPY,IND $ LARYNGOSCOPY,IND.REM.FOREIGN BODLARYNG.REM.FB $ TRACHEOSTOMY, EMERGENT TRACH,EMERG $ THORACENTESIS THORACENTESIS $ THORACENTESIS WITH TUBE THORACENTESIS W/TUBE $ CHEMICAL PLEURODESIS CHEM.PLEURODESIS $ TUBE THORACOSTOMY-WATER SEAL TUBE THORACOSTOMY $ PERICARDIOCENTESIS PERICARDIOCENTESIS $ Abbey & Abbey, Consultants, Inc. Page 6 4/20/99
7 $0 INSERTION OF TEMPORARY PACEMAKERINSERT.TEMP.PACER $ INSERTION OF AORTIC BALLOON ASS.DEINSERT INTRA-AORTIC BALOON $ INTRO. NEEDLE OR INTRACATH,EXITY ARINSERT INTRACATH,EXT $ VENIPUNCTURE <3YR,FEM.JUG,SAGITAL VENI.<3YR. FEM.,JUG,SAG $ VENIPUNCTURE<3 YR,SCALP VEIN VENI.<3YR.SCALP $ VENIPUNCTURE <3YR,OTHER VEIN VENI.<3YR. OTHER $18 VENIPUNCTURE > ADULT, PHYS. SKILL VENI.ADULT,PHYS $ VENIPUNCTURE, ROUTINE VENI.ROUTINE VENIPUNCTURE, CUTDOWN <1YR. VENI.CUTDOWN < $ VENIPUNCTURE, CUTDOWN >1YR, VENI.CUTDOWN >1YR, $9 450 TRANSFUSION BLOOD OR BLOOD COMP TRANS.BLOOD $ PUSH TRANSFUSION BLOOD, 2YR OR< PUSH TRANS. 2 OR < $ PLACEMENT OF CVP LINE 2YRS. OR > CVP LINE 2YRS.OR > $ PLACEMENT OF CVP LINE PERCUT. >2YRCVP LINE PERCUT.> $ PLACEMENT OF CVP LINE, CUTDOWN,2YCVP LINE,CTDWN.2OR< $ PLACEMENT OF CVP LINE, CUTDOWN,>2CVP LINE,CTDWN >2YR $ CATH,UMBILICAL VEIN, NEWBORN CATH.UMB.VEIN,NB $ ARTERIAL PUNCTURE(ABG'S) ART.PUNC.ABG'S $ ARTERIAL CATH, PERCUTANEOUS ART.CATH PERCUT $ ARTERIAL CATH, CUTDOWN ART.CATH CTDWN $ REPAIR OF TONGUE,FLOOR OF MOUTH>RPR.TONG.MOUTH > $ DRAINAGE OF PALATE OR UVULA DRGE. PALATE OR UVULA $ Abbey & Abbey, Consultants, Inc. Page 7 4/20/99
8 REPAIR OF PALATE UP TO 2.O CM RPR. PALATE UP 2.O CM $ REPAIR OF PALATE,> 2.O OR COMPLEX RPR.PALATE >2.O CX $ ESOPHAGOSCOPY REMOVAL FOREIGN BESOPHAGOSCOPY,REM.FB $ PERITONEOCENTIS,ABD.PARACENTESIS PERITO.ABD.PARACENT $ INSERTION OF INTRAPERITONEAL CATH.INSERT.PERIT.CATH $ REMOVAL FOREIGH BODY FROM DEEP PFB REMOVAL PENIS $ REMOVAL IMPACTED VAGINAL FB, U/ANEREM.VAGINAL FB $ VAGINAL DELIVERY IN ER VAG. DELIVERY $1, PLACENTA DELIVERY IN ER PLACENTA DELIVERY $ LUMBAR PUNCTURE LP $ ENUCLEATION OF EYE (DONOR) ENUC. OF EYE,DONOR $ REMOVAL OF FOREIGN BODY< INTRAOCFB REMOVAL INTRAOCULAR $ REMOVAL OF EMBEDDED FOREIGN BODYFB REMOVAL EYELID $ EXPRESSION OF CONJUNCTIVAL FOLLICEXPRESSION CONJ FOLLICLES $ REMOVAL FOREIGN BODY FROM EXTERNFB REMOVAL EXT AUDITORY $ CERUMEN IMPACTION CER.REM $ REMOVAL FOREIGN BODY FROM EXTERNAL AUDITORY CANAL W/ANES $ Medical And Related Services - PROFESSIONAL CF $75 ER VISIT, NEW OR EST. STRAIGHTFWD PER VISIT,STRT.FWD $ ER VISIT, LOW COMPLEXITY ER VISIT, LOW COMP $ ER VISIT, MODERATE COMPLEXITY, EXPAER VISIT, MOD COMP $ Abbey & Abbey, Consultants, Inc. Page 8 4/20/99
9 ER VISITMODERATE COMPLEXITY, DETA ER VISIT, MOD.COMP,DET $ ER VISIT, HIGH COMPLEXITY, MED. EMERER VISIT, HIGH COMP.,ME $ PHYSICIAN DIRECTION OF EMS SERVICEPHYS.DIR. EMS SERV CRITICAL CARE BY PHYSICIAN, 1ST HR. CRIT.CARE,1ST HR $ CRITICAL CARE BY PHYSICIAN, EA.ADDL CRIT.CARE,EA.30 MIN $ IV,INFUSION-THROMBOLYSIS, (ADD DRUGIV, THROMBOLYSIS $ INTESTINAL BLEEDING TUBE, INSERTIONINSERT. BLDG. TUBE $ GASTRIC INTUBATION, ASP/LAVAGE(POISGASTRIC. INTUB $ CONSCIOUS SEDATION, IV,IM,OR INHAL. CONSC.SED.IV,IM,INHAL $ CONSCIOUS SEDATION, ORAL RECTAL/INCONSC.SED.OS,REC.INHAL $ CARDIOPULMONARY RESUSCITATION CPR $ CARDIOVERSION CARDIOVERSION $ EKG INTERP. EKG INTERP $ RHYTHM EKG INTERP RHYTHM EKG INTERP $ VENTILATION MANAGEMENT VENT.MGMT $ PULSE OXIMETRY PULSE OX $ IPECAC ADMINISTRATION IPECAC ADMIN $ Sugical - PROFESSIONAL INCISION&DRAINAGE ABSCESS,CYST I&D ABS,CYST $ INCISION&DRAINAGE PILONIDAL CYST,SII&D PIL.CYST,SIM $ Abbey & Abbey, Consultants, Inc. Page 9 4/20/99
10 INCISION&REMOVAL FB,SUBQ,SIMPLE I&D,REM.FB.SIMP $ INCISION&DRAINAGE,HEMATOMA,SEROMI&D,HEM,SER $ PUNCTURE ASP.ABS,HEMATOMA,CYST I&D,ABS.CYST $ DEBRIDEMENT INFECTED SKIN, 10% DEBRID,INF,SK 10% $ DEBRIDEMENT INFECTED SKIN, EA.10% DEBRID.INF,SK,EA 10% $ DEBRIDEMENT SKIN PARTIAL THICKNESSDEBRID,SK,PT $ DEBRIDEMENT SKIN FULL THICKNESS DEBRID,SK,FT $ REMOVAL SKIN TAGS UP TO 15 REM.S/TAG $ REMOVAL SKIN TAGS EA.ADDL 10 REM.S/TAG E $ EXCISION BENIGN,LES.TR.EXT. <0.5CM EXC.LES.TR.EXT.<0.5CM $ EXCISION BENIGN,LES.TR.EXT EXC.LES.TR.EXT $ EXCISION BENIGN,LES.SCH&F <0.5CM EXC.LES.SC.NK.H&F<0.5CM $ EXCISION BENIGN,LES.SC.NK.H&F EXC.LES.SC.NK.H&F $ EXCISION BENIGN,LES.SC.NK.H&F EXC.LES.SC.NK.H&F $ EXCISION BENIGN,LES.FACE <0.5 CM. EXC.LES.FACE< $ EXCISION BENIGN,LES.FACE EXC.LES.FACE $ AVULSION NAIL PLATE,PARTORCOMP S/SAVULS,NP,PT/COMP $ AVULSION NAIL PLATE,PARTORCOMP 2NAVULS,NP,PT/COMP 2ND $ AVULSION NAIL PLATE,PARTORCOMP,EAAVULS,NP,PT/COMP.EA ADDL $ EVACUATION OFSUBUNGUAL HEMATOMAEVAC.SU.HEM $ EXCISION NAIL&MATRAIX,PART OR COMPEXC.NAIL/MAT./PTORCOMP $ REPAIR OF NAIL BED RPR.NAIL BED $ WEDGE EXCISION SKIN,NAIL WEDGE EXC. SK,NAIL $ Abbey & Abbey, Consultants, Inc. Page 10 4/20/99
11 SIMPLE LAC RPR. SCALP,NK,GEN.TR.H&FS/LAC.SC.NK.GEN.TR.H&F $ SIMPLE LAC.RPR. SCALP,NK,GEN.TR.H&FS/LAC.SC.NK.EXT $ SIMPLE LAC.RPR. SCALP,NK,GEN.TR.H&FS/LAC.SC.NK,EXT $ SIMPLE LAC.RPR.FACE <2.5 CM. S/LAC FACE < $ SIMPLE LAC.RPR.FACE S/LAC.FACE $ TREATMENT OF SUPERFICIAL WOUND D TX.WD.DEHIS $ TREATMENT OF SUPERFICIAL WO EHIS.WTS.WD.DEHIS.W/P $ INT.RPR.SCALP,AX,TRUNK,EXT.2.5 CM. INT.RPR.SC.AX,TR,EXT $ INT.RPR.SCALP,AX,TRUNKT. INT.RPR.SC.AX,TR.EXT $ INT.RPR.SCALP,AX,TRUNK,EXT INT.RPR.SC.AX,TR.EXT $ INT.RPR.NK,H&F,EXT.GENITALIA <2.5 CM.INT.RPR.NK,H&F,GEN < $ INT.RPR.FACE,<2.5 CM. INT.RPR.FACE < $ INIT.TX.FIRST DEGREE BURN,LOC.TX. INIT.TX.1ST DEG.BURN $ DRESSINGS/DEBRID. INIT/SUBS.ANES.SMDR/DEB.INIT/SUBS,ANES.SM $ DRESSINGS/DEBRID.INIT/SUBS.MED.LG. DR/DEB.INIT/SUBS,MED.LG $ DRESSINGS/DEBRID.INIT/SUBS.W/O ANESDR/DEB.INIT/SUBS.W/OANES.SM $ DRESSINGS/DEBRID.INIT/SUBS.W/O ANESDR/DEB.INIT/SUBS.W/OANES.SM $ DRESSINGS/DEBRID.INIT/SUBS.W/O ANESDR/DEB.INIT/SUBS.W/OANES.SM $ DESTRUCTION LESION ANY METHOD 1STDEST.LES,1ST $ DESTRUCTION LESION ANY METHOD 2-1DEST.LES, $ DESTRUCITON LESION ANY METHOD 15 DEST.LES, > $ DESTRUC.M/LES ANY METHOD, <0TR,EXTDEST.M/LES TR,EXT,< $ Abbey & Abbey, Consultants, Inc. Page 11 4/20/99
12 DESTRUC.M/LES ANY METHOD, 0.6TR,EXTDEST.M/LES TR.EXT $ DESTRUC.M/LES SCALP,H&F <0.5CM DEST.M/LES SC.H&F < $ DESTRUC.M/LES SCALP,H&F DEST.M/LES SC.H&F $ DESTRUC.M/LES FACE <0.5 CM DEST.M/LES FACE,< $ INCISION OF SOFT TISSUE ABSCESS,SUPINC.ST ABS.,SF $ EXPLORATION OF PENETRATING WD,NECEXP.WD.NECK $1, EXPLORATION OF PENETRATING WOUNDEXP.WD.CHEST $ EXPLORATION OF PENET NG WOUD.FL,BEXP.WD.TRUNK $ EXPLORATION OF PENETRATING WOUNDEXP.WD.EXT $ INJECTION TRIGGER PT.GANGLION CYSTINJ.TR.PT.GANG.CYST $ ARTHROCENTESIS ASP/INJ.SM. JOINT ASP/INJ SM.JT $ ARTHROCENTESIS ASP/INJ.MED.JOINT ASP/INJ.MED JT $ ARTHROCENTESIS ASP/INJ.LG.JOINT ASP/INJ.LG.JT $ CLOSED TX.NASAL BONE FX.W/O STAB. CL.TX.NOSE FX $ REMOVAL FB SHOULDER, SQ REM.FB.SHOUL.SQ $ CLOSED TX.CLAVICULAR FX.W/O MANIP. CL.TX.CLAV.FX $ CLOSED TX.ACROMIOCLAVICULAR FX.W CL.TX.AC JT.W/MANIP $ CLOSED TX. HUMERAL SHAFT FX.W/O MACL.TX.HUM FX $ CLOSED TX. RADIAL SHAFT FX.W/O MAN CL. RADIAL SHAFT FX W/O MAN $ CLOSED TX. RADIAL SHAFT FX.W MANIPUCL. RADIAL SHAFT FX W MAN $ Abbey & Abbey, Consultants, Inc. Page 12 4/20/99
13 CLOSED TX.ULNAR SHAFT FX. W/O MAN CL. ULNAR SHAFT FX W/O MAN $ CLOSED TX.ULNAR SHAFT FX. W MAN CL. ULNAR SHAFT FX W MAN $ CLOSED TX.FINGER/THUMB FX.W/O MANCL.TX.FING/THUM.W/O MAN $ CLOSED TX.DISTAL FINGER/THUMB FX.WCL.TX.DISTAL FING/THUM W/O MA $ CLOSED TX. TIBIAL SHAFT FX. W/O MAN CL. TX.TIBIAL SHAFT FX W/O MAN $ REMOVAL FB. FOOT, SUBCUTANEOUS REM.FB.FOOT, SQ $ CLOSED TX FX. GREAT TOE, W/O MANIP.CLSD.FX.GR.TOE W/O MAN $ CLOSED TX.FX.OTHER TOES, W/O MANIPCLSD.FX.OTHER TOES,W/O MAN $ APPLICATION OF LONG ARM SPLINT APPL.L/ARM SPL $ APPLICATION OF SHORT ARM SPLINT,STAPPL.S/ARM SPL.ST $ APPLICATION OF SHORT ARM SPLYNAMIAPPL.S/ARM SPL.DY $ APPLICATION OF FINGER SPLINT, STATICAPPL.FINGLSPL.ST $ APLICATION OF FINGER SPLINT,DYNAMICAPPL.FING.SPL.DYN $ STRAPPING,THORAX STR.THORAX $ STRAPPING,LOWBACK STR.LOWBACK $ STRAPPING SHOULDER STR.SHOULDER $ APPLICATION OF LONG LEG CAST APPL.L/LEG CAST $ APPLICATION OFSHORT LCAST APPL.S/LEG CAST $ APPLICATION OF LONG LEG SPLINT APPL.L/LEG SPL $ APPLICATION OF SHORT LEG SPLINT APPL.S/LEG SPL $ Abbey & Abbey, Consultants, Inc. Page 13 4/20/99
14 APPLICATION OF UNNA BOOT APPL.UNNA BOOT $ REMOVAL BIVALVING FULL ARMOR LEG CREM.BIVALV.ARM/LEG CAST $ WINDOWING OF CAST WINDOW CAST $ WEDGING OF CAST WEDGE CAST $ INTUBATION, ENDOTRACHEAL INTUB. ET $ LARYNGOSCOPY, INDIRECT LARYNGOSCOPY,IND $ LARYNGOSCOPY,IND.REM.FOREIGN BODLARYNG.REM.FB $ TRACHEOSTOMY, EMERGENT TRACH,EMERG $ THORACENTESIS THORACENTESIS $ THORACENTESIS WITH TUBE THORACENTESIS W/TUBE $ CHEMICAL PLEURODESIS CHEM.PLEURODESIS $ TUBE THORACOSTOMY-WATER SEAL TUBE THORACOSTOMY $ PERICARDIOCENTESIS PERICARDIOCENTESIS $ INSERTION OF TEMPORARY PACEMAKERINSERT.TEMP.PACER $ INSERTION OF AORTIC BALLOON ASS.DEINSERT INTRA-AORTIC BALOON $1, INTRO. NEEDLE OR INTRACATH,EXITY ARINSERT INTRACATH,EXT $ VENIPUNCTURE <3YR,FEM.JUG,SAGITAL VENI.<3YR. FEM.,JUG,SAG $ VENIPUNCTURE<3 YR,SCALP VEIN VENI.<3YR.SCALP $ VENIPUNCTURE <3YR,OTHER VEIN VENI.<3YR. OTHER $ VENIPUNCTURE > ADULT, PHYS. SKILL VENI.ADULT,PHYS $ VENIPUNCTURE, ROUTINE VENI.ROUTINE VENIPUNCTURE, CUTDOWN <1YR. VENI.CUTDOWN < $ Abbey & Abbey, Consultants, Inc. Page 14 4/20/99
15 VENIPUNCTURE, CUTDOWN >1YR, VENI.CUTDOWN >1YR, $ TRANSFUSION BLOOD OR BLOOD COMP TRANS.BLOOD $ PUSH TRANSFUSION BLOOD, 2YR OR< PUSH TRANS. 2 OR < $ PLACEMENT OF CVP LINE 2YRS. OR > CVP LINE 2YRS.OR > $ PLACEMENT OF CVP LINE PERCUT. >2YRCVP LINE PERCUT.> $ PLACEMENT OF CVP LINE, CUTDOWN,2YCVP LINE,CTDWN.2OR< $ PLACEMENT OF CVP LINE, CUTDOWN,>2CVP LINE,CTDWN >2YR $ CATH,UMBILICAL VEIN, NEWBORN CATH.UMB.VEIN,NB $ ARTERIAL PUNCTURE(ABG'S) ART.PUNC.ABG'S $ ARTERIAL CATH, PERCUTANEOUS ART.CATH PERCUT $ ARTERIAL CATH, CUTDOWN ART.CATH CTDWN $ REPAIR OF TONGUE,FLOOR OF MOUTH>RPR.TONG.MOUTH > $ DRAINAGE OF PALATE OR UVULA DRGE. PALATE OR UVULA $ REPAIR OF PALATE UP TO 2.O CM RPR. PALATE UP 2.O CM $ REPAIR OF PALATE,> 2.O OR COMPLEX RPR.PALATE >2.O CX $ ESOPHAGOSCOPY REMOVAL FOREIGN BESOPHAGOSCOPY,REM.FB $ PERITONEOCENTIS,ABD.PARACENTESIS PERITO.ABD.PARACENT $ INSERTION OF INTRAPERITONEAL CATH.INSERT.PERIT.CATH $ REMOVAL FOREIGH BODY FROM DEEP PFB REMOVAL PENIS $ REMOVAL IMPACTED VAGINAL FB, U/ANEREM.VAGINAL FB $ Abbey & Abbey, Consultants, Inc. Page 15 4/20/99
16 VAGINAL DELIVERY IN ER VAG. DELIVERY $1, PLACENTA DELIVERY IN ER PLACENTA DELIVERY $ LUMBAR PUNCTURE LP $ ENUCLEATION OF EYE (DONOR) ENUC. OF EYE,DONOR $1, REMOVAL OF FOREIGN BODY< INTRAOCFB REMOVAL INTRAOCULAR $1, REMOVAL OF EMBEDDED FOREIGN BODYFB REMOVAL EYELID $ EXPRESSION OF CONJUNCTIVAL FOLLICEXPRESSION CONJ FOLLICLES $ REMOVAL FOREIGN BODY FROM EXTERNFB REMOVAL EXT AUDITORY $ CERUMEN IMPACTION CER.REM $ REMOVAL FOREIGN BODY FROM EXTERNAL AUDITORY CANAL W/ANES $ Notes: 1. This sample fee schedule is provided for educational purposes only! The actual services provided in an ED setting will vary widely. Use this information at your own risk and with appropriate understanding. 2. The relative values used are from HCFA's RBRVS either the professional component or the technical component. 3. The conversion factors used ($110 for Facility and $75 for professional) are arbitrary and can be adusted to meet any particular needs. Abbey & Abbey, Consultants, Inc. Page 16 4/20/99
GRANDVIEW/SOUTHVIEW HOSPITALS DEPARTMENT OF EMERGENCY MEDICINE DELINEATION OF CLINICAL PRIVILEGES DATE PRIVILEGES REQUESTED PHYSICIAN NAME
DATE S PHYSICIAN NAME ****************************************************************************** I request the following clinical privileges, and I am aware that a denial of privileges relating to
Procedures in the ED. MCEP Straight Talk Most $$$ ED CPT Codes (not including E&M codes) EKGs X-rays Ultrasounds.
Procedures in the ED Most $$$ ED CPT Codes (not including E&M codes) 93010 Electrocardiogram report 31500 Insert emergency airway 36556 Insert non-tunnel CV cath 92950 Heart/lung resuscitation CPR 12001
UPMC For Reference Only PHYSICIAN ASSISTANT 2014
Summary of Services and Availability (by location) UPMC Each location has sufficient space, equipment, staffing and financial resources in place or available in sufficient time as required to support each
Emergency Room Skills Checklist
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