Fee Navigator®

    Health Service Code 07.53J

    Application of fibreglass cast, lower limb

    NOTE:
    1. Benefits for HSCs 07.53H and 07.53J include the cost of supplies and the application of cast (HSC 07.53B or 07.53D).
    2. When HSC 07.53H or 07.53J are performed in a nursing home, general or auxiliary hospital, AACC, UCC or a facility which has a contract with Alberta Health Services to provide the insured service for which a fibreglass cast is applied, only the rate equivalent to HSC 07.53B or 07.53D will be paid.
    3. When HSC 07.53H or 07.53J are claimed in association with fracture reduction HSCs, they will be reduced by a rate equivalent to HSC 07.53B or 07.53D.
    4. HSC 07.53H or 07.53J may not be claimed in association with HSC 07.53B or 07.53D.
    Category:M Minor Procedure
    Base rate:$55.37

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANTYesIncrease By25%
    ROLEANESTYesReplace Base$18.70
    ANUANU1For Each Call Pay Base At100%
    ANUANU2 - 150For Each Call Increase By$18.70
    SURCEVYesIncrease By$48.82
    SURCNTAMYesIncrease By$117.12
    SURCNTPMYesIncrease By$117.12
    SURCWKYesIncrease By$48.82
    LVPLVP75YesReduce Base To75%

    Governing Rules:

    • 6.1

      If a physician performs a minor procedure and provides a service warranting a claim for an office visit or a home visit on the same day, benefits for both may be claimed only if the services and diagnoses are unrelated.

    • 6.2

      If a service is provided in a hospital emergency department, AACC or UCC, only the minor procedure or the visit benefit, whichever is the greater, may be claimed, unless the problems are emergencies and the diagnoses are unrelated.

    • 6.7.1

      If a minor procedure (M or M+) is provided with a hospital visit on the same day, only the greater benefit HSC may be claimed.

    • 6.11.11

      Benefits for orthopedic services include the application of a cast when required and replacement of the cast within the 14 day post operative period.