Common terms: |
|
---|---|
Category: | M Minor Procedure |
Base rate: | $49.37 |
Please note, ear syringing / wax removal is billed as a visit +/- complex modifier. Ear wax is not considered a foreign body. The total physician time spent delivering the visit service may be included in the total time for the visit and can be included in the complex modifier calculation. If the physician examines the patient and the nurse (or other qualified staff) provide the ear syringing service, the nurses time may not be included in the total time for the visit or the complex modifier calculation.
Type | Code | # of calls | Explicit | Action | Amount |
---|---|---|---|---|---|
BMI | BMIANE | Yes | Increase By | 25% | |
BMI | BMIANT | Yes | Increase By | 25% | |
ROLE | ANE | Yes | Replace Base | $112.29 | |
ROLE | ANEST | Yes | Replace Base | $18.70 | |
ANU | ANU | 1 | For Each Call Pay Base At | 100% | |
ANU | ANU | 2 - 150 | For Each Call Increase By | $18.70 | |
UGA | UGA | Yes | Replace Base | $134.85 | |
TRAY | MINT | Increase By | $13.14 | ||
NBTR | NBTR | Yes | |||
SURC | EV | Yes | Increase By | $48.82 | |
SURC | NTAM | Yes | Increase By | $117.12 | |
SURC | NTPM | Yes | Increase By | $117.12 | |
SURC | WK | Yes | Increase By | $48.82 | |
LVP | LVP75 | Yes | Reduce Base To | 75% |
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.
Where a procedure is performed under general anesthesia, the following applies:
01.01A | 01.01B | 01.03 | 01.09 | 01.24A | 01.24B |
01.24BA | 01.24BB | 02.84B | 03.22A | 03.22B | 03.25 |
07.29A | 07.57A |
10.23 | 10.25 | 11.71A | 11.81A | 12.01 | 12.21 |
12.24 | 12.31 | 13.59L | 13.59N | 13.59O | 13.99BB |
14.09A | 17.39E | 17.81A | 19.81 |
21.41 | 21.42 | 21.69A | 21.69C | 22.13B | 22.13C |
22.5 A | 22.81 | 24.22A | 24.5 | 25.1 A | 26.91A |
28.8 A |
30.19A | 30.19B | 30.9 A | 32.01A | 32.1 | 32.21A |
32.23A | 32.39A | 33.22A | 33.22B | 33.51A | 33.51B |
33.61A | 34.0 A | 34.1 A | 34.89A | 35.0 A | 37.81 |
37.82A | 38.0 A | 38.89A | 39.21A | 39.62A | 39.83A |
40.5 | 40.92A | 43.95A | 45.81A | 45.83 | 45.84A |
46.04B | 46.09B | 46.09C | 46.84A | 49.0 | 49.82B |
49.83A |
50.4 A | 50.94D | 50.94E | 50.94F | 50.97A | 51.43 |
51.53A | 52.1 A | 53.81B | 53.83A | 54.92D | 58.99F |
60.82C | 61.01A | 61.29B | 61.37A | 61.39B | 62.81A |
64.95A | 66.82A | 67.81 | 67.86 | 67.96A | 68.1 |
68.32B | 69.13D | 69.29A | 69.83A | 69.83B |
70.1 | 70.2 A | 70.2 B | 70.2 H | 70.4 F | |
70.5 A | 72.91 | 74.82A | 76.91A | 78.7 A | 79.29E |
80.83B | 80.85B | 81.8 | 81.96 | 82.12A | 82.12B |
82.12C | 82.14D | 82.81A | 82.91A | 83.7 A | 87.6 |
87.72A | 87.82 | 87.89A | 87.89B | 87.91 | 87.92 |
88.92 | 89.59A |
97.81 | 97.96 | 98.03A | 98.04A | 98.12A | 98.12B |
98.12C | 98.12E | 98.12G | 98.12H | 98.12J | 98.12K |
98.12M | 98.12N | 98.12Q | 98.12R | 98.22A | 98.49A |
98.6 A | 98.6 C | 98.81A | 98.93A | 98.93B | 98.96A |
98.96B | 98.96C | 98.96D | 98.98B |
Benefits may not be claimed for procedures that do not routinely require the services of a surgical assistant or a 2nd surgeon for a 2nd surgical team, unless supporting information detailing unusual circumstances satisfactory to the Minister is provided. Such procedures include but are not limited to the following list:
01.01A | 01.01B | 01.03 | 01.04A | 01.05A | 01.09 |
01.12B | 01.14 | 01.16B | 01.16C | 01.22 | 01.22A |
01.22B | 01.22C | 01.24A | 01.24B | 01.24BA | 01.24BB |
01.32 | 01.34 | 02.84A | 02.84B |
06.35A | 06.35B | 06.39A | 06.39B | 07.09A | 07.27A |
07.27B | 07.29A | 07.29B | 07.51A | 07.51C | 07.53A |
07.53B | 07.53C | 07.53D | 07.53E | 07.54A | 07.56A |
07.57A | 07.57B | 09.01A | 09.01B | 09.01C | 09.01F |
09.05A | 09.06A | 09.07C | 09.11A | 09.12A | 09.26A |
09.49A |
15.93A | 15.93B | 15.93C | 15.94A | 15.99A | 16.2 B |
16.81A | 16.83A | 16.83B | 16.83C | 16.89A | 16.92A |
17.03A | 17.08D | 17.08E | 17.08K | 17.1 A | 17.39E |
17.71A | 17.81A | 17.89A | 18.29A | 18.29B | 19.81 |
40.0 | 40.1 A | 40.5 | 40.92A | 41.29A | 41.29B |
42.09A | 42.09B | 43.1 B | 43.81 | 43.82 | 43.95A |
43.96A | 43.96B | 43.96C | 43.96D | 43.96E | 44.01 |
44.22A | 45.81A | 45.83 | 45.84A | 45.88A |
52.1 A | 52.85A | 53.42A | 53.81A | 53.81B | 53.83A |
54.21B | 54.21C | 54.21D | 54.21E | 54.89A | 54.89B |
54.89D | 54.89E | 54.89F | 54.91A | 54.92A | 54.92B |
54.92C | 54.92D | 54.92E | 55.41A | 55.41B | 56.34A |
56.93B | 57.21A | 57.92A | 58.99B |
70.1 | 70.2 A | 70.2 B | 70.2 H | 70.4 F | 70.4 G |
70.5 A | 70.5 B | 71.8 | 71.95 | 71.96A | 72.1 C |
72.91 | 73.2 A | 73.91 | 74.82A | 75.64 | 75.83A |
76.0 | 76.1 A | 76.89A | 76.91A | 78.7 A | 79.22 |
79.23A | 79.29C | 79.29E |
80.81 | 80.83B | 80.85A | 80.85B | 81.01D | 81.09 |
81.8 | 81.91A | 81.96 | 82.12A | 82.12B | 82.12C |
82.81A | 82.91A | 83.09A | 83.2 B | 83.7 A | 84.21D |
85.5 A | 87.3 | 87.53A | 87.54A | 87.54B | 87.55A |
87.6 | 87.99A | 87.99AA | 88.02A | 88.92 | 89.98A |
91.00A | 91.01A | 91.01B | 91.01H | 91.01J | 91.02A |
91.02C | 91.02D | 91.03A | 91.03B | 91.04A | 91.04B |
91.05A | 91.06B | 91.06D | 91.06E | 91.07A | 91.08B |
91.08J | 91.12A | 91.13A | 91.72 | 91.73A | 91.73B |
91.77C | 91.78B | 91.78C |
92.70 | 92.71 | 92.72 | 92.74 | 92.75 | 92.76 |
92.78A | 92.78B | 92.78C | 93.91A | 93.91B | 95.03 |
95.81A | 95.93 | 95.96A | 96.01A | 96.01B | 96.02A |
96.02B | 96.11A | 97.81 | 97.83A | 97.89A | 97.89B |
97.96 |
A minor tray service benefit may be claimed for the following procedures only when they are performed in a location other than a nursing home, general or auxiliary hospital, AACC, UCC or a facility which has a contract with a regional health authority to provide any of these insured services.
07.53C | 07.56A | 07.57B | 10.16A | 11.23A | 12.01 |
12.21 | 13.53B | 13.59E | 13.59F | 13.59H | 13.59J |
13.59K | 13.59L | 13.59N | 13.99BB 16.89B | 16.89C | |
16.89D | 17.71A | 17.71B | 18.29E | 18.29EA 19.81 |
21.31A | 21.41 | 21.32D | 21.69C | 23.99D | 24.91 |
30.19A | 32.96A | 32.96B | 33.01A | 33.03A | 33.21A |
33.22A | 33.61A | 35.0 A | 37.81 | 37.91A | 38.0 A |
39.91B |
43.0 B | 50.98A | 51.92A | 53.81B |
61.01A | 67.93 | 70.5 B | 71.95 | 73.91 | 78.7 A |
79.22 |
80.83B | 81.8 | 93.91A | 93.91B | 94.01B | 94.04 |
95.03 | 95.93 | 95.94A | 95.94B | 95.96A | 97.81 |
97.89A | 98.01A | 98.03A | 98.03B | 98.03C | 98.03E |
98.04B | 98.04C | 98.12K | 98.12S |
If multiple procedures listed under GRs 14.1 and 14.2 are performed during the same encounter in a location other than a nursing home, general or auxiliary hospital, AACC, UCC or a facility which has a contract with a regional health authority to provide any of these insured services, the following applies:
For the same anatomical area (example - 3 moles removed from the face), only one tray may be claimed except when the condition relates to suspected cancer or infection, in which case, if required, additional tray(s) may be claimed at 50%.
For different anatomical areas, the tray for the initial procedure may be claimed at 100% and if required, the tray for each additional procedure may be claimed at 50%.
Benefits for additional trays may not exceed the benefit listed for one major tray.
Disclaimer: this tool has been produced by the AMA solely as a convenient reference and the official Government of Alberta statutes and regulations must be consulted for all purposes of interpreting and applying the law. © Alberta Medical Association 2024 | Privacy Policy