Governing Rules:

• 6.8.1

  HSCs with a designated category code of 1 and 15 include related post-operative services and those with a designated category code of 3, 4, 6 and 14 include both related pre-operative and post-operative services.

  1. a consultation benefit may be claimed up to and including the day of surgery.
  2. pre-operative hospital care may be claimed by the physician who performs the surgery if information is submitted to show that conservative treatment was attempted before surgery was performed.
  3. benefits may be claimed as applicable for complications occurring during or following post-operative time periods.
  4. Deleted
  5. HSC 03.04R may be claimed in the pre-operative time frame when all conditions in the notes have been met.

  The following chart gives the pre-operative and post-operative periods.

  Category	Pre-operative	Post-operative
  1	0 - Days	14 - Days
  3	7 - Days	7 - Days
  4	7 - Days	14 - Days
  6	14 - Days	14 - Days
  14	30 - Days	14 - Days
  15	0 - Days	7 - Days

• 12.7

  An additional benefit per case (modifiers L30AN, L30AT, L30AT2, L44ANE) may be claimed for anesthetic services provided to neonates and infants under 44 weeks of conceptual age. Refer to the Price List for the additional benefit amount.