Category: | 6 Major Procedure (pre-operative period: 14 days, post-operative period: 14 days) |
---|---|
Base rate: | $86.67 |
Type | Code | # of calls | Explicit | Action | Amount |
---|---|---|---|---|---|
BMI | BMIANE | Yes | Increase By | 25% | |
BMI | BMIANT | Yes | Increase By | 25% | |
BMI | BMIPRO | Yes | Increase By | 25% | |
ROLE | ANE | Yes | Replace Base | $111.05 | |
ROLE | ANEST | Yes | Replace Base | $18.70 | |
ROLE | SA | Yes | Replace Base | $148.42 | |
ROLE | SAQS | Yes | Replace Base | $51.10 | |
ROLE | SSST | Yes | Replace Base | $325.09 | |
ANU | ANU | 1 | For Each Call Pay Base At | 100% | |
ANU | ANU | 2 - 150 | For Each Call Increase By | $18.70 | |
SAU | SAU | 1 | For Each Call Pay Base At | 100% | |
SAU | SAU | 2 - 33 | For Each Call Increase By | $37.13 | |
SAQU | SAQU | 1 - 36 | For Each Call Pay Base At | 100% | |
UGA | UGA | Yes | Replace Base | $134.85 | |
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% |
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.
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 |
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 |
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