Category: | 14 Major Procedure (pre-operative period: 30 days, post-operative period: 14 days) |
---|---|
Base rate: | $291.30 |
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 | $112.39 | |
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 | |
VANE | L30AN | Increase By | $110.16 | ||
VANE | L30AT | Increase By | $110.16 | ||
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% | |
RECO | CMPRSC | Yes | Increase Base To | 125% | |
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 | |
LMTS | L44ANE | Yes | Increase Base By | $110.16 | |
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 |
Functional area includes the following anatomical areas: Head, face, neck, shoulder, axilla, elbow, wrist, hand, groin, perineum, hip, knee, ankle, foot, and includes coverage of exposed vital structures (bone, tendon, major vessel, nerve). Paired structures would be claimed as two separate areas, e.g., right and left wrist would be claimed as two separate areas.
The Body Mass Index (BMI) modifier may be claimed for selected procedures, obstetrical services, anesthesia, second qualified surgeon and surgical assistant services provided in any location when the following criteria are met:
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