I
CERTAIN DIAGNOSTIC AND THERAPEUTIC PROCEDURES
II
OPERATIONS ON THE NERVOUS SYSTEM
III
OPERATIONS ON THE ENDOCRINE SYSTEM
IV
OPERATIONS ON THE EYES
V
OPERATIONS ON THE EARS
VI
OPERATIONS ON THE NOSE, MOUTH,AND PHARYNX
VII
OPERATIONS ON THE RESPIRATORY SYSTEM
VIII
OPERATIONS ON THE CARDIOVASCULAR SYSTEM
IX
OPERATIONS ON THE HEMIC AND LYMPHATIC SYSTEMS
X
OPERATIONS ON THE DIGESTIVE SYSTEM AND ABDOMINAL REGION
XI
OPERATIONS ON THE URINARY TRACT
XII
OPERATIONS ON THE MALE GENITAL ORGANS
XV
OPERATIONS ON THE MUSCULOSKELETAL SYSTEM
XVI
OPERATIONS ON THE BREAST
XVII
OPERATIONS ON SKIN AND SUBCUTANEOUS TISSUE
XVIII
PROCEDURES NOT ELSEWHERE CLASSIFIED
LABORATORY AND PATHOLOGY
DIAGNOSTIC RADIOLOGY
NOTE: 1. As stated in G.R. 11.1.1, claims for services in the Diagnostic Radiology section will not be payable unless the physician has been approved by the CPSA to provide those services. 2. An additional 30% of the benefit applies to patients 12 years of age and younger, for some diagnostic radiology HSCs. Refer to Price List.
- DIAGNOSTIC IMAGING
- ANGIOGRAPHY
  NOTE: If cine, video or automatic rapid film changer are used, add 50%, refer to Price List.
- NUCLEAR MEDICINE
- DIAGNOSTIC ULTRASOUND
  NOTE: 1. An additional 30% of the benefit applies to patients 12 years of age and younger, except for HSCs X325, X326 and X327. 2. Ultrasound benefits include Doppler colour mapping. 3. Quantitative spectral analysis with directional flow and/or Doppler measurements (HSC X337) may be claimed in addition to ultrasound services except for HSCs X304, X306A, X306B, X323, X331, X332 and X333. 4. Where notes indicate HSCs may not be claimed in addition to X301-X338, this refers to being claimed by the same or different physician in the same location on the same day.
THERAPEUTIC RADIOLOGY

Health Service Code X 28

Sternum and/or sterno-clavicular joint

Additional notes:

Listed under - DIAGNOSTIC RADIOLOGY:
1. As stated in G.R. 11.1.1, claims for services in the Diagnostic Radiology section will not be payable unless the physician has been approved by the CPSA to provide those services.
2. An additional 30% of the benefit applies to patients 12 years of age and younger, for some diagnostic radiology HSCs. Refer to Price List.

Category:	T Test
Base rate:	$41.34

Fee modifiers:

Type	Code	# of calls	Explicit	Action	Amount
AGE	L13			Increase Base To	130%
CALL	CALL13	1		For Each Call Pay Base At	130%
CALL	CALL13	2 - 2		For Each Call Pay Base At	65%
CALL	NBRSER	1		For Each Call Pay Base At	100%
CALL	NBRSER	2 - 2		For Each Call Pay Base At	50%
XRAY	CINE		Yes	Increase Base To	150%
XRAY	STEREO		Yes	Increase By	$17.62

Governing Rules:

No Governing Rules.

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Health Service Codes

Health Service Code X 28

Sternum and/or sterno-clavicular joint

Additional notes:

Fee modifiers:

Governing Rules:

Fee Navigator®

Health Service Codes

Health Service Code X 28

Sternum and/or sterno-clavicular joint

Additional notes:

Fee modifiers:

Governing Rules:

Fee Navigator^®