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Doctors Gazette 2022

Part lll : Procedures

14. Nervous System

 

 

 

Specialist

General Practitioner

Anaesthetic

U

R

U

R

U

R          T/M

14.1

Diagnostic procedures

 

 

 

 

 

 

2685

Electro-oculography: Unilateral

30

851.10

 

 

 

 

2686

Electro-oculography: Bilateral

53

1 503.61

 

 

 

 

2708

Evaluation of cognitive evoked potential with visual or audiology stimulus

80

2 269.60

 

 

 

 

2709

Full spinogram including bilateral median and posterior-tibial studies

140

3 971.80

 

 

 

 

2711

Electro- encephalogram (EEG): 20-40 minutes record:Equipment cost for taking of record (Technical component)(refer to item 2712 for interpretation and report)

105.60

2 995.87

105.60

2 995.87

 

 

2712

Clinical interpretation and report of item 2711: Electroencephalogram (EEG): 20-40 minutes record (Professional component)

16.60

470.94

16.60

470.94

 

 

2713

Spinal (lumbar) puncture. For diagnosis, for drainage of spinal fluid or for therapeutic indications

18.4

522.01

18.4

522.01

 

 

2714

Cisternal or lateral cervical (C1-C2) puncture: Without injection - stand -alone procedure

32

907.84

32

907.84

 

 

2735

Air encephalography and posterior fossa tomography: Posterior fossa tomography attendance by clinician

31.50

893.66

 

 

 

 

2737

Air encephalography and posterior fossa tomography: Visual field charting on Bjerrum Screen

7

198.59

7

198.59

 

 

2739

Ventricular needling without burring: Tapping only

16

453.92

16

453.92

4

530.24 +T

2741

Ventricular needling without burring: Plus introduction of air and/or contrast dye for ventriculography

43

1 219.91

43

1 219.91

4

530.24 +T

2743

Subdural tapping: First sitting

15

425.55

15

425.55

4

530.24 +T

 

 

 

 

 

 

 

 

14.2

Introduction of burr holes for

 

 

 

 

 

 

2747

Burr hole(s): Ventricular puncture. Includes injection of gas, contrast media, dye or radioactive material

223.80

6 349.21

179.04

5 079.36

8

1060.48 +T

2749

Catheterisation for ventriculography and/or drainage

150

4 255.50

120

3 404.40

8

1060.48 +T

2752

Twist drill hole(s): Includes subdural, intracerebral or ventricular puncture for evacuation and/or drainage of subdural haematoma

272.20

7 722.31

217.76

6 177.85

9

1193.04 +T

2753

Burr hole(s). Includes evacuation and/or drainage of haematoma: Extradural or subdural

379.40

10 763.58

303.52

8 610.86

9

1193.04 +T

2754

Burr hole(s) or trephine: Includes subsequent tapping (aspiration) of intracranial abscess

296.40

8 408.87

237.12

6 727.09

9

1193.04 +T

2755

Burr hole(s): Includes aspiration of haematoma or cyst, intracerebral (total procedure)

369.90

10 494.06

295.92

8 395.25

9

1193.04 +T

2757

Burr hole(s) or trephine: Includes drainage of brain abscess or cyst (total procedure)

402.80

11 427.44

322.24

9 141.95

9

1193.04 +T

2760

Burr hole(s) or trephine: Supratentorial, exploratory, not followed by other surgery

255.90

7 259.88

204.72

5 807.91

9

1193.04 +T

2761

Burr hole(s) or trephine: Infratentorial, unilateral or bilateral

Use once per service

218.90

6 210.19

175.12

4 968.15

9

1193.04 +T

 

 

 

 

 

 

 

 

14.3

Nerve procedures

 

 

 

 

 

 

2765

Nerve conduction studies (see items 0733 and 3285)

26

737.62

26

737.62

4

530.24 +T

14.3.1

Nerve repair of suture

 

 

 

 

 

 

2767

Suture Brachial Plexos (see also items 2837 and 2839)

379

10 752.23

303.20

8 601.78

6

795.36 +T

2769

Suture: Large nerve: Primary

297.70

8 445.75

238.16

6 756.60

5

662.80 +T

2771

Suture: Large nerve: Secondary

202

5 730.74

161.60

4 584.59

5

662.80+T

2773

Suture: Digital nerve: Primary

199

5 645.63

159.20

4 516.50

3

397.68 +T

2775

Suture: Digital nerve: Secondary

96

2 723.52

96

2 723.52

3

397.68 +T

2777

Nerve graft: Simple

309

8 766.33

247.20

7 013.06

4

530.24 +T

2779

Fascicular: First fasciculus

202

5 730.74

161.6

4 584.59

4

530.24 +T

2781

Fascicular: Each additional fasciculus

50

1 418.50

50

1 418.50

4

530.24 +T

2782

Nerve pedicle transfer: First stage (not to be used together with item 2783)

309.10

8 769.17

247.28

7 015.33

4

530.24 +T

2783

Fascicular: Nerve flap: To include all stages

224

6 354.88

179.2

5 083.90

4

530.24 +T

2784

Nerve pedicle transfer: Second stage (not to be used together with item 2783)

338.30

9 597.57

270.64

7 678.06

4

530.24 +T

2785

Fascicular: Facio-accessory or facio-hypoglossal anastomosis

124

3 517.88

120

3 404.40

6

795.36 +T

2787

Fascicular: Grafting of facial nerve

215

6 099.55

172

4 879.64

5

662.80 +T

 

 

 

 

 

 

 

 

14.3.2

Neurectomy

 

 

 

 

 

 

2795

Procedures for pain relief: Paravertebral facet joint nerve: Destruction by neurolytic agent, lumbar spine/sacral, one level (unilateral or bilateral)

45.4

1 288.00

45.4

1 288.00

5

662.80 +T

2796

Procedures for pain relief: Paravertebral facet joint nerve: Destruction by neurolytic agent, lumbar spine/sacral, each additional level each additional level (unilateral or bilateral)

+    16.3

462.43

16.3

462.43

5

662.80 +T

2797

Procedures for pain relef: Paravertebral facet joint nerve: Destruction by neurolytic agent, cervica/thoracic, one level (unilateral or bilateral)

44

1 248.28

44

1 248.28

5

662.80 +T

2798

Procedures for pain relief: Paravertebral facet joint nerve: Destruction by neurolytic agent, cervica/thoracic, each additional level (unilateral or bilateral)

+       15

425.55

15

425.55

5

662.80 +T

2799

Intrathecal injections for pain

36

1 021.32

36

1 021.32

4

530.24 +T

2800

Plexus nerve block - as part of treatment refer to annexure C on the back of this gazette (motivation to be supplied by treating doctor)

36

1 021.32

36

1 021.32

 

Fees as for specialist

2801

Epidural injection, plexus nerve block or peripheral nerve block for pain refer to annexure C on the back of this gazette, motivation to be supplied by treating doctor (see modifier 0045 for post-operative pain relief) (refer to modifier 0021 for epidural anaesthetic)

36

1 021.32

36

1 021.32

 

Fees as for specialist

2802

Peripheral nerve block - as part of treatment (motivation to be supplied)

25

709.25

25

709.25

 

Fees as for specialist

2803

Alcohol injection in peripheral nerves for pain: Unilateral

20

567.40

20

567.40

3

397.68 +T

2804

Inserting an indwelling nerve catheter (includes removal of catheter) (not for bolus technique) To be used only with items 2799, 2800, 2801 or 2802

+ 10

283.70

10

283.70

 

Fees as for specialist

2805

Alcohol injection in peripheral nerves for pain: Bilateral

35

992.95

35

992.95

3

397.68 +T

2809

Peripheral nerve section for pain

45

1 276.65

45

1 276.65

3

397.68 +T

2913

Obturator or Stoffels

96

2 723.52

96

2 723.52

3

397.68 +T

2815

Excision interdigital neuroma - Morton

82.3

2 334.85

82.3

2 334.85

3

397.68 +T

 

 

 

 

 

 

 

 

14.3.3

Other nerve procedures

 

 

 

 

 

 

2827

Transposition of ulnar nerve

170

4 822.90

136

3 858.32

3

397.68 +T

2829

Neurolysis: Minor

51

1 446.87

51

1 446.87

3

397.68 +T

2831

Neurolysis: Major

141

4 000.17

120

3 404.40

3

397.68 +T

2833

Neurolysis: Digital

141

4 000.17

120

3 404.40

3

397.68 +T

2837

Brachial plexus, suture or neurolysis (item 2767)

300

8 511.00

240

6 808.80

6

795.36 +T

2839

Total brachial plexus exposure with graft, neurolysis and transplantation

895.2

25 396.82

716.16

20 317.46

6

795.36 +T

2849

Sympathetic block Other levels: Unilateral

20

567.40

20

567.40

3

397.68 +T

2851

Sympathetic block: Other levels: Bilateral

35

992.95

35

992.95

3

397.68 +T

 

 

 

 

 

 

 

 

14.4

Skull procedures

 

 

 

 

 

 

2859

Depressed skull fracture: Elevation of fracture, compound or comminuted, extradural (total procedure)

377.90

10 721.02

302.32

8 576.82

9

1 193.04 +T

2860

Depressed skull fracture: Elevation of fracture, simple,  extradural (total procedure)

307.10

8 712.43

245.68

6 969.94

9

1 193.04 +T

2862

Depressed skull fracture: Elevation of fracture with repair of dura and/or debridement of brain (total procedure)

455.10

12 911.19

364.08

10 328.95

11

1 458.16 +T

2863

Cranioplasty: Skull defect = <5 cm diameter: With/without prosthesis

309.10

8 769.17

247.28

7 015.33

9

1 193.04 +T

2875

Theco-peritorteal C.S.F. shunt

280

7 943.60

224

6 354.88

8

1 060.48 +T

6043

Cranioplasty: Skull defect: >5 cm diameter

340.80

9 668.50

272.64

7 734.80

9

1 193.04 +T

6044

Removal of bone flap or prosthetic plate of skull: For malignancy/acquired deformity of head/infection or inflammatory reaction due to device, implant and/or graft

264.90

7 515.21

211.92

6 012.17

9

1 193.04 +T

6045

Replacement of bone flap or prosthetic plate of skull: For malignancy/acquired deformity of head/open fracture/late effect of fracture/infection or inflammatory reaction due to device, implant and/or graft (total procedure)

311.40

8 834.42

249.12

7 067.53

9

1 193.04 +T

6046

Cranioplasty: Skull defect, with reparative brain surgery: with/without prosthesis

Cannot be used with items 6047 to 6048

421.70

11 963.63

337.36

9 570.90

11

1 458.16 +T

6047

Cranioplasty: Includes autograft and obtaining bone grafts: =<5 cm diameter (total procedure)

Cannot be used with items 6046 and 6048

371.40

10.536.62

297.12

8 429.29

9

1 193.04 +T

6048

Cranioplasty: Includes autograft and obtaining bone grafts: >5 cm diameter (total procedure)

Cannot be used with items 6046 to 6047

432.70

12 275.70

346.16

9 820.56

9

1 193.04 +T

6049

Incision and retrieval: Cranial bone graft for cranioplasty, subcutaneous. ADD to primary procedure 6046 to 6048

37.30

1 058.20

37.30

1 058.20

 

+T

6061

Creationk of subarachnoid/subdural-peritoneal shunt: Pleural or peritoneal space or other terminus, through burr hole and directing and tunneling the distal end of the shunt subcutaneously towards the draining site (non-neuroendoscopic procedure) (total procedure)

290.80

8 250.00

232.64

6 600.00

10

1 325.60 +T

6062

Replacement or irrigation: Subarachnoid or subdural catheter, non-neuroendoscopic procedure (total procedure)

111.40

3 160.42

111.40

3 160.42

10

1 325.60 +T

6063

Ventriculocisternostomy of the third ventricle: Stereotactic, neuroendoscopic method (under CT guidance for stereotactic positioning) (items 6055 and 6148 may not be added)

358.80

10 179.16

287.04

8 143.32

10

1 325.60 +T

6064

Replacement/irrigation: Previously placed intraoperative ventricular catheter

158.30

4 490.97

126.64

3 592.78

10

1 325.60 +T

6065

Replacement/revision: Cerebrospinal fluid (CSF) shunt/obstructed valve/distal catheter in shunt system

252.30

7 157.75

201.84

5 726.20

10

1 325.60 +T

6066

Reprogramming of programmable cerebrospinal shunt, at the time of a routine office visit

26.00

737.62

26.00

737.62

10

1 325.60 +T

6067

Removal: Complete cerebrospinal fluid shunt system only (non-neuroendoscopic procedure)

180.00

5 106.60

144.00

4 085.28

10

1 325.60 +T

6068

Cerebrospinal fluid (CSF) shunt system: Complete removal, with replacement by similar or other shunt at same operation

335.50

9 518.14

268.40

7 614.51

10

1 325.60 +T

 

 

 

 

 

 

 

 

14.6

Shunt procedures and neuroendoscopy

 

 

 

 

 

 

2869

Ventriculocisternostomy: From the third ventricle to the cisterna magna (total procedure)

409.00

 

327.20

 

 

 

2871

Creation of shunt: ventriculo-atrial, -jugular, -auricular

Cannot be used with item 2873

307.20

 

245.76

 

 

 

2873

Creation of shunt: ventriculo-peritoneal, -pleural, other terminus

Cannot be used with item 2871

315.40

 

252.32

 

 

 

6055

Neuroendoscopy: Intracranial placement or replacement of ventricular catheter and attachment to shunt system or external drainage. ADD to main procedure

56.00

 

56.00

 

 

 

6058

Neuroendoscopy: Intracranial, with retrieval of foreign body

364.80

10 349.38

291.84

8 279.50

 

 

 

 

 

 

 

 

 

 

14.7

Posterior fossa surgery

 

 

 

 

 

 

2879

Glosso-pharyngeal nerve

480

13 617.6D

384

10 894.08

6

795.36 +T

2881

Eighth nerve: Intracranial

480

13 617.6D

384

10 894.08

8

1 060.48 +T

 

 

 

 

 

 

 

 

14.7.1

Supratentorial procedures

 

 

 

 

 

 

2892

Micro vascular decompression of cranial nerve (suboccipital)

553

15 688.61

442

12 539.54

6

795.36 +T

2893

Craniectomy for excision of brain abscess: Infratentorial or posterior fossa for excision of brain abscess

648.30

18 392.27

518.64

14 713.82

13

1 723.28 +T

2899

Craniectomy for extra-dural haematoma or empyema

375

10 638.75

300

8 511.00

11

1 458.16 +T

 

 

 

 

 

 

 

 

14.8

Craniotomy for

 

 

 

 

 

 

6085

Craniectomy/craniotomy: With exploration of the infratentorial area (below the tentorium of the cerebellum), posterior fossa (total procedure)

596.40

16 919.87

477.12

13 535.89

13

1 723.28 +T

6086

Craniectomy/craniotomy: With evacuation of infratentorial, intracerebellar haematoma (total procedure)

614.30

17 427.69

491.44

13 942.15

13

1 723.28 +T

6087

Craniectomy/craniotomy: With drainage of intracranial abscess in the infratentorial region with suction and irrigating the area while monitoring for haemorrhage (total procedure)

631.80

17 924.17

505.44

14 339.33

13

1 723.28 +T

6088

Cranial decompression caused by excess fluid (e.g. blood and pathological tissue), using posterior fossa approach by drilling/sawing through the occipital bone (total procedure)

605.10

17 166.69

484.08

13 733.35

13

1 723.28 +T

6090

Craniectomy at base of skull (suboccipitat): With freeing and section of one or more cranial nerves (total procedure)

624

17 702.88

499.20

14 162.30

11

1 458.16 +T

6115

Craniectomy/craniotomy: Supratentorial exploration

487.1

13 819.03

389.68

11 055.22

11

1 458.16 +T

6116

Incision and subcutaneous placement of cranial bone graft (e.g. split-or full thickness): shaving graft or bone dust: with donor site already exposed for the main procedure

25.9

734.78

25.9

734.78

11

1 458.16 +T

6117

Craniectomy/craniotomy: Drainage of intracranial abscess in the supratentorial region (total procedure)

564.7

16 020.54

451.76

12 816.43

11

1 458.16 +T

6118

Decompression craniectomy/craniotomy: With or without duraplasty, for treating intracranial hypertension (most commonly caused by severe closed-head trauma) without evacuation of associated intraparenchymal haematoma or lobectomy

705.1

20 003.69

564.08

16 002.95

11

1 458.16 +T

6120

Decompression of (roof of) orbit only: Transcranial approach (total procedure)

548.6

15 563.78

438.88

12 451.03

11

1 458.16 +T

6125

Craniectomy/trephination (bone flap craniotomy): Supratentorial excision of brain abscess

566.2

16 063.09

452.96

12 850.48

11

1 458.16 +T

6141

Craniectomy/craniotomy:

554.3

15 725.49

442.44

12 580.39

11

1 458.16 +T

6142

Craniectomy/craniotomy:

589.9

16 735.46

471.92

13 388.37

11

1 458.16 +T

2904

Craniectomy/craniotomy: With evacuation of supratentiorial, intracerebral haematoma

590.20

16 743.97

472.16

13 395.18

11

1 458.16 +T

2905

Craniotomy with elevation of bone flap: Excision of epileptogenic focus without electrocorticography during surgery

489

13 872.93

391.20

11 098.34

11

1 458.16 +T

2909

CSF-leaks

450

12 766.50

360

10 213.20

11

1 458.16 +T

 

 

 

 

 

 

 

 

14.8.1

Stereo-tactic cerebral and spinal cord procedures

 

 

 

 

 

 

2918

(code moved to consultation section)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14.8.2

Repair and/or Reconstruction of Surgical Defects of Skull Base

 

 

 

 

 

 

6196

Repair of dura or cerebrospinal fluid (CSF) leak: Secondary repair, anterior, middle or posterior cranial fossa following surgery of the skull base, by free tissue graft 9e.g. pericranium, fascia, tensor fascia lata, adipose tissue, homologous or sythetic grafts)

Cannot be used with item 6197

388.7

11 027.42

310.96

8 821.94

11

1 458.16 +T

6197

Repair of dura or cerebrospinal fluid (CSF) leak: Secondary anterior, middle or posterior cranial fossa following surgery of the skull base, by local or regionalised vascularised pedicle flap or myocutaneous flap (including galea, temporalis, frontalis or occipitalis muscle)

Cannot be used with item 6196

437.8

12 420.39

350.24

9 936.31

11

1 458.16 +T

 

 

 

 

 

 

 

 

14.9

Spinal operations

 

 

 

 

 

 

2923

Chordotomy: Unilateral

178

5 049.86

142.4

4 039.89

3

397.68 +T+M

2925

Chordotomy: Open

350

9 929.50

280

7 943.60

3

397.68 +T+M

2927

Rhizotomy: Extradural, but intraspinal

320

9 078.40

256

7 262.72

3

397.68 +T+M

2928

Rhizotomy: Intradural

350

9 929.50

280

7 943.60

3

397.68 +T+M

 

 

 

 

 

 

 

 

14.10

Arterial ligations

 

 

 

 

 

 

2951

Carotis: Trauma

120

3 404.40

120

3 404.40

8

1 060.48 +T

 

 

 

 

 

 

 

 

14.11

Medical Psychotherapy

 

 

 

 

 

 

2957

Individual psychotherapy (specific psychotherapy with approved evidence based method) - per short session (10-20 minutes)

20

567.40

16

453.92

 

 

2968

Group therapy: Adults 95 per group): Code per person per 80-minuted session

Use once per day only.

8

226.96

8

226.96

 

 

2974

Individual psychotherapy (specific psychotherapy with approved evidence based method) - per intermediate session (21-40 minutes)

40

1 134.80

32

907.84

 

 

2975

Individual psychotherapy (specific psychotherapy with approved evidence based method) - per extended session (41 minutes or longer)

60

1 702.20

48

1 361.76

 

 

 

 

 

 

 

 

 

 

14.12

Physical treatment methods

 

 

 

 

 

 

2970

Electro-convulsive treatment (ECT) - each time (see rule (Va)

17

482.29

17

482.29

3

397.68 +T