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R 385
Compensation for Occupational Injuries and Diseases Act, 1993 (Act No. 130 of 1993)Consultation fees in accordance with the Consultation Services UnitPart III : Procedures16. Eye |
|
Specialist |
General Practitioner |
Anaesthetic
|
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U/E |
R |
U/E |
R |
U/E |
R T/M |
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16.1 |
Procedures performed in rooms |
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16.1.1 |
Eye investigations Note: Not more that three (3) items in this section may be charged during one visit
Eye investigations and photography refer to one or both eyes except where otherwise indicated
Material used is excluded.The tariff for photography is not related to the number of photographs taken |
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3002 |
Gonioscopy |
7 |
115.08 |
7 |
115.08 |
|
|
3003 |
Fundus contact lens or 90D lens examination (not to be charged with item 3004 and/ or item 3012) |
7 |
115.08 |
7 |
115.08 |
|
|
3004 |
Peripheral fundus examination with indirect ophthalmoscope (not to be charged with item 3003 and/or item 3012) |
7 |
115.08 |
7 |
115.08 |
|
|
3009 |
Basic capital equipment used in own rooms by Opthalmologists. Only to be charged at first and follow-up consultations. Not to be charged for post-operative follow-up consultations |
+ 11.68 |
192.02 |
- |
#VALUE! |
|
|
3013 |
Ocular motility assessment: Comprehensive examination |
12 |
197.28 |
12 |
197.28 |
|
|
3014 |
Tonometry per test with maximum of 2 tests for provocative ionometry (one or both eyes) |
7 |
115.08 |
7 |
115.08 |
|
|
3021 |
Retina function assessment including refraction after occular surgery (within four months) maximum two examinations |
9 |
147.96 |
9 |
147.96 |
|
|
16.1.2 |
Special eye investigations |
||||||
3015 |
Charting of visual field with manual perimeter |
28 |
460.32 |
28 |
460.32 |
|
|
3016 |
Retinal threshold test without storage facilities |
30 |
493.20 |
30 |
493.20 |
|
|
3017 |
Retinal threshold test inclusive of computer disc storage for Delta or Statpak programs |
74 |
1,216.56 |
74 |
1,216.56 |
|
|
3018 |
Retinal threshold trend evaluation (additional to 3017) |
16 |
263.04 |
16 |
263.04 |
|
|
3020 |
Pachymetry: Only when own instrument is used, per eye. Only in addition to corneal surgery |
46 |
758.24 |
46 |
758.24 |
|
|
3025 |
Electronic tonography |
19 |
312.36 |
19 |
312.36 |
|
|
3027 |
Fundus photography |
21 |
345.24 |
21 |
345.24 |
|
|
3029 |
Anterior segment microphotography |
21 |
345.24 |
21 |
345.24 |
|
|
3031 |
Fluorescein angiography: One or both eyes |
45 |
739.80 |
45 |
739.80 |
4 |
307.24 +T |
3032 |
Eyelid and orbit photography |
9 |
147.96 |
9 |
147.96 |
|
|
3033 |
Interpretation of item 3031 referred by other clinician |
15 |
246.60 |
15 |
246.60 |
|
|
3034 |
Determination of lens implant power per eye |
15 |
246.60 |
15 |
246.60 |
|
|
3035 |
Where a minor procedure usually done in the consulting rooms requires a general anaesthetic or use of an operating theatre, an additional fee may be charged |
22 |
361.68 |
22 |
361.68 |
|
As per procedure |
3036 |
Corneal topography: For pathological corneas only on special motivation. For refractive surgery - may be charged once pre-operative and once post-operative per sitting (for one or both eyes) |
36 |
591.84 |
36 |
591.84 |
|
|
16.2 |
Retina |
||||||
3037 |
Surgical treatment of retinal detachment including vitreous replacement but excluding vitrectomy |
306.9 |
5,045.44 |
245.52 |
4,036.35 |
6 |
460.86 +T |
3039 |
Prophylaxis and treatment of retina and choroid by cryotherapy and/or diathermy and/or photocoagulation and/or laser per eye |
105 |
1,726.20 |
105 |
1,726.20 |
6 |
460.86 +T |
3041 |
Pan retinal photocoagulation (per eye), done in one sitting (Subsequent sittings: Modifier 0005) |
150 |
2,466.00 |
120 |
1,972.80 |
6 |
460.86 +T |
3044 |
Removal of encircling band and/or buckling material |
105 |
1,726.20 |
105 |
1,726.20 |
6 |
460.86 +T |
16.3 |
Cataract |
||||||
3045 |
Intra-capsular extraction |
210 |
3,452.40 |
168 |
2,761.92 |
7 |
537.67 +T |
3047 |
Extra-capsular (including capsulotomy) |
210 |
3,452.40 |
168 |
2,761.92 |
7 |
537.67 +T |
3049 |
Insertion of lenticulus in addition to 3045 or 3047 (cost of lens excluded) Modifier 0005 not applicable |
57 |
937.08 |
57 |
937.08 |
7 |
537.67 +T |
3050 |
Repositioning of intra ocular lens |
171.10 |
2,812.88 |
136.88 |
2,250.31 |
7 |
537.67 +T |
3051 |
Needling of capsulotomy |
130 |
2,137.20 |
120 |
1,972.80 |
4 |
307.24 +T |
3052 |
Laser capsulotomy |
105 |
1,726.20 |
105 |
1,726.20 |
4 |
307.24 +T |
3057 |
Removal of lenticulus |
210 |
3,452.40 |
168 |
2,761.92 |
7 |
537.67 +T |
3058 |
Exchange of intra ocular lens |
236 |
3,879.84 |
188.8 |
3,103.87 |
7 |
537.67 +T |
3059 |
lnsertion of lenticulus when 3045 or 3047 was not executed (cost of lens excluded) |
210 |
3,452.40 |
168 |
2,761.92 |
7 |
537.67 +T |
3060 |
Use of own surgical microscope for surgery or examination (not for slit lamp microscope) (for use by opthalmologists only) |
4 |
65.76 |
|
|
|
|
16.4 |
Glaucoma |
||||||
3061 |
Drainage operation |
247.6 |
4,070.54 |
198.08 |
3,256.44 |
6 |
460.86 +T |
3062 |
Implanataion of aqueous shunt device/seton in glaucoma (additional to item 3061) |
60 |
986.40 |
60 |
986.40 |
6 |
460.86 +T |
3063 |
Cycloryotherapy or cyclodiathermy |
105 |
1,726.20 |
105 |
1,726.20 |
6 |
460.86 +T |
3064 |
Laser trabeculoplasty |
105 |
1,726.20 |
105 |
1,726.20 |
6 |
460.86 +T |
3065 |
Removal of blood anterior chamber |
105 |
1,726.20 |
105 |
1,726.20 |
4 |
307.24 +T |
3067 |
Goniotomy |
210 |
3,452.40 |
168 |
2,761.92 |
7 |
537.67 +T |
16.5 |
Intra-ocular foreign body |
||||||
3071 |
Intra-ocular foreign body: Anterior to iris |
127 |
2,087.88 |
120 |
1,972.80 |
4 |
307.24 +T |
3073 |
Intra-ocular foreign body: Posterior to iris (including prophylactic thermal treatment to retina) |
210 |
3,452.40 |
168 |
2,761.92 |
6 |
460.86 +T |
16.6 |
Strabismus |
||||||
3075 |
Strabismus (whether operation performed on one eye or both): Operation on one or two muscles |
175.60 |
2,886.86 |
140.48 |
2,309.49 |
5 |
384.05 +T |
3076 |
Strabismus (whether operation performed on one eye or both). Operation on three or four muscles |
200 |
3,288.00 |
160 |
2,630.40 |
5 |
384.05 +T |
3077 |
Strabismus (whether operation performed on one eye or both): Subsequent operation, one or two muscles |
120 |
1,972.80 |
120 |
1,972.80 |
5 |
384.05 +T |
3078 |
Strabismus (whether operation performed on one eye or both): Subsequent operation on three or four muscles Subsequent operation on three of four muscles |
150 |
2,466.00 |
120 |
1,972.80 |
5 |
384.05 +T |
16.7 |
Globe |
||||||
3080 |
Examination of eyes under general anaesthetic where no surgery is done |
80 |
1,315.20 |
80 |
1,315.20 |
4 |
307.24 +T |
3081 |
Treatment of minor perforating injury |
161.6 |
2,656.70 |
129.28 |
2,125.36 |
6 |
460.86 +T |
3083 |
Treatment of major perforating injury |
267.5 |
4,397.70 |
214 |
3,518.16 |
6 |
460.86 +T |
3085 |
Enucleation or Evisceration |
105 |
1,726.20 |
105 |
1,726.20 |
5 |
384.05 +T |
3087 |
Enucleation or Evisceration with mobile implant:· Excluding cost of implant and prosthesis |
160 |
2,830.40 |
128 |
2,104.32 |
5 |
384.05 +T |
3088 |
Hydroxyapatite insertion (Additional to item 3087) |
+ 40 |
657.60 |
40 |
657.60 |
5 |
384.05 +T |
3089 |
Subconjunctival injection if not done at the time of operation |
10 |
184.40 |
10 |
164.40 |
5 |
384.05 +T |
3091 |
Retrobulbar injection (if not done at time of operation) |
16 |
263.04 |
16 |
283.04 |
4 |
307.24 +T |
3092 |
External laser treatment for superficial lesions |
53 |
871.32 |
53 |
871.32 |
|
|
3096 |
Adding of air or gas in vitreous as a post-operative procedure or pneumoretinopexy |
130 |
2,137.20 |
120 |
1,972.80 |
7 |
537.67 +T |
3097 |
Anterior vitrectomy |
280 |
4,603.20 |
224 |
3,682.56 |
6 |
460.86 +T |
3098 |
Removal of silicon from globe |
280 |
4,603.20 |
224 |
3,682.56 |
6 |
460.86 +T |
3099 |
Posterior vitrectromy including anterior vitrectomy, encircling of globe and vitreous replacement |
419 |
6,888.36 |
335.2 |
5,510.69 |
6 |
460.86 +T |
3100 |
Lensectomy done at time of posterior vitrectomy |
30 |
493.20 |
30 |
493.20 |
7 |
537.67 +T |
16.8 |
Orbit |
||||||
3101 |
Drainage of orbital abscess |
105 |
1,726.20 |
105 |
1,726.20 |
5 |
384.05 +T |
3104 |
Removal orbital prosthesis |
212.7 |
3,496.79 |
170.16 |
2,797.43 |
5 |
384.05 +T |
3105 |
Exenteration |
275 |
4,521.00 |
220 |
3,616.80 |
5 |
384.05 +T |
3107 |
Orbitomy requiring bone flap |
393 |
6,460.92 |
314.40 |
5,168.74 |
5 |
384.05 +T |
3108 |
Eye socket reconstruction |
206 |
3,386.64 |
164.8 |
2,709.31 |
5 |
384.05 +T |
3109 |
Hydroxyapetite implantation in eye cavity when evisceration or enucleation was done previously |
300 |
4,932.00 |
240 |
3,945.60 |
5 |
384.05 +T |
3110 |
Second stage hydroxyapatite implantation |
110 |
1,808.40 |
110 |
1,808.40 |
5 |
384.05 +T |
16.9 |
Cornea |
||||||
3111 |
Contact lenses: Assessment involving preliminary fittings and tolerance |
• |
#VALUE! |
• |
• |
|
|
3113 |
Fitting of contact lenses and instructions to patient: Includes eye examination, first fittings of the contact lenses and further post-fitting visits for one year |
200 |
3,288.00 |
160 |
2,630.40 |
|
|
3115 |
Fitting of only one contact lens and instructions to patient: Eye examination , first fitting of the contact lens and further post-fitting visits for one year included |
166 |
2,729.04 |
132.8 |
2,183.23 |
|
|
3116 |
Astigmatic correction with T cuts or wedge resection in pathological corneal astigmatism following trauma, intra ocular surgery or penetrating keratoplasty |
135.2 |
2,222.69 |
120 |
1,972.80 |
6 |
460.86 +T |
3117 |
Removal of foreign body: One the basis of fee per consultation |
|
|
|
• |
4 |
307.24 +T |
3118 |
Curettage of cornea after removal of foreign body (aftercare excluded) |
10 |
164.40 |
10 |
164.40 |
|
|
3119 |
Tattooing |
26 |
427.44 |
26 |
427.44 |
4 |
307.24 +T |
3121 |
Corneal graft (Lamellar or full thickness) |
289 |
4,751.16 |
231.2 |
3,800.93 |
6 |
460.86 +T |
3123 |
Insertion of intra-corneal or intrascleral prosthesis for refractive surgery |
254 |
4,175.76 |
203.2 |
3,340.61 |
6 |
460.86 +T |
3125 |
Keratectomy |
127 |
2,087.88 |
120 |
1,972.80 |
6 |
460.86 +T |
3127 |
Cauterisation of cornea (by chemical, thermal or cryotherapy methods) |
10 |
164.40 |
10 |
164.40 |
4 |
307.24+T |
3130 |
Pterygium or conjunctival cyst. No conjunctival flap or graft used |
96.9 |
1,593.04 |
96.9 |
1,593.04 |
4 |
307.24 +T |
3131 |
Paracentesis |
53 |
871.32 |
53 |
871.32 |
4 |
307.24 +T |
3136 |
Conjunctival flap or graft: Not for use with pterygium surgery |
95.7 |
1,573.31 |
95.7 |
1,573.31 |
6 |
460.86 +T |
16.10 |
Ducts |
||||||
3133 |
Probing and/or syringing, per duct |
10 |
164.40 |
10 |
164.40 |
4 |
307.24 +T |
3135 |
Insert polythene tubes/stent: Unilateral: Additional |
51.8 |
851.59 |
51.8 |
851.59 |
4 |
307.24 +T |
3137 |
Excision of lacrimal sac: Unilateral |
132 |
2,170.08 |
120 |
1,972.80 |
4 |
307.24 +T |
3139 |
Dacryocystorinostomy (single) with or without polythene tube |
210 |
3,452.40 |
168 |
2,761.92 |
5 |
384.05 +T |
3141 |
Sealing Punctum surgical/cautery: Per eye |
24.9 |
409.36 |
24.9 |
409.36 |
4 |
307.24 +T |
3142 |
Sealing Punctum with plugs: Per eye |
20 |
328.80 |
20 |
328.80 |
4 |
307.24 +T |
3143 |
Three-snip operation |
10 |
164.40 |
10 |
164.40 |
4 |
307.24 +T |
3145 |
Repair of caniculus: Primary procedure |
132 |
2,170.08 |
120 |
1,972.80 |
4 |
307.24 +T |
3147 |
Repair of caniculus: Secondary procedure |
175 |
2,877.00 |
140 |
2,301.60 |
4 |
307.24 +T |
16.11 |
lris |
||||||
3149 |
lndectomy or iridotomy by open operationas isolated procedure |
132 |
2,170.08 |
120 |
1,972.80 |
4 |
307.24 +T |
3153 |
lndectomy or iridotomy by laser or photocoagulation as isolated procedure (maximum one procedure) |
105 |
1,726.20 |
105 |
1,726.20 |
4 |
307.24 +T |
3157 |
Division ofanterior synechiae as isolated procedure |
132 |
2,170.08 |
120 |
1,972.80 |
4 |
307.24 +T |
3158 |
Repair iris as in dialysis: Anterior chamber reconstruction |
142.4 |
2,341.06 |
120 |
1,972.80 |
4 |
307.24 +T |
16.12 |
Lids |
||||||
3161 |
Tarsorrhaphy |
47 |
772.68 |
47 |
772.68 |
4 |
307.24 +T |
3165 |
Repair of skin laceration of the lid. Simple |
27.3 |
448.81 |
27.3 |
448.81 |
4 |
307.24 +T |
3176 |
Lid operation for facial nerve paralysis including tarsorrhapy but excluding cost of material |
187 |
3,074.28 |
149.6 |
2,459.42 |
4 |
307.24 +T |
16.12.1 |
Entropion or ectropion by |
||||||
3177 |
Entropion or ectropion by cautery |
10 |
164.40 |
10 |
164.40 |
4 |
307.24 +T |
3179 |
Entropion or ectropion by suture |
49.4 |
812.14 |
49.4 |
812.14 |
4 |
307.24 +T |
3181 |
Entropion or ectropion by open operation |
111.5 |
1,833.08 |
111.5 |
1,833.08 |
4 |
307.24 +T |
3183 |
Entropion or ectropion by free skin, mucosal grafting or flap |
122.6 |
2,015.54 |
120 |
1,972.80 |
4 |
307.24 +T |
16.12.2 |
Reconstruction of eyelid |
||||||
3185 |
Staged procedure for partial or total loss of eyelid: First stage |
259 |
4,257.96 |
207.2 |
3,406.37 |
4 |
307.24 +T |
3187 |
Staged procedure for partial or total loss of eyelid: Subsequent |
206 |
3,386.64 |
164.8 |
2,709.31 |
4 |
307.24 +T |
3189 |
Full thickness eyelid Iaceration for injury:· Direct repair |
136.5 |
2,244.08 |
120 |
1,972.80 |
4 |
307.24 +T |
3172 |
Blepharoplasty lower eyelid plus fat pad |
125.80 |
2,068.15 |
120 |
1,972.80 |
4 |
307.24 +T |
3191 |
Blepharoplasty: Upper lid for improvement in function (unilateral) |
150.2 |
2,469.29 |
120.16 |
1,975.43 |
4 |
307.24 +T |
16.12.3 |
Ptosis |
||||||
3193 |
Repair by superior rectus, levator or frontalis muscle operation |
190 |
3,123.60 |
152 |
2,498.88 |
4 |
307.24 +T |
3195 |
Ptosis: By lesser procedure. e.g. sling operation: Unilateral |
137.6 |
2,262.14 |
120 |
1,972.80 |
4 |
307.24 +T |
3197 |
Ptosis: By lesser procedure, e.g. sling operation: Bilateral |
186 |
2,729.04 |
132.8 |
2,183.23 |
4 |
307.24 +T |
16.13 |
Conjunctiva |
||||||
3199 |
Repair of conjunctiva by grafting |
132 |
2,170.08 |
120 |
1,972.80 |
4 |
307.24 +T |
3200 |
Repair of lacerated conjunctiva |
47 |
772.68 |
47 |
772.68 |
4 |
307.24 +T |
16.14 |
General |
||||||
3196 |
Diamond knife: Use of own diamond knife during intraocular surgery |
12 |
197.28 |
|
|
|
|
3198 |
Eximer laser: Hire fee |
284.13 |
4,671.10 |
|
|
|
|
3201 |
Laser apparatus (ophthalmic): hire fee for one or both eyes treated in one sitting (not to be used with IOL master) |
109 |
1,791.96 |
|
|
|
|
3202 |
PHAKO emulsification apparatus (hire fee) |
109 |
1,791.96 |
|
|
|
|
3203 |
Vitrectomy apparatus (hire fee) |
120 |
1,972.80 |
|
|
|
|