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R 385
Compensation for Occupational Injuries and Diseases Act, 1993 (Act No. 130 of 1993)Scale of FeesAnnual Increase in Medical Tariffs for Medical Service Providers - 2024Chiropractor Gazette 2024Chiropractor Tariff of Fees as from 1 April 2024 (Practice 004) |
General Rules |
|
Rule |
Rule Description |
001 |
Unless timely steps are taken (at least two hours) to cancel an appointment for a consultation the relevant consultation fee shall be payable by the employee. |
002 |
Pre-authorisation for Chiropractor services may only be granted if the primary medical practitioners written referral letter clearly indicates the reason for the referral, relationship to the original injury. The referral may be on the Chiropractors or medical practitioners letterhead, provided it is signed by the referring doctor.
Submission of a report is required after every consultation, treatment and/or therapy services rendered with the applicable codes
Chiropractor services only applicable for outpatient Only one visit per day and a maximum of 5 visits per claim is allowed. |
003 |
The consultation code may be charged only once per day and once per claim. Consultation includes history taking, guidance, education, health promotion and/or consultation. Subsequent visits are considered as follow-up to the initial visits |
004 |
A maximum of three diagnostic procedures may be charged at the same consultation or visit. Diagnostic procedures include physical examination, neurological examination, orthopaedic examination, ergonomical analysis and postural analysis. |
005 |
A maximum of three types of treatment procedures (modalities and or methods) may be charged at the same consultation or visit for any single diagnosis. Treatment procedures include, inter alia: spinal or extra-spinal manipulation, acupuncture, cold applications, non-heating modalities, deep heating radiation, soft tissue manipulation, superficial heating therapy and therapeutic exercises (other than in relation to preparation or fitting of appliances). |
006 |
After a series of 5 treatments in respect to one patient for the same condition, the Chiropractor should refer the patient/employee back to the treating medical practitioner concerned to report to the Compensation Fund if further treatment is necessary. Payment for treatment in excess of the stipulated number may be granted by the Compensation Fund after receipt of motivation letter from the treating medical practitioner concerned. |
007 |
X-ray films: Chiropractor practitioners to use x-ray results from referring medical practitioner |
Tariff Codes |
||
Code |
Code Description |
RAND |
1. |
CONSULTATIONS |
|
04301 |
Initial consultation - including the taking of a full case history or pertinent history, but excluding remedies, immobilisation and manipulation procedures Consultation includes history taking, guidance, education, health promotion and/or consultation. Code may be charged only once per visit per claim. (Refer to Rule 003) |
355.16 |
2. |
DIAGNOSTIC PROCEDURES |
|
|
Only a single item from this section may be charged per patient encounter. Diagnostic procedures included in the scope of practice are; physical examination, neurological examination Initial consultation - charge 04313 (may only be used once per episode of injury ) Follow up consultation - use 04311 or 04312 only When using 04312 at a subsequent consultation, a motivation detailing why two diagnostic are required at a follow up treatment. Use form WCL5 to submit your motivation. Only one of items 311, 312 or 313 can be used per visit (Refer to rule 004) |
|
04311 |
Single diagnostic procedure (May be used with up to three treatment/therapeutic codes) |
230.23 |
04312 |
Two diagnostic procedures (Attach Motivation) |
349.81 |
04313 |
Three diagnostic procedures (May only be used on an initial Consultation ) |
460.46 |
3. |
IMMOBILISATION OR THERAPEUTIC EXERCISE IN RELATION TO PREPARATION OR FITTING OF APPLIANCES |
|
Only a single item from this section may be charged per patient encounter Only one of items 321 or 322 can be used per visit |
||
04321 |
Single instance of immobilization or therapeutic exercises |
696.05 |
04322 |
Two instances of immobilization or therapeutic exercises (Attach Motivation) |
874.52 |
4. |
TREATMENT (THERAPEUTIC PROCEDURES) |
|
Only a single item from this section may be charged per patient encounter Only one of items 331, 332, 333, 334, 335 or 336 can be used per visit |
04331 |
Single treatment procedure |
489.02 |
04332 |
Two treatment procedures |
592.53 |
04333 |
Three treatment procedures |
696.05 |
04334 |
Four treatment procedures |
799.56 |
04335 |
Five treatment procedures |
903.08 |
04336 |
Six treatment procedures |
1004.81 |
Radiology |
||
04049 |
Ankle - AP/LAT |
284.30 |
04050 |
Ankle - Complete Study - 3 views |
425.63 |
04051 |
Cervical - AP/LAT |
284.04 |
04052 |
Cervical - AP/LAT/OBL |
425.63 |
04053 |
Cervical study - 6 views |
851.30 |
04054 |
Cervical - Davis Series -7 views |
992.59 |
04055 |
Elbow -AP/LAT |
278.73 |
04056 |
Elbow - 3 views |
425.63 |
04057 |
Foot - AP/LAT |
284.04 |
04058 |
Foot - 3 views |
425.63 |
04059 |
Femur - AP/LAT |
567.50 |
04060 |
Hand - AP/LAT |
284.04 |
04061 |
Hand - 3 views |
425.63 |
04062 |
Hip unilateral - 1 view |
198.70 |
04063 |
Hip - 2 views |
397.10 |
04064 |
Knee - AP/LAT |
284.04 |
04065 |
Knee - 3 views |
425.63 |
04066 |
Lumbo-Sacral - 3 views |
680.86 |
04067 |
Lumbar spine & pelvis - 5 views |
1020.88 |
04068 |
Pelvis AP |
284.04 |
04069 |
Pelvis - 3 views |
624.29 |
04070 |
Ribs -Unilateral - 2 views |
340.29 |
04071 |
Ribs -Bilateral - 3 views |
510.43 |
04072 |
Radius/Ulna |
284.04 |
04073 |
Spine -Full spine study - AP/LAT |
1020.88 |
04074 |
Spine - 8 X 10- Single study |
168.05 |
04075 |
Spine - 10 X 12- Single study |
170.43 |
04076 |
Spine - 14 X 17- Single study |
284.04 |
04077 |
Shoulder - 1 view |
170.43 |
04078 |
Shoulder - 2 views |
340.29 |
04079 |
Thoraco - Lumbar - AP/LAT |
567.50 |
04080 |
Thoracic - AP |
567.50 |
04081 |
Tibia/Fibula - AP/LAT |
567.50 |
04082 |
Wrist - AP/LAT |
284.04 |
04083 |
Wrist - 3 views |
425.63 |
04084 |
Stress views - Lumbar |
355.89 |
04100 |
Consumables |
|
Radiation Control Council Certificate number to be on account if X-Rays charged |