General Rules

Rule

Rule Description

001

The service of a registered woundcare nurse shall be available only on written referral by the treating doctor.

The medical treating doctor must clearly indicate the reason for the referral, relationship to the original injury.

The referral may be on the service provider's (Wound care Practitioner) letterhead, provided it is signed by the referring doctor.

002

Medical invoices should be accompanied by medical reports.

003

Wound care services should be rendered to Out-patients only.

004

Service dates claimed for should not overlap to the following month.

005

Travel fee:

Please note that the Fund does not accept the responsibility for transport expenses, as they are deemed to be included in the fee.

Tariff Code  

Code

Code Description

 RAND

88002

Per 60 minutes.

The first consultation, counselling, assessment, training and full history of the patient is taken:

821.18

88001

The first consultation, counselling, assessment, training and full history of the patients with minimal factors which may influence healing.

410.59

88040

Per 30 minutes.

Treatment of simple wounds / burns requiring dressing only, assessing suture lines in uncomplicated patients.

No additional time should be allocated to this code.

178.97

88041

Per  30  minutes.

Treatment of extensive wounds / burns requiring extensive nursing management eg. irrigation, etc

Ongoing wound assessment and education with every visit.

431.65

88411

Additional time - for additional 15 minutes

Can only be billed with 88041

115.81

88020

Per specimen.

This included correct collection of material, swab or tissue, completion of documentation and speedy delivery  to laboratory. Ensuring copies of reports to relevant team members are received and acted upon.

Specimen type  should be stated where applicable.

115.81

88042

Per 30 minutes.

Treatment of moderate wounds / Burns without complications. eg.  drains or fistula and insertion of sutures.

Ongoing wound assessment and education with every visit.

231.62

880421

Additional time - for additional 15 minutes

Can only be billed with 88042

115.81

LIMITED BILATERAL NON-EVASIVE PHYSIOLOGIC STUDIES OF UPPER AND LOWER EXTREMITY ARTERIES

88046

Per Ankle Brachial Pressure Index (ABPI).

Involves testing systolic blood pressure on both arms and both legs with a hand held Doppler. Interpretation of results will determine if patient requires referral to vascular surgeon and if compression bandaging is suitable.

263.2

88047

Trans cutaneous Oxygen pressure (TcPO2).

Measured by a trans cutaneous oxymeter. This measures the oxygen pressure in and around injured tissue, also used in lower limb assessment where arterial incompetence is suspected. Accurate indicator arterial disease and expected would healing.

589.56

88049

Emergency / Urgent / unplanned treatment

231.62

Wound Packs

88301

Cost of material and special medicine used in treatment. Charges for medicine used in treatment not to exceed the retail Ethical Price List

List of Materials