Compensation for Occupational Injuries and Diseases Act, 1993 (Act No. 130 of 1993)Scale of FeesAnnual Increase in Medical Tariffs for Medical Service Providers - 2021Doctors Gazette 2021Part lll : Procedures19. RadiologySchedule |
This schedule must be used in conjunction with the Radiological Society of SA Guidelines. Please refer to the PET guidelines in Annexure D.
Code Structure Framework
(a) | The tariff code consists of 5 digits |
(i) | 1st digit indicates the main anatomical region or procedural category. |
0 = General (non specific)
1 = Head
2 = Neck
3 = Thorax
4 = Abdomen and Pelvis (soft tissue)
5 = Spine, Pelvis and Hips
6 = Upper limbs
7 = Lower limbs
8 = Interventional
9 = Soft tissue regions (nuclear medicine)
eg "Head" = 1xxxx
(ii) | 2nd digit indicates the sub region within a main region or category eg. |
"Head/Skull and Brain" = 10xxx
(iii) | 3rd digit indicates modality |
1 = General (Black and White) x-ray
2 = Ultrasound
3 = Computed Tomography
4 = Magnetic Resonance Imaging
5 = Angiography
6 = Interventional radiology
9 = Nuclear Medicine (Isotopes)
eg:
Head/Skull and Brain/General x-ray 101xx
(iv) | 4th and 5th digits are specific to a procedure/examination, eg |
"Head/Skull and Brain/General/X-ray of the skull" = 10100.
Guidelines for use of coding structure
• | The vast majority of the codes describe complete procedures/examination and their use for the appropriate studies is self-explanatory. |
• | Some codes may have multiple applications and their use is described in notes associated with each code |
• | Codes 00510 to 00560 (Angiography machine codes) may only be used by owners of the equipment and who have registered such equipment with the Board of Healthcare Funders/RSSA. |
• | The machine codes 00510, 00520, 00530, 00540, 00550, 00560 may not be added to 60540, 60550, 70530, 70535 (Antegrade Venography, upper and lower limbs) |
• | Where public sector hospital equipment is used for a procedure, the units will be reduced by 33.33 %. |
Consumables
Contrast Medium
o | Prior to the implementation of Act 90, contrast will be billed according to the official 2004 RSSA reimbursement price list, without mark up. |
o | After the implementation of Act 90, contrast medium will be billed according to the suppliers' list price, without mark up. |
o | Angiography catheters, angioplasty balloons, stents, coils and other embolisation materials, guide wires and drains are |
General Comments on Procedural Codes
o | AII x-ray tomography codes are stand alone studies and may be used as a unique study or in combination with the appropriate regional study if done simultaneously. May not be added to 20130, 42110, 42115. |
o | Setting of sterile tray is included in all appropriate procedure codes. |
o | Where introduction of contrast is necessary eg. sialography, arthrography, angiography, etc, the codes used for the procedures are comprehensive and include the introduction of contrast or isotopes. |
o | The use of Doppler or Colour Doppler as an adjunct to a study (eg small parts thyroid) is included in the code for that study. |
o | CT Angiography (10330, 20330, 32300, 32310, 44300, 44310, 44320, 44330, 60310, 70310, 70320) are stand alone studies and may not be added to the regional contrasted studies (see 10335, 20340, 20350, 44325 for combined studies). |
o | Angiography and interventional procedures include selective and super selective catheterization of vessels as are necessary to perform the procedures. |
Codes 00230 (Ultrasound guidance), 00320 (CT guidance) and 00430 (MR guidance) are stand alone procedures that include the regional study and may not be added to any of the ultrasound, CT or MR regional studies
General Codes
Modifiers
00091 | Radiology and nuclear medicine services rendered to hospital inpatients |
00092 | Radiology and nuclear medicine services rendered to outpatients |
00093 | A reduction of one third (33.33%) will apply to radiological examinations where hospital equipment it used |
Equipment/Diagnostic
00090 | Consumables used in radiology procedures: cost price PLUS 26% (up to a maximum of R26,00). (Where applicable, VAT should be added to the above). |
Appropriate code to be provided. See separate codes for contrast and isotopes
00110 X-ray skeletal survey under five years
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Other special/General Practitioner |
Specialists |
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U/E |
R |
U/E |
R |
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00090 |
Consumables used in radiology procedures |
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00091 |
Radiology and nuclear medicine services rendered to hospital inpatients |
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00092 |
Radiology and nuclear medicine services rendered to outpatients |
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00093 |
A reduction of one third (33.33%) will apply to radiological examinations where hospital equipment it used |
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00115 |
X-ray skeletal survey over five years |
- |
- |
10.40 |
2 012.30 |
||||||||||
00120 |
X-ray sinogram any region |
- |
- |
10.89 |
2 107.11 |
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00130 |
X-ray with mobile unit in other facility |
- |
- |
1.90 |
367.63 |
||||||||||
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To be added to applicable procedure codes eg 30100. |
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00135 |
X-ray control view in theatre any region |
- |
- |
5.26 |
1 017.76 |
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00140 |
X-ray fluoroscopy any region |
- |
- |
2.26 |
437.29 |
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May only be added to the examination when fluoroscopy is not included in the standard procedure code. May not be added to:
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00145 |
X-ray fluoroscopy guidance for biopsy, any region |
- |
- |
5.30 |
1 025.50 |
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Add to the procedure eg. 80600, 80605, 80610 |
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|
|
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00150 |
X-ray C-Arm (equipment fee only, not procedure) per half hour Only to be used if equipment is owned by the radiologist. |
- |
- |
2.42 |
468.25 |
||||||||||
00155 |
X-ray C-arm fluoroscopy in theatre per half hour (procedure only) |
- |
- |
2.30 |
445.03 |
||||||||||
00160 |
X-ray fixed theatre installation (equipment fee only) |
- |
- |
2.26 |
437.29 |
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Only to be used if equipment is owned by the radiologist. |
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00190 |
X-ray examination contrast material |
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Identification code for the use of contrast with a procedure. Appropriate codes to be supplied. |
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00210 |
Ultrasound with mobile unit in other facility |
- |
- |
1.84 |
356.02 |
||||||||||
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Add to the relevant ultrasound examination codes eg 10200. |
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|
|
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||||||||||
00220 |
Ultrasound intra-operative study |
- |
- |
7.32 |
1 416.35 |
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Covers all regions studied. Single code per operative procedure. |
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00230 |
Ultrasound guidance |
- |
- |
12.10 |
2 341.23 |
||||||||||
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guidance. Guided procedure code to be added eg. 80600, 80605, 80610. |
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|
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00240 |
Ultrasound guidance for tissue ablation |
- |
- |
11.24 |
2 174.83 |
||||||||||
|
Comprehensive ultrasound code including regional study and guidance Radiologist assistance (01030) may be added if procedure is performed by a non -radiologist. Guided procedure code to be added if performed by a radiologist. 80620 or 80630. |
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00250 |
Ultrasound limited Doppler study any region |
- |
- |
6.50 |
1 257.69 |
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Stand alone code may not be added to any other code. |
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00290 |
Ultrasound examination contrast material |
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Identification code for the use of contrast with a procedure. |
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Appropriate codes to be supplied. |
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00310 |
CT planning study for radiotherapy |
- |
- |
21.37 |
4 134.88 |
||||||||||
00320 |
CT guidance (separate procedure) |
- |
- |
16.92 |
3 273.65 |
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Comprehensive CT code including regional study and guidance. Guided procedure code to be added eg 80600, 80605, and 80610. |
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|
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00330 |
CT guidance, with diagnostic procedure |
- |
- |
8.46 |
1 636.93 |
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To be added to the diagnostic procedure code. Guided procedure code to be added eg 80600, 80605, 80610. |
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00340 |
CT guidance and monitoring for tissue ablation |
- |
- |
21.15 |
4 092.31 |
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May only be used once per procedure for a region. Radiologist assistance (01030) may be added if procedure is performed by a non-radiologist. If performed by radiologist, add procedural code 80620, or 80630. |
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00390 |
CT examination contrast material |
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Identification code for the use of contrast with a procedure. |
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Appropriate codes to be supplied. |
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00420 |
MR Spectroscopy any region |
- |
- |
28.90 |
5 591.86 |
||||||||||
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May be added to the regional study, once only. |
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||||||||||
00430 |
MR guidance for needle replacement |
- |
- |
42.56 |
8 234.93 |
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Comprehensive MRI code including region studied and guidance. Guided procedure code to be added eg 80600, 80605, 80610. |
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00440 |
MR low field strength imaging of peripheral joint any region |
- |
- |
12.00 |
2 321.88 |
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00450 |
MR planning study for radiotherapy or surgical procedure |
- |
- |
38.00 |
7 352.62 |
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00455 |
MR planning study for radiotherapy or surgical procedure, with contrast |
- |
- |
47.00 |
9 094.03 |
||||||||||
00490 |
MR examination contrast material |
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Identification code for the use of contrast with a procedure. |
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Appropriate codes to be supplied. |
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00510 |
Analogue monoplane screening table |
- |
- |
41.01 |
7 935.02 |
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A machine code may be added once per complete procedure/patient visit |
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00520 |
Analogue monoplane table with DSA attachment |
- |
- |
47.50 |
9 190.78 |
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A machine code may be added once per complete procedure/patient visit. |
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00530 |
Dedicated angiography suite: Analogue monoplane unit. Once off charge per patient by owner of equipment. |
- |
- |
47.50 |
9 190.78 |
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A machine code may be added once per complete procedure/patient visit. |
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||||||||||
00540 |
Digital monoplane screening table |
- |
- |
79.92 |
15 463.72 |
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A machine code may be added once per complete procedure/patient visit. |
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00550 |
Dedicated angiography suite: Digital monoplane unit. Once off charge per patient by owner of equipment. |
- |
- |
93.03 |
18 000.37 |
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A machine code may be added once per complete procedure/patient visit. |
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00560 |
Dedicated angiography suite: Digital bi-plane unit. Once off charge per patient by owner of equipment |
- |
- |
125.00 |
24 186.25 |
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A machine code may be added once per complete procedure/patient visit. |
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00590 |
Angiography and interventional examination contrast material |
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Identification code for the use of contrast with a procedure. |
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Appropriate codes to be supplied. |
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00900 |
Nuclear Medicine study Bone, whole body, appendicular and axial skeleton |
- |
- |
34.92 |
6 756.67 |
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00903 |
Nuclear Medicine study - Bone, whole body, appendicular and axial skeleton and SPECT |
- |
- |
48.33 |
9 351.37 |
||||||||||
00906 |
Nuclear Medicine study - Venous thrombosis regional |
- |
- |
21.54 |
4 167.77 |
||||||||||
00909 |
Nuclear Medicine study - Tumour whole body |
- |
- |
34.15 |
6 607.68 |
||||||||||
00912 |
Nuclear Medicine study - Tumour whole body multiple studies |
- |
- |
47.56 |
9 202.38 |
||||||||||
00915 |
Nuclear Medicine study - Tumour whole body and SPECT |
- |
- |
47.56 |
9 202.38 |
||||||||||
00918 |
Nuclear Medicine study - Tumour whole body multiple studies & SPECT |
- |
- |
60.98 |
11 799.02 |
||||||||||
00921 |
Nuclear Medicine study - Infection whole body |
- |
- |
31.45 |
6 085.26 |
||||||||||
00924 |
Nuclear Medicine study - infection whole body with SPECT |
- |
- |
44.86 |
8 679.96 |
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00927 |
Nuclear Medicine study - infection whole body multiple studies |
- |
- |
44.86 |
8 679.96 |
||||||||||
00930 |
Nuclear Medicine study - infection whole body with SPECT multiple studies |
- |
- |
58.27 |
11 274.66 |
||||||||||
00933 |
Nuclear Medicine study - Bone marrow imaging limited area |
- |
- |
24.10 |
4 663.11 |
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00936 |
Nuclear Medicine study - Bone marrow imaging whole body |
- |
- |
37.51 |
7 257.81 |
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00939 |
Nuclear Medicine study - Bone marrow imaging limited area multiple studies |
- |
- |
37.51 |
7 257.81 |
||||||||||
00942 |
Nuclear Medicine study - Bone marrow imaging whole body multiple studies |
- |
- |
50.92 |
9 852.51 |
||||||||||
00945 |
Nuclear Medicine study - Spleen imaging only - haematopoietic |
- |
- |
24.10 |
4 663.11 |
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00960 |
Nuclear Medicine therapy - Hyperthyroidism |
- |
- |
11.99 |
2 319.95 |
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00965 |
Nuclear Medicine therapy - Thyroid carcinoma and metastases |
- |
- |
6.47 |
1 251.88 |
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00970 |
Nuclear Medicine therapy - Intra-cavity radio-active colloid therapy |
- |
- |
6.47 |
1 251.88 |
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00975 |
Nuclear Medicine therapy - Interstitial radio-active colloid therapy |
- |
- |
6.47 |
1 251.88 |
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00980 |
Nuclear Medicine therapy - Intravascular radio pharmaceutical therapy particulate |
- |
- |
6.47 |
1 251.88 |
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00985 |
Nuclear Medicine therapy - Intra-articular radio pharmaceutical therapy |
- |
- |
6.47 |
1 251.88 |
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00990 |
Nuclear Medicine isotope |
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Identification code for the use of isotope with a procedure. |
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Appropriate codes to be supplied. |
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00991 |
Nuclear Medicine Substrate |
- |
- |
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00956 |
PET/CT scan whole body without contrast |
- |
- |
165.13 |
31 951.00 |
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00957 |
PET/CT scan whole body with contrast |
- |
- |
163.19 |
31 575.63 |
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00951 |
PET/CT local |
- |
- |
120.00 |
23 218.80 |
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00952 |
PET/CT local with contrast |
- |
- |
124.68 |
24 124.33 |
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Call and assistance |
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01010 |
Emergency call out fee, first case |
- |
- |
3.00 |
580.47 |
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01020 |
Emergency call out fee, subsequent cases same trip |
- |
- |
2.00 |
386.98 |
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01030 |
Radiologist assistance in theatre, per half hour |
- |
- |
6.00 |
1 160.94 |
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01040 |
Radiographer attendance in theatre, per half hour |
- |
- |
1.60 |
309.58 |
||||||||||
01050 |
Written report on study done elsewhere, short |
- |
- |
1.50 |
290.24 |
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01055 |
Written report on study done elsewhere, extensive |
- |
- |
4.20 |
812.66 |
||||||||||
01060 |
Written report for medico legal purposes, per hour |
- |
- |
9.72 |
1 880.72 |
||||||||||
01070 |
Consultation for pre-assessment of interventional procedure |
- |
- |
4.86 |
940.36 |
||||||||||
01100 |
X-ray procedure after hours, per procedure |
- |
- |
2.00 |
386.98 |
||||||||||
01200 |
Ultrasound procedure after hours, per procedure |
- |
- |
4.00 |
773.96 |
||||||||||
01300 |
CT procedure after hours, per procedure |
- |
- |
10.00 |
1 934.90 |
||||||||||
01400 |
MR procedure after hours, per procedure |
- |
- |
14.00 |
2 708.86 |
||||||||||
01500 |
Angiography procedure after hours, per procedure |
- |
- |
20.00 |
3 869.80 |
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01600 |
Interventional procedure after hours, per procedure |
- |
- |
26.00 |
5 030.74 |
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01970 |
Consultation for nuclear medicine study |
- |
- |
2.20 |
425.68 |
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Monitoring |
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ECG/Pulse oximetry monitoring (02010). Use for monitoring patients requiring conscious sedation during imaging procedure. Not to be used as a routine. |
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02010 |
ECG/pulse Oximeter monitoring |
- |
- |
2.00 |
386.98 |
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Head |
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Skull and Brain |
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Codes 10100 (skull) and 10110 (tomography) may be combined. |
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10100 |
X-ray of the skull |
- |
- |
3.86 |
746.87 |
||||||||||
10110 |
X-ray tomography of the skull |
- |
- |
4.30 |
832.01 |
||||||||||
10120 |
X-ray shuntogram for VP shunt |
- |
- |
15.36 |
2 972.01 |
||||||||||
10200 |
Ultrasound of the brain - Neonatal |
- |
- |
7.38 |
1 427.96 |
||||||||||
10210 |
Ultrasound of the brain including doppler |
- |
- |
13.22 |
2 557.94 |
||||||||||
10220 |
Ultrasound of the intracranial vasculature, including B mode, pulse and colour doppler |
- |
- |
15.04 |
2 910.09 |
||||||||||
10300 |
CT Brain uncontrasted |
- |
- |
22.65 |
4 382.55 |
||||||||||
10310 |
CT Brain with contrast only |
- |
- |
33.28 |
6 439.35 |
||||||||||
10320 |
CT Brain pre and post contrast |
- |
- |
40.48 |
7 832.48 |
||||||||||
10325 |
CT brain pre and post contrast for perfusion studies |
- |
- |
49.10 |
9 500.36 |
||||||||||
|
Stand alone code may not be added to any other CT studies of the brain, except for code 10330 |
|
|
|
|
||||||||||
10330 |
CT angiography of the brain |
- |
- |
77.58 |
15 010.95 |
||||||||||
10335 |
CT of the brain pre and post contrast with angiography |
- |
- |
97.91 |
18 944.61 |
||||||||||
10340 |
CT brain for cranio-stenosis including 3D |
- |
- |
34.16 |
6 609.62 |
||||||||||
10350 |
CT Brain stereotactic localisation |
- |
- |
19.36 |
3 745.97 |
||||||||||
10360 |
CT base of skull coronal high resolution study for CSF leak |
- |
- |
34.90 |
6 752.80 |
||||||||||
10400 |
MR of the brain, limited study |
- |
- |
43.56 |
8 428.42 |
||||||||||
10410 |
MR of the brain, uncontrasted |
- |
- |
63.80 |
12 344.66 |
||||||||||
10420 |
MR of the brain with contrast |
- |
- |
75.94 |
14 693.63 |
||||||||||
10430 |
MR of the brain pre and post contrast |
- |
- |
104.04 |
20 130.70 |
||||||||||
10440 |
MR of the brain pre and post contrast, for perfusion studies |
- |
- |
107.44 |
20 788.57 |
||||||||||
10450 |
MR of the brain plus angiography |
- |
- |
92.20 |
17 839.78 |
||||||||||
10460 |
MR of the brain pre and post contrast plus angiography |
- |
- |
121.23 |
23 456.79 |
||||||||||
10470 |
MR angiography of the brain uncontrasted |
- |
- |
58.50 |
11 319.17 |
||||||||||
10480 |
MR angiography of the brain contrasted |
- |
- |
74.02 |
14 322.13 |
||||||||||
10485 |
MR of the brain, with diffusion studies |
- |
- |
79.00 |
15 285.71 |
||||||||||
10490 |
MR of the brain, pre and post contrast, with diffusion studies |
- |
- |
110.64 |
21 407.73 |
||||||||||
10492 |
MR study of the brain plus angiography plus diffusion, uncontrasted |
- |
- |
95.00 |
18 381.55 |
||||||||||
10495 |
MR of the brain pre and post contrast plus angiography and diffusion |
- |
- |
125.44 |
24 271.39 |
||||||||||
10500 |
Arteriography of intracranial vessels: 1 - 2 vessels |
- |
- |
48.60 |
9 403.61 |
||||||||||
10510 |
Arteriography of intracranial vessels: 3 - 4 vessels |
- |
- |
82.33 |
15 930.03 |
||||||||||
10520 |
Arteriography of extra-cranial (non-cervical) vessels |
- |
- |
48.44 |
9 372.66 |
||||||||||
10530 |
Arteriography of intracranial and extra-cranial (non-cervical) vessels |
- |
- |
118.09 |
22 849.23 |
||||||||||
10540 |
Arteriography of intracranial vessels (4) plus 3 D rotational angiography |
- |
- |
97.57 |
18 878.82 |
||||||||||
10550 |
Arteriography of intracranial vessels (1) plus 3D rotational angiography |
- |
- |
37.29 |
7 215.24 |
||||||||||
10560 |
Venography of dural sinuses |
- |
- |
52.23 |
10 105.98 |
||||||||||
10900 |
Nuclear Medicine study - Bone regional, static |
- |
- |
21.50 |
4 160.04 |
||||||||||
10905 |
Nuclear Medicine study - Bone regional, static,with flow |
- |
- |
27.53 |
5 326.78 |
||||||||||
10910 |
Nuclear Medicine study - Bone regional, static with SPECT |
- |
- |
34.92 |
6 756.67 |
||||||||||
10915 |
Nuclear Medicine study - Bone regional, static, with flow, with SPECT |
- |
- |
40.94 |
7 921.48 |
||||||||||
10920 |
Nuclear Medicine study - Brain, planar, complete, static |
- |
- |
16.92 |
3 273.85 |
||||||||||
10925 |
Nuclear Medicine study - Brain complete static with vascular flow |
- |
- |
22.95 |
4 440.60 |
||||||||||
10930 |
Nuclear Medicine study - Brain, planar, complete, static, with SPECT |
- |
- |
30.33 |
5 868.55 |
||||||||||
10935 |
Nuclear Medicine study - Brain, planar, complete, static, with flow, with SPECT |
- |
- |
36.36 |
7 035.30 |
||||||||||
10940 |
Nuclear Medicine study - CSF flow imaging cisternography |
- |
- |
21.60 |
4 179.38 |
||||||||||
10945 |
Nuclear Medicine study - Ventriculography |
- |
- |
13.41 |
2 594.70 |
||||||||||
10950 |
Nuclear Medicine study - Shunt evaluation static, planar |
- |
- |
13.41 |
2 594.70 |
||||||||||
10955 |
Nuclear Medicine study - CFS leakage detection and localisation |
- |
- |
13.41 |
2 594.70 |
||||||||||
10960 |
Nuclear medicine study - CSF SPECT |
- |
- |
13.41 |
2 594.70 |
||||||||||
10971 |
PET/CT scan of the brain uncontrasted |
- |
- |
110.12 |
21 307.12 |
||||||||||
10972 |
PET/CT of the brain contrasted |
- |
- |
116.11 |
22 466.12 |
||||||||||
10981 |
PET/CT perfusion scan of the brain |
- |
- |
131.07 |
25 360.73 |
||||||||||
|
|
|
|
|
|
||||||||||
|
Facial bones and nasal bones |
|
|
|
|
||||||||||
|
Codes 11100 (facial bones) and 11110 (tomography) may be combined |
|
|
|
|
||||||||||
11100 |
X-ray of the facial bones |
- |
- |
3.93 |
760.42 |
||||||||||
11110 |
X-ray tomography of the facial bones |
- |
- |
4.30 |
832.01 |
||||||||||
11120 |
X-ray of the nasal bones |
- |
- |
2.39 |
462.44 |
||||||||||
11300 |
CT of the facial bones |
- |
- |
20.96 |
4 055.55 |
||||||||||
11310 |
CT of the facial bones with 3D reconstructions |
- |
- |
30.40 |
5 882.10 |
||||||||||
11320 |
CT of the facial bones/soft tissue, pre and post contrast |
- |
- |
41.26 |
7 983.40 |
||||||||||
11400 |
MR of the facial soft tissue |
- |
- |
62.40 |
12 073.78 |
||||||||||
11410 |
MR of the facial soft tissue pre and post contrast |
- |
- |
100.60 |
19 465.09 |
||||||||||
11420 |
MR of the facial soft tissue plus angiography, with contrast |
- |
- |
110.30 |
21 341.95 |
||||||||||
11430 |
MR angiography of the facial soft tissue |
- |
- |
74.02 |
14 322.13 |
||||||||||
|
Orbits, lacrimal glands and tear ducts Code 12130 (tomography) may be added to 12100 or 12110 or 12120 (orbits) or 12140 (dacrocystography). |
|
|
|
|
||||||||||
12100 |
X-ray orbits less than three views |
- |
- |
3.56 |
688.82 |
||||||||||
12110 |
X-ray of the orbits, three or more views, including foramina |
- |
- |
5.30 |
1 025.50 |
||||||||||
12120 |
X-ray of the orbits for foreign body |
- |
- |
3.56 |
688.82 |
||||||||||
12130 |
X-ray tomography of the orbits |
- |
- |
4.30 |
832.01 |
||||||||||
12140 |
X-ray dacrocystography |
- |
- |
11.20 |
2 167.09 |
||||||||||
12200 |
Ultrasound of the orbit/eye |
- |
- |
5.13 |
992.60 |
||||||||||
12210 |
Ultrasound of the orbit/eye including doppler |
- |
- |
10.97 |
2 122.59 |
||||||||||
12300 |
CT of the orbits single plane |
- |
- |
15.70 |
3 037.79 |
||||||||||
12310 |
CT of the orbits, more than one plane |
- |
- |
20.59 |
3 983.96 |
||||||||||
12320 |
CT of the orbits pre and post contrast single plane |
- |
- |
36.03 |
6 971.44 |
||||||||||
12330 |
CT of the orbits pre and post contrast multiple planes |
- |
- |
39.70 |
7 681.55 |
||||||||||
12400 |
MR of the orbits |
- |
- |
62.46 |
12 085.39 |
||||||||||
12410 |
MR or the orbitae, pre and post contrast |
- |
- |
100.64 |
19 472.83 |
||||||||||
12900 |
Nuclear Medicine study - Dacrocystography |
- |
- |
20.77 |
4 018.79 |
||||||||||
|
|
|
|
|
|
||||||||||
|
Paranasal sinuses |
|
|
|
|
||||||||||
|
Code 13120 (tomography) may be added to 13100, 13110 (paranasal sinuses), 13130 (nasopharyngeal) |
|
|
|
|
||||||||||
13100 |
X-ray of the paranasal sinuses, single view |
|
|
2.74 |
530.16 |
||||||||||
13110 |
X-ray of the paranasal sinuses, two or more views |
- |
- |
3.66 |
708.17 |
||||||||||
13120 |
X-ray tomography of the paranasal sinuses |
- |
- |
4.30 |
832.01 |
||||||||||
13130 |
X-ray of the naso-pharyngeal soft tissue |
- |
- |
2.74 |
530.16 |
||||||||||
13300 |
CT of the paranasal sinuses single plane, limited study |
- |
- |
7.20 |
1 393.13 |
||||||||||
13310 |
CT of the paranasal sinuses, two planes, limited study |
- |
- |
12.40 |
2 399.28 |
||||||||||
13320 |
CT of the paranasal sinuses, any plane, complete study |
- |
- |
15.42 |
2 983.62 |
||||||||||
13330 |
CT of the paranasal sinuses, more than one plane, complete study |
- |
- |
20.77 |
4 018.79 |
||||||||||
13340 |
CT of the paranasal sinuses, any plane, complete study: pre and post contrast |
- |
- |
34.74 |
6 721.84 |
||||||||||
13350 |
CT of the paranasal sinuses, more than one plane, complete study; pre and post contrast |
- |
- |
41.01 |
7 935.02 |
||||||||||
13400 |
MR of the paranasal sinuses |
- |
- |
60.27 |
11 661.64 |
||||||||||
13410 |
MR of the paranasal sinuses, pre and post contrast |
- |
- |
96.59 |
18 689.20 |
||||||||||
|
|
|
|
|
|
||||||||||
|
Mandible, teeth and maxilla |
|
|
|
|
||||||||||
|
Code 14110 (orthopantomogram) may be combined with 14100 (mandible) if two separate studies are performed. Code 14110 (orthopantomogram) may be combined with 15100 and/or 15110 (TM joint) if complete separate studies are performed. Code 14160 (tomography) may be combined with 14130 or 14140 or 14150 (teeth). Code 14160 (tomography) may be combined with 15100 and/or 15110 (TM joint) if complete separate studies are performed. Code 14330 and 14340 (Dental implants) may be combined if mandible and maxilla are examined at the same visit. |
|
|
|
|
||||||||||
14100 |
X-ray of the mandible |
- |
- |
3.66 |
708.17 |
||||||||||
14110 |
X-ray orthopantomogram of the jaws and teeth |
- |
- |
4.06 |
785.57 |
||||||||||
14120 |
X-ray maxillofacial cephalometry |
- |
- |
2.77 |
535.97 |
||||||||||
14130 |
X-ray of the teeth single quadrant |
- |
- |
2.00 |
386.98 |
||||||||||
14140 |
X-ray of the teeth more than one quadrant |
- |
- |
2.53 |
489.53 |
||||||||||
14150 |
X-ray of the teeth full mouth |
- |
- |
3.62 |
700.43 |
||||||||||
14160 |
X-ray tomography of the teeth per side |
- |
- |
3.23 |
624.97 |
||||||||||
14300 |
CT of the mandible |
- |
- |
22.28 |
4 310.96 |
||||||||||
14310 |
CT of the mandible, pre and post contrast |
- |
- |
41.26 |
7 983.40 |
||||||||||
14320 |
CT mandible with 3D reconstructions |
- |
- |
30.40 |
5 882.10 |
||||||||||
14330 |
CT for dental implants in the mandible |
- |
- |
27.45 |
5 311.30 |
||||||||||
14340 |
CT for dental implants in the maxilla |
- |
- |
27.45 |
5 311.30 |
||||||||||
14400 |
MR of the mandible/maxilla |
- |
- |
63.80 |
12 344.66 |
||||||||||
14410 |
MR of the mandible/maxilla, pre and post contrast |
- |
- |
98.64 |
19 085.85 |
||||||||||
|
|
|
|
|
|
||||||||||
|
T M Joints |
|
|
|
|
||||||||||
|
Code 15100 (TM joint) and 15120 (tomography) may be combined. Code 15110 (TM joint) and 15130 (tomography) may be combined. Code 15140 (arthrography) and 15120 (tomography) may be combined. Code 15150 (arthrography) and 15130 (tomography)may be combined. Codes 15320 (CT arthrogram) and 15420 (MR arthrogram) include introduction of contrast (00140 may not be added). |
|
|
|
|
||||||||||
15100 |
X-ray tempero-mandibular joint, left |
- |
- |
3.56 |
668.82 |
||||||||||
15100 |
X-ray tempero-mandibular joint, right |
- |
- |
3.56 |
668.82 |
||||||||||
15120 |
X-ray tomography tempero-mandibular joint, left |
- |
- |
4.30 |
832.01 |
||||||||||
15130 |
X-ray tomography tempero-mandibular joint, right |
- |
- |
4.30 |
832.01 |
||||||||||
15140 |
X-ray arthrography of the tempero-mandibular joint, left |
- |
- |
15.41 |
2 981.68 |
||||||||||
15150 |
X-ray arthrography of the tempero-mandibular joint, right |
- |
- |
15.41 |
2 981.68 |
||||||||||
15200 |
Ultrasound tempero-mandibular joints, one or both sides |
- |
- |
6.56 |
1 269.29 |
||||||||||
15300 |
CT of the tempero-mandibular joints |
- |
- |
25.38 |
4 910.78 |
||||||||||
15310 |
CT of the tempero-mandibular joints plus 3D reconstructions |
- |
- |
34.50 |
6 675.41 |
||||||||||
15320 |
CT arthrogram of the tempero-mandibular joints |
- |
- |
35.96 |
6 957.90 |
||||||||||
15400 |
MR of the tempero-mandibular joints |
- |
- |
63.80 |
12 344.66 |
||||||||||
15410 |
MR of the tempero-mandibular joints, pre and post contrast |
- |
- |
100.84 |
19 511.53 |
||||||||||
15420 |
MR arthrogram of the tempero-mandibular joints |
- |
- |
74.71 |
14 455.64 |
||||||||||
|
|
|
|
|
|
||||||||||
|
Mastoids and internal auditory canal |
|
|
|
|
||||||||||
|
Code 16100 (mastoids) and 16120 (tomography) may be combined. Code 16110 (mastoids bilat) and 16130 (tomography) may be combined Code 16140 (IAM's) and 16150 (tomography) may be combined. |
|
|
|
|
||||||||||
16100 |
X-ray of the mastoids, unilateral |
- |
- |
3.59 |
694.63 |
||||||||||
16110 |
X-ray of the mastoids, bilateral |
- |
- |
7.18 |
1 389.26 |
||||||||||
16120 |
X-ray tomography of the petro-temporal bone, unilateral |
- |
- |
4.30 |
832.01 |
||||||||||
16130 |
X-ray tomography of the petro-temporal bone, bilateral |
- |
- |
8.60 |
1 664.01 |
||||||||||
16140 |
X-ray internal auditory canal, bilateral |
- |
- |
5.23 |
1 011.95 |
||||||||||
16150 |
X-ray tomography of the internal auditory canal, bilateral |
- |
- |
4.30 |
832.01 |
||||||||||
16300 |
CT of the mastoids |
- |
- |
|