Compensation for Occupational Injuries and Diseases Act, 1993 (Act No. 130 of 1993)

Scale of Fees

Annual Increase in Medical Tariffs for Medical Service Providers - 2021

Doctors Gazette 2021

Part lll : Procedures

19. Radiology

Schedule

Purchase

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

Other special/General Practitioner

Specialists

U/E

00090

Consumables used in radiology procedures

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

00115

X-ray skeletal survey over five years

10.40

2 012.30

00120

X-ray sinogram any region

10.89

2 107.11

00130

X-ray with mobile unit in other facility

1.90

367.63

To be added to applicable procedure codes eg 30100.

00135

X-ray control view in theatre any region

5.26

1 017.76

00140

X-ray fluoroscopy any region

2.26

437.29

May only be added to the examination when fluoroscopy is not included in the standard procedure code. May not be added to:

•	any angiography, venography, lymphangiography or interventional codes

•	any contrasted fluoroscopy examination.

00145

X-ray fluoroscopy guidance for biopsy, any region

5.30

1 025.50

Add to the procedure eg. 80600, 80605, 80610

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

Only to be used if equipment is owned by the radiologist.

00190

X-ray examination contrast material

Identification code for the use of contrast with a procedure.

Appropriate codes to be supplied.

00210

Ultrasound with mobile unit in other facility

1.84

356.02

Add to the relevant ultrasound examination codes eg 10200.

00220

Ultrasound intra-operative study

7.32

1 416.35

Covers all regions studied. Single code per operative procedure.

00230

Ultrasound guidance

12.10

2 341.23

guidance. Guided procedure code to be added eg. 80600, 80605, 80610.

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.

00250

Ultrasound limited Doppler study any region

6.50

1 257.69

Stand alone code may not be added to any other code.

00290

Ultrasound examination contrast material

Identification code for the use of contrast with a procedure.

Appropriate codes to be supplied.

00310

CT planning study for radiotherapy

21.37

4 134.88

00320

CT guidance (separate procedure)

16.92

3 273.65

Comprehensive CT code including regional study and guidance.

Guided procedure code to be added eg 80600, 80605, and 80610.

00330

CT guidance, with diagnostic procedure

8.46

1 636.93

To be added to the diagnostic procedure code. Guided procedure code to be added eg 80600, 80605, 80610.

00340

CT guidance and monitoring for tissue ablation

21.15

4 092.31

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.

00390

CT examination contrast material

Identification code for the use of contrast with a procedure.

Appropriate codes to be supplied.

00420

MR Spectroscopy any region

28.90

5 591.86

May be added to the regional study, once only.

00430

MR guidance for needle replacement

42.56

8 234.93

Comprehensive MRI code including region studied and guidance.

Guided procedure code to be added eg 80600, 80605, 80610.

00440

MR low field strength imaging of peripheral joint any region

12.00

2 321.88

00450

MR planning study for radiotherapy or surgical procedure

38.00

7 352.62

00455

MR planning study for radiotherapy or surgical procedure, with contrast

47.00

9 094.03

00490

MR examination contrast material

Identification code for the use of contrast with a procedure.

Appropriate codes to be supplied.

00510

Analogue monoplane screening table

41.01

7 935.02

A machine code may be added once per complete procedure/patient visit

00520

Analogue monoplane table with DSA attachment

47.50

9 190.78

A machine code may be added once per complete procedure/patient visit.

00530

Dedicated angiography suite: Analogue monoplane unit. Once off charge per patient by owner of equipment.

47.50

9 190.78

A machine code may be added once per complete procedure/patient visit.

00540

Digital monoplane screening table

79.92

15 463.72

A machine code may be added once per complete procedure/patient visit.

00550

Dedicated angiography suite: Digital monoplane unit. Once off charge per patient by owner of equipment.

93.03

18 000.37

A machine code may be added once per complete procedure/patient visit.

00560

Dedicated angiography suite: Digital bi-plane unit. Once off charge per patient by owner of equipment

125.00

24 186.25

A machine code may be added once per complete procedure/patient visit.

00590

Angiography and interventional examination contrast material

Identification code for the use of contrast with a procedure.

Appropriate codes to be supplied.

00900

Nuclear Medicine study Bone, whole body, appendicular and axial skeleton

34.92

6 756.67

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

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

00936

Nuclear Medicine study - Bone marrow imaging whole body

37.51

7 257.81

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

00960

Nuclear Medicine therapy - Hyperthyroidism

11.99

2 319.95

00965

Nuclear Medicine therapy - Thyroid carcinoma and metastases

6.47

1 251.88

00970

Nuclear Medicine therapy - Intra-cavity radio-active colloid therapy

6.47

1 251.88

00975

Nuclear Medicine therapy - Interstitial radio-active colloid therapy

6.47

1 251.88

00980

Nuclear Medicine therapy - Intravascular radio pharmaceutical therapy particulate

6.47

1 251.88

00985

Nuclear Medicine therapy - Intra-articular radio pharmaceutical therapy

6.47

1 251.88

00990

Nuclear Medicine isotope

Identification code for the use of isotope with a procedure.

Appropriate codes to be supplied.

00991

Nuclear Medicine Substrate

00956

PET/CT scan whole body without contrast

165.13

31 951.00

00957

PET/CT scan whole body with contrast

163.19

31 575.63

00951

PET/CT local

120.00

23 218.80

00952

PET/CT local with contrast

124.68

24 124.33

Call and assistance

•	Emergency call out code 01010 only to be used if radiologist is called out to the rooms to report on an examination after normal working hours. May not be used for routine reporting during extended working hours.

•

Emergency call out code 01020 only to be used when a radiologist reports on subsequent cases after having been called out to the rooms to report an initial after hours procedure. This code may also be used for home tele-radiology reporting of an emergency procedure. May not be used for routine reporting during normal or extended working hours.

•	Radiologist assistance in theatre code 01030 only to be used if the radiologist is actively involved in assisting another radiologist or clinician with a procedure.

•	Radiographer assistance in theatre 01040 may not be used for procedures performed in facilities owned by the radiologist; ie only for attendance in hospital theatres etc. Does not apply to Bed Side Unit (BSU) examinations.

•	Second opinion consultations only to be used if a written report is provided as indicated in codes 01050, 01055, 01060. Not intended for ad hoc verbal consultations.

01010

Emergency call out fee, first case

3.00

580.47

01020

Emergency call out fee, subsequent cases same trip

2.00

386.98

01030

Radiologist assistance in theatre, per half hour

6.00

1 160.94

01040

Radiographer attendance in theatre, per half hour

1.60

309.58

01050

Written report on study done elsewhere, short

1.50

290.24

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

01600

Interventional procedure after hours, per procedure

26.00

5 030.74

01970

Consultation for nuclear medicine study

2.20

425.68

Monitoring

ECG/Pulse oximetry monitoring (02010). Use for monitoring patients requiring conscious sedation during imaging procedure. Not to be used as a routine.

02010

ECG/pulse Oximeter monitoring

2.00

386.98

Head

Skull and Brain

Codes 10100 (skull) and 10110 (tomography) may be combined.

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