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GT Shield

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 - 2018

Specialists

III. Procedures

19. Radiology

19.14 Interventional radiological procedures

 


Specialist Radiologist

Other Specialists and General Practitioner

Anaesthetic

U

R

U

R

U

R

T

Specialist Radiologist with own facility

Non-radiologist or specialist radiologist without own facility (calculate at 60% of the fee)

Anaesthetic



U

R

U

R

U

R

T

19.

Radiology

 

 

 

 

 

 

 



 

 

 

 

 

 

 

19.14

Interventional radiological procedures

 

 

 

 

 

 

 



 

 

 

 

 

 

 

5014

Atherectomy (per vessel)

 

 

204.6

5123.18

 

 

 

5016

Aspiration thrombectomy (per vessel)

 

 

131.4

3290.26

 

 

 

5018

On-table thrombolysis/transcatheter performed in angiograph suite

 

 

106.8

2674.27

5

559.30

+

5022

Embolisation non-intracranial. per vessels

 

 

106.8

2674.27

9

1006.74

+T

5031

Antegrade ureteric stent insertion

 

 

69.6

1742.78

6

671.16

+T

5033

Percutaneous cystostomy in radiology suite

 

 

30

751.20

 

 

 

5035

Urethral balloon dilatation in radiology suit

 

 

22.8

570.91

 

 

 


Percutaneous Abdominal/pelvic/other drain insertion, any modality

 

 

34.2

856.37

 

 

 

5037

Urethral stenting in radiology suite

 

 

102.6

2569.10

 

 

 

5041

Balloon occlusion

 

 

106.8

2674.27

9

1006.74

+T

5043

Intracranial angioplasty

 

 

204.6

5123.18

13

1454.18

+T

5045

Hepatic arterial infusion catheter insertion

 

 

156

3906.24

6

671.16

+T

5047

Combined internal/external biliary drainage

 

 

102.6

2569.10

9

1006.74

+T

5049

Percutaneous gall bladder drainage

 

 

69.6

1742.78

9

1006.74

+T

5072

Tunnelled/Subcutaneous arterial/venous line performed in radiology suite

 

 

82.2

2058.29

5

559.30

+T

5074

IVC filter Insertion jugular or femoral route

 

 

156

3906.24

9

1006.74

+T

5076

Intravascular foreign body removal, arterial or venous, any route

 

 

204.6

5123.18

9

1006.74

+T

5078

Percutaneous sclerotherapy of an arteriovenous malformation (AVM)

 

 

70.2

1757.81

 

 

 

5080

Transjugular intrahepatic portosystemic shunt

 

 

335.4

8395.42

13

1454.18

+T

5082

Transjugular liver biopsy

 

 

69.6

1742.78

9

1006.74

+T

5088

Oesophageal stent insertion in radiology suite

 

 

102.6

2569.10

6

671.16

+T

5090

Trachial stent insertions

 

 

102.6

2569.10

6

671.16

+T

5091

GIT Balloon dilatation under fluoroscope



66.6

1667.66

6

671.16

+T

5092

Other GIT stent insertion



102.6

2569.10

6

671.16

+T

5093

Percutaneous gastrostomy in radiology suite



85.8

2148.43

 

 

 

5094

Cutting needle biopsy with image guidance



22.8

570.91

 

 

 

5095

Chest drain Insertion in radiology suite



32.4

811.30

 

 

 





 

 

 

 

 


This schedule must be used in conjunction with the Radiological Society of S A 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 with a main region or category eg. "Head,/Skull and Brain" = 10xxx
(iii) 3rd digit indicates modality
1 = General (Black and White) x-rays
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 fora procedure, the units will be reduced by 33.33%.

















Consumables

Prior to the implementation of Act 90, contrast will be billed according to the official 2004 RSSA reimbursement price list, without mark up.
After the implementation of Act 90, contrast medium will be billed according to the suppliers' list price, without mark up.
Angiography catheters, angioplasty balloons, stents, coils and other embolisation materials, guide wires and drains are

















General Comments on Procedural Codes









All 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.
Setting of sterile tray is Included in all appropriate procedure codes.
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.
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.
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).
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 is 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 specialist/

General Practitioner

Specialist

00090

Consumables used in radiology procedures

 

U

R

U

R

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 is used

 

 

 

 

 

00115

X-ray skeletal survey over five years

 

-

 

10.40

1698.11

00120

X-ray sinogram any region

 

-

-

10.89

1778.12

00130

X -ray with mobile unit in other facility

 

-

-

1.90

310.23


To be added to applicable procedure codes eg 30100.

 

 

 

 

 

00135

X-ray control view in theatre any region

 

-

-

5.26

858.85

00140

X-ray fluoroscopy any region

 

-

-

2.26

369.01


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

865.38


Add to the procedure eg. 80600, 80605, 80610.

 

 

 

 

 

00150

X-ray C-Arm (equipment fee only, not procedure) per half hour

 

-

-

2.42

395.14


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

 

 

 

 

 

00155

X-ray C-arm fluoroscopy in theatre per half hour (procedure only)

 

-

-

2.30

375.54

00160

X-ray fixed theatre installation (equipment fee only)

 

-

-

2.26

369.01


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

300.44


Add to the relevant ultrasound examination codes eg 10200.

 

 

 

 

 

00220

Ultrasound intra-operative study

 

-

-

7.32

1195.21


Covers all regions studied. Single code per operative procedure.

 

 

 

 

 

00230

Ultrasound guidance

 

-

-

12.10

1975.69


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

 

 

 

 

 

00240

Ultrasound guidance for tissue ablation

 

-

-

11.24

1835.27


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

1061.32


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

3489.29

00320

CT guidance (separate procedure)

 

-

-

16.92

2762.70


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

1381.35


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

3453.37


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

May be added to the regional study, once only

 

 

 

28.90

4718.79

00430

MR Guidance for needle replacement

 

 

 

42.56

6949.20


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

1959.36

00450

MR planning study for radiotherapy or surgical procedure

 

 

 

38.00

6204.64

00455

MR planning study for radiotherapy or surgical procedure, with contrast

 

 

 

47.00

7674.16

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

6696.11


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

 

 

 

 

 

00520

Analogue monoplane table with DSA attachment

 

-

-

47.50

7755.80


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

7755.80


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

 

 

 

 

 

00540

Digital monoplane screening table

 

-

-

79.92

13049.34


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

15189.94


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

20410.00


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

5701.74

00903

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

 

-

-

48.33

7891.32

00906

Nuclear Medicine study - Venous thrombosis regional

 

-

-

21.54

3517.05

00909

Nuclear Medicine study - Tumour whole body

 

-

-

34.15

5576.01

00912

Nuclear Medicine study - Tumour whole body multiple studies

 

-

-

47.56

7765.60

00915

Nuclear Medicine study - Tumour whole body and SPECT

 

-

-

47.56

7765.60

00918

Nuclear Medicine study - Tumour whole body multiple studies & SPECT

 

-

-

60.98

9956.81

00921

Nuclear Medicine study - Infection whole body

 

-

-

31.45

5135.16

00924

Nuclear Medicine study - infection whole body with SPECT

 

-

-

44.86

7324.74

00927

Nuclear Medicine study - infection whole body multiple studies

 

 

 

44.86

7324.74

00930

Nuclear Medicine study - infection whole body with SPECT

 

-

-

58.27

9514.33

00933

Nuclear Medicine study - Bone marrow imaging limited area

 

-

-

24.10

3935.05

00936

Nuclear Medicine study - Bone marrow imaging whole body

 

-

-

37.51

6124.63

00939

Nuclear Medicine study - Bone marrow imaging limited area multiple studies

 

-

-

37.51

6124.63

00942

Nuclear Medicine study - Bone marrow imaging whole body multiple studies

 

-

-

50.92

8314.22

00945

Nuclear Medicine study - Spleen imaging only - haematopoietic

 

-

-

24.10

3935.05

00960

Nuclear Medicine therapy - Hyperthyroidism

 

-

-

11.99

1957.73

00965

Nuclear Medicine therapy - Thyroid carcinoma and metastases

 

-

-

6.47

1056.42

00970

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

 

-

-

6.47

1056.42

00975

Nuclear Medicine therapy - Interstitial radio -active colloid therapy

 

-

-

6.47

1056.42

00980

Nuclear Medicine therapy - Intravascular radio pharmaceutical

therapy particulate

 

-

-

6.47

1056.42

00985

Nuclear Medicine therapy Intra- articular radio pharmaceutical therapy

 

-

-

6.47

1056.42

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

26962.43

00957

PET/CT scan whole body with contrast

 

-

-

163.19

26645.66

00951

PET/CT local

 

-

-

120.00

19593.60

00952

PET/CT local with contrast

 

-

-

124.68

20357.75



 

 

 

 

 


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; le 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

489.94

01020

Emergency call out fee, subsequent cases same trip

 

-

-

2.00

326.56

01030

Radiologist assistance in theatre, per half hour

 

-

-

6.00

979.68

01040

Radiographer attendance in theatre, per half hour

 

-

-

1,60

261.25

01050

Written report on study done elsewhere, short

 

-

-

1.50

244.92

01055

Written report on study done elsewhere, extensive

 

-

-

4.20

685.78

01060

Written report for medico legal purposes, per hour

 

-

-

9.72

1587.08

01070

Consultation for pre -assessment of interventional procedure

 

-

-

4.86

793.54

01100

X -ray procedure after hours, per procedure

 

-

-

2.00

326.56

01200

Ultrasound procedure after hours, per procedure

 

-

-

4.00

653.12

01300

CT procedure after hours, per procedure

 

-

-

10.00

1632.80

01400

MR procedure after hours, per procedure

 

-

-

14.00

2285.92

01500

Angiography procedure after hours, per procedure

 

-

-

20.00

3265.60

01600

Interventional procedure after hours, per procedure

 

-

-

26.00

4245.28

01970

Consultation for nuclear medicine study

 

-

-

2.20

359.22



 

 

 

 

 


Monitoring

 

-

-

 

 


ECG/Pulse oximetry monitoring (02010). Use for monitoring patients requiring conscious sedation during imaging procedure

 

-

-

 

 

02010

ECG/pulse Oximeter monitoring

 

-

-

2.00

326.56



 

 

 

 

 


Head

 

-

-

 

 



 

 

 

 

 


Skull and Brain

 

-

-

 

 


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

 

-

-

 

 

10100

X-ray of the skull

 

-

-

3.86

630.26

10110

X -ray tomography of the skull

 

-

-

4.30

702.10

10120

X-ray shuntogram for VP shunt

 

-

-

15.36

2507.98

10200

Ultrasound of the brain - Neonatal

 

-

-

7.38

1205.01

10210

Ultrasound of the brain including doppler

 

-

-

13.22

2158.56

10220

Ultrasound of the intracranial vasculature, including B mode, pulse and colour doppler

 

-

-

15.04

2455.73

10300

CT Brain uncontrasted

 

-

-

22.65

3698.29

10310

CT Brain with contrast only

 

-

-

33.28

5433.96

10320

CT Brain pre and post contrast

 

-

-

40.48

6609.57

10325

CT brain pre and post contrast for perfusion studies

 

-

-

49.10

8017.05


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

12667.26

10335

CT of the brain pre and post contrast with angiography

 

-

-

97.91

15986.74

10340

CT brain for cranio-stenosis including 3D

 

-

-

34.16

5577.64

10350

CT Brain stereotactic localisation

 

-

-

19.36

3161.10

10360

CT base of skull coronal high resolution study for CSF leak

 

-

-

34.90

5 698.47

10400

MR of the brain, limited study

 

-

-

43.56

7112.48

10410

MR of the brain uncontrasted

 

-

-

63.80

10417.26

10420

MR of the brain with contrast

 

-

-

75.94

12399.48

10430

MR of the brain pre and post contrast

 

-

-

104.04

18987.65

10440

MR of the brain pre and post contrast, for perfusion studies

 

-

-

107.44

17542.80

10450

MR of the brain plus angiography

 

-

-

92.20

15054.42

10460

MR of the brain pre and post contrast plus angiography

 

-

-

121.23

19794.43

10470

MR angiography of the brain uncontrasted

 

-

-

58.50

9551.88

10480

MR angiography of the brain contrasted

 

-

-

74.02

12085.99

10485

MR of the brain, with diffusion studies

 

-

-

79.00

12899.12

10490

MR of the brain, pre and post contrast, with diffusion studies,

 

-

-

110.84

18065.30

10492

MR study of the brain plus angiography plus diffusion, uncontrasted

 

-

-

95.00

15511.60

10495

MR of the brain pre and post contrast plus angiography and diffusion

 

-

-

125.44

20481.84

10500

Arteriography of intracranial vessels: 1 - 2 vessels

 

-

-

48.60

7935.41

10510

Arteriography of intracranial vessels: 3 -4 vessels

 

-

-

82.33

13442.84

10520

Arteriography of intracranial vessels (4) plus 3 D rotational  angiography

 

-

-

48.44

7909.28

10530

Arteriography of intracranial and extra- cranial (non -cervical) vessels

 

-

-

118.09

19281.74

10540

Arteriography of intracranial vessels (4) plus 3 D rotational angiography

 

-

-

97.57

15931.23

10550

Arteriography of intracranial vessels (1) plus 3D rotational angiography

 

-

-

37.29

6088.71

10560

Venography of dural sinuses

 

-

-

52.23

8528.11

10900

Nuclear Medicine study - Bone regional, static

 

-

-

21.50

3510.52

10905

Nuclear Medicine study - Bone regional, static, with flow

 

-

-

27.53

4495.10

10910

Nuclear Medicine study - Bone regional, static with SPECT

 

-

-

34.92

5701.74

10915

Nuclear Medicine study - Bone regional, static, with flow, with SPECT

 

-

-

40.94

6684.68

10920

Nuclear Medicine study - Brain, planar, complete, static

 

-

-

16.92

2762.70

10925

Nuclear Medicine study - Brain complete static with vascular flow

 

-

-

22.95

3747.28

10930

Nuclear Medicine study - Brain, planar, complete, static, with SPECT

 

-

-

30.33

4952.28

10935

Nuclear Medicine study - Brain, planar, complete, static, with flow, with SPECT

 

-

-

36.36

5936.86

10940

Nuclear Medicine study - CSF flow imaging cisternography

 

-

-

21.60

3526.85

10945

Nuclear Medicine study - Ventriculography

 

-

-

13.41

2189.58

10950

Nuclear Medicine study -Shunt evaluation static, planar

 

-

-

13.41

2189.58

10955

Nuclear Medicine study - CFS leakage detection and localisation

 

-

-

13.41

2189.58

10960

Nuclear medicine study - CSF SPECT

 

-

-

13.41

2189.58

10971

PET/CT scan of the brain uncontrasted

 

-

-

110.12

17980.39

10972

PET/CT of the brain contrasted

 

-

-

116.11

18958.44

10981

PET/CT perfusion scan of the brain

 

-

-

131.07

21401.11



 

 

 

 

 


Facial bones and nasal bones

 

 

 

 

 


Codes 11100 (facial bones) and 11110 (tomography) may be combined

 

 

 

 

 

11100

X -ray of the facial bones

 

-

-

3.93

641.69

11110

X -ray tomography of the facial bones

 

-

-

4.30

702.10

11120

X -ray of the nasal bones

 

-

-

2.39

390.24

11300

CT of the facial bones

 

-

-

20.96

3422.35

11310

CT of the facial bones with 3D reconstructions

 

-

-

30.40

4063.71

11320

CT of the facial bones/soft tissue, pre and post contrast

 

-

-

41.26

6736.93

11400

MR of the facial soft tissue MR of the facial soft tissue pre

 

-

-

62.40

10188.67

11410

MR of the facial soft tissue pre and post contrast

 

-

-

100.60

16425.97

11420

MR of the facial soft tissue plus angiography, with contrast

 

-

-

110.30

19009.78

11430

MR angiography of the facial soft tissue

 

-

-

74.02

12085.99



 

 

 

 

 


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

581.23

12110

X-ray of the orbits, three or more views, including foramina

 

-

-

 

865.39

12120

X-ray of the orbits for foreign body

 

-

-

3.56

581.28

12130

X-ray tomography of the orbits

 

-

-

4.30

702.10

12140

X-ray dacrocystography

 

-

-

11.20

1828.74

12200

Ultrasound of the orbit/eye

 

-

-

5.13

837.63

12210

Ultrasound of the orbit/eye including doppler

 

-

-

10.97

1791.18

12300

CT of the orbits single plane

 

-

-

15.70

2563.50

12310

CT of the orbits, more than one plane

 

-

-

20.59

3361.04

12320

CT of the orbits pre and post contrast single plane

 

-

-

36.03

5882.98

12330

CT of the orbits pm and post contrast multiple planes

 

-

-

39.70

6482.22

12400

MR of the orbits

 

-

-

62.46

10198.47

12410

MR of the orbitae, pre and post contrast

 

-

-

100.64

16432.50

12900

Nuclear Medicine study - Dacrocystography

 

-

-

20.77

3391.33



 

 

 

 

 


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

447.39

13110

X -ray of the paranasal sinuses, two or more views

 

-

-

3.66

597.60

13120

X -ray tomography of the paranasal sinuses

 

-

-

4.30

702.10

13130

X -ray of the naso- pharyngeal soft tissue

 

-

-

2.74

447.39

13300

CT of the paranasal sinuses single plane, limited study

 

-

-

7.20

1175.62

13310

CT of the paranasal sinuses, two planes, limited study

 

-

-

12.40

2024.67

13320

CT of the paranasal sinuses, any plane, complete study

 

-

-

15.42

2517.78

13330

CT of the paranasal sinuses, more than one plane, complete study

 

-

-

20.77

3391.33

13340

CT of the paranasal sinuses, any plane, complete study: pre and

post contrast

 

-

-

34.74

5672.35

13350

CT of the paranasal sinuses, more than one plane, complete study; pre and post contrast

 

-

-

41.01

6696.11

13400

MR of the paranasal sinuses

 

-

-

60.27

9840.89

13410

MR of the paranasal sinuses, pre and post contrast

 

-

-

96.59

15771.22



 

 

 

 

 


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

597.60

14110

X-ray orthopantomogram of the jaws and teeth

 

-

-

4.06

662.92

14120

X-ray maxillofacial cephalometry

 

-

-

2.77

452.29

14130

X-ray of the teeth single quadrant

 

-

-

2.00

326.56

14140

X-ray of the teeth more than one quadrant

 

-

-

2.53

413.10

14150

X-ray of the teeth full mouth

 

-

-

3.62

591.07

14160

X-ray tomography of the teeth per side

 

-

-

3.23

527.39

14300

CT of the mandible

 

-

-

22/28

3637.88

14310

CT of the mandible, pre and post contrast

 

-

-

41.26

6736.93

14320

CT mandible with 3D reconstructions

 

-

-

30.40

4963.71

14330

CT for dental implants in the mandible

 

-

-

27.45

4482.04

14340

CT for dental implants in the maxilla

 

-

-

27.45

4482.04

14400

MR of the mandible/maxilla

 

-

-

63.80

10417.26

14410

MR of the mandibla/maxilla, pre and post contrast

 

-

-

98.64

16105.94



 

 

 

 

 


TM 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

581.28

15110

X-ray tempero-mandibular joint, right

 

-

-

3.56

581.28

15120

X-ray tomography tempero-mandibular joint, left

 

-

-

4.30

581.28

15130

X-ray tomography tempero-mandibular joint, right

 

-

-

4.30

702.10

15140

X-ray arthrography of the tempero-mandibular joint, left

 

-

-

15.41

702.10

15150

X-ray arthrography of the tempero-mandibular joint, right

 

-

-

15.41

2516.14

15200

Ultrasound tempero-mandibular joints, one or both sides

 

-

-

6.56

1071.12

15300

CT of the tempero-mandibular joints

 

-

-

25/38

4144.05

15310

CT of the tempero-mandibular joints plus 3D reconstructions

 

-

-

34.50

5633.16

15320

CT arthrogram of the tempero-mandibular joints

 

-

-

35.96

5871.55

15400

MR of the tempero-mandibular joints

 

-

-

63.80

10417.26

15410

MR of the tempero-mandibular joints, pre and post contrast

 

-

-

100.84

16465.16

15420

MR arthrogram of the tempero-mandibular joints

 

-

-

74.71

12198.65



 

 

 

 

 


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

586.18

16110

X -ray of the mastoids, bilateral

 

-

-

7.18

1172.35

16120

X-ray tomography of the patro-temporal bone, unilateral

 

-

-

4.30

702.10

168130

X -ray tomography of the petro- temporal bone, bilateral

 

-

-

8.60

1404.21

16140

X -ray internal auditory canal, bilateral

 

-

-

5.23

853.95

16150

X -ray tomography of the internal auditory canal, bilateral

 

-

-

4.30

702.10

16300

CT of the mastoids

 

-

-

 

 

16310

CT of the internal auditory canal

 

-

-

 

 

16320

CT of the internal auditory canal, pre and post contrast

 

-

-

 

 

16330

CT of the ear structures, limited study

 

-

-

 

 

16340

CT of the middle and inner ear structures, high definition including all reconstructions in various planes

 

-

-

 

 

16400

MR of the internal auditory canals, limited study

 

-

-

 

 

16410

MR of the internal auditory canals, pre and post contrast, limited study

 

-

-

 

 

16420

MR of the internal auditory canals, pre and post contrast, complete study

 

-

-

 

 

16430

MR of the ear structures

 

-

-

 

 

16440

MR of the era structures, pre and post contrast

 

-

-

 

 



 

 

 

 

 


Sella turcica

 

 

 

 

 


Code 17100 (sella) and 17110 (tomography) may be combined.

 

 

 

 

 

17100

X-ray of the sella turcica

 

-

-

3.08

502.90

17110

X-ray tomography of the sella turcica

 

-

-

4.30

702.10

17300

CT of the sella turcica/hypophysis

 

-

-

17.45

2849.24

17310

CT of the sella turcica/hypophysis, pre and post contrast

 

-

-

42.26

6900.21



 

 

 

 

 


Salivary glands and floor of the mouth

 

 

 

 

 



 

 

 

 

 


Neck

 

 

 

 

 


Code 20120 (laryngography) includes fluoroscopy (00140 may not be added).

Code 20130 (speech) includes tomography and cinematography

(00140 may not be added).

Code 20450 (MR Angiography) may be combined with 10410 (MR brain).

 

 

 

 

 

20100

X-ray of soft tissue of the neck

 

-

-

2.74

447.39

20110

X -ray of the larynx including tomography

 

-

-

9.39

1533.20

20120

X-ray laryngography

 

-

-

8.28

1351.96

20130

X -ray evaluation of pharyngeal movement and speech by  screening and/or cine with or without video recording

 

-

-

8.30

1355.22

20200

Ultrasound of the thyroid

 

-

-

6.56

1071.12

20210

Ultrasound of soft tissue of the neck

 

-

-

6.56

1071.12

20220

Ultrasound of the carotid arteries, bilateral including B mode, pulsed and colour doppler

 

-

-

15.00

2449.20

20230

Ultrasound of the entire extracranial vascular tree including carotids, vertebral and subdavian vessels with B mode, pulse  and colour doppler

 

-

-

21.84

3566.04

20240

Ultrasound study of the venous system of the neck including pulse and colour Doppler

 

-

-

10.80

1763.42

20300

CT of the soft tissues of the neck

 

-

-

18.25

2979.86

20310

CT of the soft tissues of the neck, with contrast

 

-

-

38.15

6229.13

20320

CT of the soft tissues of the neck, pre and post contrast

 

-

-

43.81

7153.30

20330

CT angiography of the extracranial vessels in the neck

 

-

-

79.36

12957.90

20340

... intracranial vessels of the brain

 

-

-

107.50

17552.60

20350

CT angiography of the extracranial vessels in the neck and intracranial vessels of the brain plus a pre and post contrast study of the brain

 

-

-

124.43

20316.93

20400

MR of the soft tissue of the neck

 

-

-

63.60

10384.61

20410

MR of the soft tissue of the neck, pre and post contrast

 

-

-

102.04

16661.09

20420

MR of the soft tissue of the neck and uncontrasted angiography

 

-

-

92.60

15119.73

20430

MR angiography of the extracranial vessels in the neck, without contrast

 

-

-

59.60

9731.49

20440

MR angiography of the extracranial vessels in the neck, with contrast

 

-

-

74.02

12085.99

20450

MR angiography of the extra and intracranial vessels with contrast

 

-

-

116.05

18948.64

20460

MR angiography of the intra and extra cranial vessels plus brain, without contrast

 

-

-

135.17

22070.56

20470

MR angiography of the infra and extra cranial vessels plus brain, with contrast

 

-

-

156.05

25479.84

20500

Arteriography of cervical vessels: carotid 1 - 2 vessels

 

-

-

44.43

7254.53

20510

Arteriography of cervical vessels: vertebral 1 - 2 vessels

 

 

 

50.73

8283.19

20520

Arteriography of cervical vessels: carotid and vertebral

 

 

 

77.63

12675.43

20530

Arteriography of aortic arch and cervical vessels

 

 

 

91.97

15016.86

20540

Arteriography of aortic arch, cervical and intracranial vessels

 

 

 

108.87

17776.29

20550

Venography of jugular and vertebral veins

 

 

 

48.95

7992.56



 

 

 

 

 


Thyroid (Nuclear Medicine)

 

 

 

 

 

21900

Nuclear Medicine study - Thyroid, single uptake

 

 

 

9.68

1580.55

21910

Nuclear medicine study - Thyroid, multiple uptake

 

 

 

14.69

2398.58

21920

Nuclear medicine study - Thyroid imaging with uptake

 

 

 

17.72

2893.32

21930

Nuclear medicine study - Thyroid imaging

 

 

 

12.72

2076.92

21940

Nuclear medicine study - Thyroid imaging with vascular flow

 

 

 

18.74

3059.87

21950

Nuclear medicine study - Thyroid suppression /stimulation

 

 

 

12.72

2076.92

29961

PET/CT scan of the soft tissue of the neck uncontrasted

 

 

 

105.87

17286.45

29962

PET/CT scan of the soft tissue of the neck contrasted

 

 

 

111.69

18236.74



 

 

 

 

 


Thorax

 

 

 

 

 



 

 

 

 

 


Chest wall, pleura, lungs and mediastinum

 

 

 

 

 


Code 30140 (tomography) may be combined with 30100 or 30110 (chest) or 30150 or 30155 (ribs) or 30160 (thoracic inlet).

Codes 30170 (Sterno-clavicular) and 30175 (tomography) may be combined.

Code 30180 (sternum) and 30185 (tomography) may be combined.

Code 30340 (CT limited high resolution) may be combined with 30310 or 30320 or 30330 (CT chest). Motivation may be required.

Code 30350 (high resolution) is a stand alone study.

Code 30360, (CT chest for pulmonary embolism) is a complete examination and includes the preceding uncontrasted CT scan of the chest, and may not be combined with 40330 or 40333 (CT abdomen and pelvis).

Code 30370 (CT pulmonary embolism plus CT venography) may not be combined with 70230 (Doppler).

 

 

 

 

 

30100

X-ray of the chest, single view

 

-

-

3.04

496.37

30110

X-ray of the chest two views, PA and lateral

 

-

-

3.84

627.00

30120

X-ray of the chest complete with additional views

 

-

-

4.24

692.31

30130

X-ray of the chest complete including fluoroscopy

 

-

-

4.48

731.49

30140

X -ray tomography of the chest

 

-

-

4.30

702.10

30150

X-ray of the ribs

 

-

-

4.79

782.11

30155

X-ray of the chest and ribs

 

-

-

6.42

1048.26

30160

X -ray of the thoracic inlet

 

-

-

2.56

418.00

30170

X-ray of the stemo-clavicular joints

 

-

-

4.21

687.41

30175

X-ray tomography of the sterno-clavicular joint

 

-

-

4.30

702.10

30180

X-ray of the sternum

 

-

-

4.21

687.41

30185

X-ray tomography of the sternum

 

-

-

4.30

702.10

30200

Ultrasound of the chest wall, any region

 

-

-

6.56

1071.12

30210

Ultrasound of the pleural space

 

-

-

6.56

1071.12

30220

Ultrasound of the mediastinal structures

 

-

-

6.56

1071.12

30300

CT of the chest, limited study

 

-

-

9.50

1551.16

30310

CT of the chest uncontested

 

-

-

26.60

4343.25

30320

CT of the chest contrasted

 

-

-

42.43

6927.97

30330

CT of the chest, pre and post contrast

 

-

-

45.70

7461.90

30340

CT of the chest, limited high resolution study

 

-

-

11.20

1828.74

30350

CT of the chest, complete high resolution study

 

-

-

24.01

3920.35

30355

CT of the chest, prone and expiratory studies

 

-

-

33.30

5437.22

30360

CT of the chest for pulmonary embolism

 

-

-

57.12

9326.55

30370

CT of the chest for pulmonary embolism with CT venography of abdomen, pelvis and lower limbs

 

-

-

80.28

13108.12

30400

MR of the chest

 

-

-

63.60

10384.61

30410

MR of the chest with uncontrasted angiography

 

-

-

92.60

15119.73

30420

MR of the chest, pre and post contrast

 

-

-

102.04

16661.09

30900

Nuclear Medicine study - Lung perfusion

 

-

-

21.54

3517.05

30910

Nuclear Medicine study - Lung ventilation, aerosol

 

 

 

21.50

3510.52

30920

Nuclear Medicine study - Lung perfusion and ventilation

 

 

 

42.03

6862.66

30930

Nuclear Medicine study - Lung ventilation using radio-active gas

 

 

 

14.17

2313.68

30940

Nuclear Medicine study - Lung perfusion and ventilation using radio-active gas

 

 

 

34.69

5664.18

30950

Nuclear medicine study - Muco ciliary clearance study dynamic

 

 

 

26.51

4328.55

30960

Nuclear medicine study - alveolar permeabillity

Stand alone code. Not to be combined with 30910.

 

-

-

26.51

4328.55

30970

Nuclear medicine study - quantitative evaluation of lung perfusion and ventilation

 

-

-

6.02

982.95


Stand alone code. Not to be combined with 30920.

 

-

-

 

0.00

30981

PET/CT scan of the chest uncontrasted

 

 

 

111.44

18195.92

30982

PET/CT scan of the chest contrasted

 

 

 

117.42

19172.34

30983

PET/CT scan of the chest pre and post contrast

 

 

 

148.32

24217.69



 

 

 

 

 


Oesophagus

 

 

 

 

 


may not be added)

 

 

 

 

 

31100

X-ray barium swallow

 

-

-

6.60

1077.65

31105

X-ray 3 phase dynamic contrasted swallow

 

-

-

12.60

2057.33

31110

X-ray barium swallow, double contrast

 

-

-

7.92

1293.18

31120

X-ray barium swallow with cinematography

 

-

-

10.07

1644.23



 

 

 

 

 


Aorta and large vessels

 

 

 

 

 


Codes 32210 and 32220 (IVUS) may be combined

 

 

 

 

 

32200

intervention, once per complete procedure

 

-

-

4.20

685.78

32210

Ultrasound intravascular (IVUS) first vessel

 

-

-

8.44

1378.08

32220

Ultrasound intravascular (IVUS) subsequent vessels

 

-

-

5.30

865.38

32300

CT angiography of the aorta and branches

 

-

-

79.08

12912.18

32305

CT angiography of the thoracic and abdominal aorta and branches

 

 

 

105.50

17226.04

32310

CT angiography of the pulmonary vasculature

 

 

 

79.08

12912.18

32400

MR angiography of the aorta and branches

 

 

 

78.50

12817.48

32410

MR angiography of the pulmonary vasculature

 

 

 

105.27

17188.49

32500

Arteriography of thoracic aorta

 

 

 

28.26

4614.29

32510

Arteriography of bronchial intercostal vessels alone

 

 

 

50.15

8188.49

32520

Arteriography of thoracic aorta, bronchial and intercostal vessels

 

 

 

67.43

11009.97

32530

Arteriography of pulmonary vessels

 

 

 

63.27

10330.73

32540

Arteriography of heart chambers, coronary arteries

 

 

 

44.27

7228.41

32550

Venography of thoracic vena cava

 

 

 

28.38

4633.89

32560

Venography of vena cava, azygos system

 

 

 

56.31

9194.3-

32570

Venography patency of A-port or other central line

 

 

 

19.64

3206.82



 

 

 

 

 


Heart

 

 

 

 

 


Codes 33300 (CT anatomy/function) and 33310 (CT Angiography) may be done as stand alone studies or as additive studies if both are performed at the same time

 

 

 

 

 

33205

Ultrasound study of the hear for foetal or paediatric cases including doppler

 

-

-

12.30

2008.34


or 33210. This code is intended for paediatric and foetal cases only

 

-

-

 

 

33200

Ultrasound study of the hear, including Doppler

 

-

-

8.20

1338.90

33210

Ultrasound study of the hear trans-oesophageal

 

-

-

10.52

1717.71

33220

Ultrasound intravascular imaging to guide placement of  intracoronary stent once per vessel

 

-

-

5.20

849.06

33300

CT anatomical/functional study of the heart

 

-

-

34.61

5651.12

33310

CT angiography of hear vessels

 

 

 

81.28

13271.40

33970

Nuclear Medicine study - Multi stage treadmill ECG test

 

 

 

6.66

1087.44



 

 

 

 

 


Abdomen and Pelvis

 

 

 

 

 



 

 

 

 

 


Abdomen/stomach/bowel

 

 

 

 

 


Code 40120 (tomography) maybe combined with 40100 or 40105 or 40110 (abdomen).

Codes 40140 to 40190 (barium studies) include fluoroscopy (00140 may not be added).

Code 40190 ( intussusception) is a stand alone code and may not be combined with 40160 or 40165 (barium enema), (00140 may not be added).

 

 

 

 

 

40100

X-ray of the abdomen

 

-

-

3.32

542.09

40105

X-ray of the abdomen supine and erect, or decubitus

 

-

-

5.36

875.18

40110

X-ray of the abdomen multiple views including chest

 

-

-

8.10

1322.57

40120

X-ray tomography of the abdomen

 

-

-

4.30

702.10

40140

X -ray barium meal single contrast

 

-

-

8.87

1448.29

40143

X -ray barium meal double contrast

 

-

-

11.99

1957.73

40147

X -ray barium meal double contrast with follow through

 

-

-

15.80

2579.82

40150

X -ray small bowel enteroclysis (meal)

 

-

-

25.45

4155.48


intubation) may be added

 

-

-

 

 

40153

X-ray small bowel meal follow through single contrast

 

-

-

19.55

3192.12

40157

X-ray small bowel meal with pneumocolon

 

-

-

25.63

4184.87

40160

X-ray large bowel enema single contrast

 

-

-

12.97

2117.74

40165

X-ray large bowel enema single

 

-

-

19.83

3205.19

40170

X-ray guided gastro oesophageal intubation

 

-

-

1.60

261.25

40175

X-ray guided duodenal intubation

 

-

-

2.80

457.18

40180

X-ray defaecogram

 

-

-

12.97

2117.74

40190

X-ray guided reduction of intussusception

 

-

-

16.27

2656.57

40200

Ultrasound study of the abdominal wall

 

-

-

5.54

904.57

40210

Ultrasound study of the whole abdomen including the pelvis

 

-

-

8.24

1345.43

40300

CT study of the abdomen

 

 

 

26.41

4312.22

40310

CT study of the abdomen with contrast

 

-

-

44.82

8319/21

40313

CT study of the abdomen pre and post contrast

 

 

 

52.99

8652.21

40320

CT of the pelvis

 

-

-

26.13

4268.51

40323

CT of the pelvis with contrast

 

-

-

47.48

7752.53

40327

CT of the pelvis pre and post contrast

 

-

-

53.87

8795.89

40330

CT of the abdomen and pelvis

 

-

-

38.50

6286.28

40333

CT of the abdomen and pelvis with contrast

 

-

-

62.17

10151.12

40337

CT of the abdomen and pelvis pre and post contrast

 

-

-

67.43

11009.97

40340

CT triphasic study of the liver, abdomen and pelvis pre and post contrast

 

-

-

74.11

12100.68

40345

CT of the chest, abdomen and pelvis without contrast

 

-

-

70.12

11449.19

40350

CT of the chest, abdomen and pelvis with contrast

 

-

-

88.35

14425.79

40355

CT of the chest triphasic of the liver, abdomen and pelvis with contrast

 

-

-

93.05

15193.20

40360

CT of the base of skull to symphysis pubis with contrast

 

-

-

102.73

16773.75

40365

CT colonoscopy

 

-

-

34.78

5678.88


Stand alone study, may not be added to any code between 40300 and 40360

 

-

-

 

 

40400

MR of the abdomen

 

-

-

64.58

10544.62

40410

MR of the abdomen pre and post contrast

 

-

-

100.84

10465.16

40420

MR of the pelvis, soft tissue

 

-

-

64.68

10544.62

40430

MR of the pelvis, soft tissue, pre and post contrast

 

-

-

102.04

16661.09

40900

Nuclear Medicine study - Castro oesophageal reflux and emptying

 

-

-

21.50

3510.52

40905

Nuclear Medicine study - Gastro oesophageal reflux and emptying multiple studies

 

-

-

34.92

5701.74

40910

Nuclear Medicine study - Gastro intestinal protein loss

 

-

-

21.50

3510.52

40915

Nuclear Medicine study - Gastro intestinal protein loss multiple studies

 

-

-

34.92

5701.74

40920

Nuclear Medicine study - Acute GIT bleed static/dynamic

 

-

-

21.50

3510.52

40925

Nuclear medicine study -Acute GiT bleed multiple studies

 

-

-

34.92

5701.74

40930

Nuclear medicine study - Meckel's localisation

 

-

-

20.77

3391.33

40935

Nuclear medicine study - Gastric mucosa imaging

 

-

-

20.77

3391.33

40940

Nuclear medicine study - colonic transit multiple studies

 

-

-

44.86

7324.74


Stand alone code

 

-

-

 

 

40951

PET /CT scan of the abdomen and pelvis uncontrasted

 

-

-

119.53

19516.86

40952

PET /CT scan of the abdomen and pelvis contrasted

 

-

-

129.31

21113.74

40953

PET /CT scan of the abdomen and pelvis pre and post contrast

 

-

-

140.50

22940.85



 

 

 

 

 


Liver, spleen, gall bladder and pancreas

 

 

 

 

 


Code 41110, 41120 and 41130 (cholangiography) include

fluoroscopy (00140 may not be added).

 

 

 

 

 

41100

X-ray ERCP including screening

 

-

-

18.90

3085.99

41105

X-ray ERCP reporting on images done in theatre

 

 

-

2.40

391.87

41110

X-ray cholangiography intra- operative

 

-

-

8.45

1379.72

41120

X-ray T -tube cholangiography post operative

 

-

-

14.05

2294.08

41130

X-ray transhepatic percutaneous cholangiography

 

-

-

32.34

5280.48

41200

Ultrasound study of the upper abdomen

 

-

-

7.00

1142.96

41210

uitrasouna soppier or the hepatic and spienro veins and interior vena cava in assessment of portal venous hypertension or thrombosis

 

-

-

9.80

1600.14


Code 41210 is a stand alone study and may not be added to 40200, 40210, 41200 or 42200

 

 

 

 

 

41300

CT of the abdomen triphasic study - liver

 

-

-

54.90

8964.07

41400

MR study of the liver/pancreas

 

-

-

64.78

10577.28

41410

MR study of the liver/pancreas pre and post contrast

 

-

-

100.84

15465.16

41420

MRCP

 

-

-

49.20

8033.38

41430

MR study of the abdomen with MRCP

 

-

-

92.98

15181.77

41440

MR study of the liver/pancreas pre and post contrast

 

-

-

133.60

21814.21

41900

Nuclear Medicine study - Liver and spleen, planar views only

 

-

-

21.50

3510.52

41905

Nuclear Medicine study - Liver and spleen, with flow study

 

-

-

27.53

4495.10

41910

Nuclear Medicine study - Liver and spleen, planar views SPECT

 

-

-

34.92

5701.74

41915

SPECT

 

-

-

40.94

6684.68

41920

Nuclear Medicine study - Hepatobiliary system planar static/dynamic

 

-

-

21.50

3510.52

41925

Nuclear Medicine study - hepatobiliary tract including flow

 

-

-

26.51

4328.55

41930

Nuclear medicine study - Hepatobiliary system planar, static/dynamic multiple studies

 

-

-

34.92

5701.74

41935

Nuclear medicine study - Hepatobiliary tract including flow multiple studies

 

-

-

39.92

6518.14

41940

Nuclear medicine study - Gall bladder ejection fraction

 

-

-

6.02

982.95

41945

Nuclear medicine study - biliary gastric reflux study

 

-

-

20.77

3391.33



 

 

 

 

 


Renal tract

 

 

 

 

 

42100

X-ray tomography of the renal tract

 

 

 

 

 


Code 42100 (tomography) may not be added to 42110 or 42115

(IVP).

Codes 42115 (IVP), 42120 (cystography), 42130 (urethography),

42140 (MCU), 42150 (retrograde), and 42160 (prograde) include fluoroscopy (00140 may not be added).

 

 

 

 

 

42110

X-ray excretory urogram including tomography

 

-

-

24.86

4059.14

42115

X-ray excretory urogram including tomography with micturating  study

 

-

-

32.86

5365.38

42120

X-ray cystography

 

-

-

15.05

2457.36

42130

X-ray urethrography

 

-

-

15.37

2509.61

42140

X-ray micturating cysto-urethrography

 

-

-

19.30

3151.30

42150

X-ray retrograde /prograde pyelography

 

-

-

12.53

2045.90

42155

X-ray retrograde /prograde pyelography reporting on images done in theatre

 

-

-

2.41

393.50

42160

X-ray prograde pyelogram - percutaneous

 

-

-

32.67

5334.36

42200

Ultrasound study of the renal tract including bladder

 

-

-

7.42

1211.54

42205

Ultrasound doppler for resistive index in vessels of transplanted kidney

 

-

-

3.80

620.46


Code 42205 is a stand alone study and may not be added to 42200

 

 

 

 

 

42210

Ultrasound study of the renal arteries including Doppler

 

-

-

10.60

1730.77

42400

MR of the renal tract for obstruction

 

-

-

47.00

7674.16

42410

MR of the kidneys without contrast

 

-

-

64.58

10544.62

42420

MR of the kidneys pre and post contast

 

-

-

102.24

10693.75

42900

Nuclear Medicine study - Renal imaging, static (e.g. DMSA)

 

-

-

21.94

3582.36

42905

Nuclear Medicine study - Renal imaging, static (e.g. DMSA) with flow

 

-

-

27.96

4565.31

42910

Nuclear Medicine study - Renal imaging, static (e.g. DMSA) with SPECT

 

-

-

35.35

5771.95

42915

Nuclear Medicine study - Renal imaging, static (e.g. DMSA), with flow, with SPECT

 

-

-

41.37

6754.89

42920

Nuclear Medicine study - Renal imaging dynamic (renogram) and vascular flow

 

-

-

26.51

4328.55

42930

Nuclear Medicine study - Renovascular study, baseline

 

-

-

26.51

4328.55

42940

Nuclear Medicine study - Renovascular study, with intervention

 

-

-

26.51

4328.55

42950

Nuclear medicine study - indirect voiding cystogram

 

-

-

6.02

982.95



 

 

 

 

 


Aorta and vessels

 

 

 

 

 


Code 44400 (MR Angiography) may be combined with 40400 (MR abdomen)

 

 

 

 

 

44200

Ultrasound study of abdominal aorta and branches including

doppler

 

-

-

18.32

2991.29

44205

Ultrasound study of the IVC and pelvic veins including Doppler

 

-

-

14.00

2285.02

44300

CT angiography of abdominal aorta and branches

 

-

-

 

0.00

44305

CT angiography of the abdominal aorta and branches and pre and post contrast study of the upper abdomen

 

-

-

76.72

12526.94

44310

CT angiography of the pelvis

 

-

-

94.32

15400.57

44320

CT angiography of the abdominal aorta and pelvis

 

-

-

78.64

12840.34

44325

CT angiography of the abdominal aorta and pelvis and pre and post contrast study of the upper abdomen and pelvis

 

-

-

89.54

14620.09

44330

CT portogram

 

-

-

74.40

12148.03

44400

MR angiography of abdominal aorta and branches

 

-

-

76.64

12513.78

44500

Areteriography of abdominal aorta alone

 

-

-

28.12

4591.43

44503

Arteriography of aorta plus coeliac, mesenteric branches

 

-

-

75.63

12348.87

44505

Arteriography of aorta plus renal, adrenal branches

 

-

-

63.01

10288.27

44507

Arteriography of aorta plus non-visceral branches

 

-

-

60.79

9925.79

44510

Arteriography of coeliac, mesenteric vessels alone

 

-

-

64.35

10507.07

44515

Arteriorgrpahy of renal, adrenal vessels alone

 

-

-

49.49

8080.73

44517

Aerteriography of non-visceral abdominal vessels alone

 

-

-

54.91

8965.70

44520

Arteriography of internal and external iliac vessels alone

 

-

-

56.72

9261.24

44525

Venography of internal and external iliac veins alone

 

-

-

52.11

10141.32

44530

Corpora cavernosography

 

-

-

25.06

4091.80

44535

Vasography, vesciculography

 

-

-

29.19

4786.14

44540

Venography of inferior vena cava

 

-

-

26.12

4264.87

44543

Venography of hepatic veins alone

 

-

-

53.77

8779.57

44545

Venography of inferior vena cava and hepatic veins

 

 

 

68.91

11251.62

44550

Venography of lumbar azygos system alone

 

 

 

43.89

7166.36

44555

Venography of inferior vena cava and lumbar azygos veins

 

 

 

65.46

10688.31

44560

Venography of renal, adrenal veins alone

 

 

 

43.99

7182.69

44565

Venography of inferior vena cava and renal /adrenal veins

 

 

 

68.39

11166.72

44570

Venography of spermatic, ovarian veins alone

 

 

 

40.39

6594.88

44573

Venography of inferior vena cava, renal, spermatic, ovarian veins

 

 

 

73.99

12081.09

44580

Venography indirect splenoportogram

 

 

 

48.67

7946.84

44583

Venography direct splenoportogram

 

 

 

31.59

5158.02

44587

Venography transhepatic portogram

 

 

 

66.75

10898.94



 

 

 

 

 


Spine, Pelvis and Hips

 

 

 

 

 


Code 51340 (CT myelography, cervical), 52330 (CT myelography

thoracic) and 53340 (CT myelography lumbar) are stand alone studies and may not be combined with the conventianla

myelography codes viz. 51160, 52150, 53160

 

 

 

 

 



 

 

 

 

 


General

 

 

 

 

 


Code 50130 (Lumbar puncture) and 50140 (cistemal puncture) include fluoroscopy and introduction of contrast (00140 may not be added).

 

 

 

 

 

50100

X-ray of the spine scoliosis view AP only

 

-

-

7.00

1142.96

50105

X-ray of the spine scoliosis view AP and lateral

 

-

-

12.00

1959.36

50110

X-ray of the spine scoliosis view AP and lateral including stress views

 

-

-

18.54

3027.21

50120

X-ray bone densitometry

 

-

-

11.52

1880.99

50130

X-ray guided lumbar puncture

 

-

-

4.80

783.74

50140

X -ray guided cistemal puncture cistemogram

 

-

-

22.98

3752.17

50300

CT quantitative bone mineral density

 

-

-

11.83

1931.60

50500

Arteriorgram of the spinal column and cord, all vessels

 

-

-

127.23

29664,11

50510

Venography of the spinal,  paraspinal veins

 

-

-

58.45

9543.72



 

 

 

 

 


Cervical

 

 

 

 

 


Code 51100 (stress) is a stand alone study and may not be added to 51110, 51120 (cervical spine), 51160 (myelography) and 51170 (discography).

Code 51140 (tomography) may be combined with 51110 or 51120 (spine).

Code 51160s (myelography) and 51170 (discography) include fluoroscopy and introduction of contrast (00140 may not be added).

Code 51300 (CT) limited - limited to a single cervical vertebral body.

Code 51310 (CT) regional study - 2 vertebral bodies and intervertebral disc spaces.

Code 51320 (CT) complete study - an extensive study of the cervical spine.

Code 51340 (CT myelography) - post myelographic study and includes all disc levels, includes fluoroscopy and introduction of contrast (00140 may not be added).

 

 

 

 

 

51100

X-ray of the cervical spine, stress views only

 

-

-

4.14

675.98

51110

X-ray of the cervical spine, one or two views

 

-

-

3.01

491.47

51120

X-ray of the cervical spine, more than two views

 

-

-

4.28

698.84

51130

X-ray of the cervical spine, more than two views including stress views

 

-

-

7.58

1237.66

51140

X-ray Tomography cervical spine

 

-

-

4.30

702.10

51160

X-ray myelography of the cervical spine

 

-

-

27.46

4483.67

51170

X-ray discography cervical spine per level

 

-

-

25.17

4109.76

51300

CT of the cervical spine limited study

 

-

-

9.50

1551.16

51310

CT of the cervical spine - regional study

 

-

-

13.91

2271.22

51320

CT of the cervical spine - complete study

 

-

-

37.13

6062.59

51330

CT of the cervical spine pre and post contrast

 

-

-

58.85

9609.03

51340

CT myelography of the cervical spine

 

-

-

47.19

7705.18

51350

CT myelography of the cervical spine following myelogram

 

-

-

21.69

3541.54

51400

MR of the cervical spine, limited study

 

-

-

44.40

7249.63

51410

MR of the cervical spine and cranio- cervical junction

 

-

-

64.82

10583.81

51420

MR of the cervical spine and crania- cervical junction pre and post contrast

 

-

-

102.14

16677.42

51900

Nuclear Medicine study - Bone regional cervical

 

-

-

21.50

3510.52

51910

Nuclear Medicine study - Bone tomography regional cervical

 

-

-

13.41

2189.58

51920

Nuclear Medicine study - with flow

 

-

-

6.02

982.95



 

 

 

 

 


Thoracic

 

 

 

 

 


Code 52120 (tomography) may be combined with 52100 or 52110 (spine).

Code 52150 ( myelography) includes fluoroscopy and introduction of contrast (00140 may not be added).

Code 52300 (CT) limited study - limited to a single thoracic vertebral body.

Code 52305 (CT) regional study - 2 vertebral bodies and intervertebral disc paces.

Code 52310 (CT) complete study - an extensive study of the thoracic spine.

Code 52330 (CT myelography) - post myelographic study and includes all disc levels, fluoroscopy and introduction of contrast (00140 may not be added).

 

 

 

 

 

52100

X -ray of the thoracic spine, one or two views

 

-

-

3.21

524.13

52110

X -ray of the thoracic spine, more than two views

 

-

-

4.00

653.12

52120

X -ray tomography thoracic spine

 

-

-

4.30

702.10

52140

X -ray of the thoracic spine, more that two views including stress views

 

-

-

6.64

1084.18

52150

X-ray myelography of the thoracic spine

 

-

-

18.62

3040.27

52300

CT of the thoracic spine limited study

 

-

-

9.50

1551.16

52305

CT of the thoracic spine - regional study

 

-

-

13.91

2271.22

52310

CT of the thoracic spine complete study

 

-

-

35.78

5842.16

52320

CT of the thoracic spine pre and post contrast

 

-

-

58.85

9609.03

52330

CT myelography of the thoracic spine

 

-

-

48.09

7852.14

52340

CT myelography of the thoracic spine following myelogram

 

-

-

20.37

3326.01

52400

MR of the thoracic spine, limited study

 

-

-

46.60

7608.85

52410

MR of the thoracic spine

 

-

-

64.34

10505.44

52420

MR of the thoracic spine pre and post contrast

 

-

-

101.42

16559.86

52900

Nuclear Medicine study - Bone regional dorsal

 

-

-

21.50

3510.52

52910

Nuclear Medicine study- Bone tomography regional dorsal

 

-

-

13.41

2189.58

52920

Nuclear Medicine study - with flow

 

-

-

6.02

982.95



 

 

 

 

 


Lumbar

 

 

 

 

 


Code 53100 (stress) is a stand alone study and may not be added to 53110, 53120 (lumbar spine). 53160 (myelography) and 53170 (discography).

Code 53140 (tomography) may be combined with 53110 or 53120 (spine).

Codes 53160 ( myelography) and 53170 (discography) include fluoroscopy and introduction of contrast (00140 may not be added).

Code 53300 (CT) limited study - limited to a single lumbar vertebral body.

Code 53310 (CT) regional study - 2 vertebral bodies and intervertebral disc spaces.

Code 53320 (CT) complete study - an extensive study of the lumbar spine.

Code 53340 (CT myelography) - post myelographic study and includes all disc levels, fluoroscopy and introduction of contrast (00140 may not be added).

 

 

 

 

 

53100

X-ray of the lumbar spine - stress study only

 

-

-

4.14

675.98

53110

X-ray of te lumbar spine, one or two views

 

-

-

3.56

581.28

53120

X -ray of the lumbar spine, more than iwo views

 

-

-

4.46

728.23

53130

X -ray of the lumbar spine, more that two views including stress views

 

-

-

7.52

1227.87

53140

X-ray tomography lumbar spine

 

-

-

4.30

702.10

53160

X-ray myelography of the lumbar spine

 

-

-

23.94

3908.92

53170

X-ray discography lumbar spine per level

 

-

-

25.17

4109.76

53300

CT of the lumbar spine limited study

 

-

-

9.50

1551.16

53310

CT of the lumbar spine - regional study

 

-

-

13.91

2271.22

53320

CT of the lumbar spine complete study

 

-

-

37.64

6145.86

53330

CT of the lumbar spine pre and post contrast

 

-

-

58.85

9609.03

53340

CT myelography of the lumbar spine

 

-

-

49.11

8018.68

53350

CT myelography of the lumbar spine following myelogram

 

-

-

23.46

3830.55

53400

MR of the lumbar spine, limited study

 

-

-

46.20

7543.54

53410

MR of the lumbar spine

 

-

-

64.32

10502.17

53420

MR of the lumbar spine pre and post contrast

 

-

-

103.29

16865.19

53900

Nuclear medicine study - Bone regional lumbar

 

-

-

21.50

3510.52

53910

Nuclear medicine study - bone tomography regional lumbar

 

-

-

13.41

2189.58

53920

Nuclear medicine study - with flow

 

-

-

6.02

982.95



 

 

 

 

 


Sacrum

 

 

 

 

 


Code 54120 (tomography) may be combined with 54100 (sacrum) or 54110 (Si joints).

Code 54300 (CT) limited study- limited to single sacral vertebral body.

Code 54310 (CT) complete study - an extensive study of the sacral spine.

 

 

 

 

 

54100

X-ray of the sacrum and coccyx

 

-

-

3.58

584.54

54110

X-ray of the sacro-iliac joints

 

-

-

4.10

669.45

54120

X-ray tomography - sacrum and/or coccyx

 

-

-

4.30

702.10

54300

CT of the sacrum - limited study

 

-

-

7.60

1240.93

54310

CT of the sacrum - complete study - uncontrasted

 

-

-

25.61

4181.60

54320

CT of the sacrum with contrast

 

-

-

46.93

7862.73

54330

CT of the sacrum with contrast

 

-

-

52.97

8648.94

54400

MR of the sacrum

 

-

-

65.00

10613.20



 

 

 

101.04

16497.81


Pelvis

 

 

 

 

 


Codes 55110 (tomograph) and 55100 (pelvis) may be combined.

 

 

 

 

 


Code 55300 (CT) limited study - limited to a small region of interest of the pelvis, eg. ascetabular roof or public ramus.

 

 

 

 

 

55100

X-ray of the pelvis

 

-

-

3.66

597.60

55110

X -ray tomography - pelvis

 

-

-

4.30

702.10

55300

CT of the bony pelvis limited

 

-

-

9.50

1551.16

55310

CT of the bony pelvis complete uncontrasted

 

-

-

25.61

4181.60

55320

CT of the bony pelvis complete 3D recon

 

-

-

37.47

6118.10

55330

CT of the bony pelvis with contrast

 

-

-

46.93

7662.73

55340

CT of the bony pelvis - pre and post contrast

 

-

-

52.97

8648.94

55400

MR of the bony pelvis

 

-

-

65.00

10613.20

55410

MR of the bony pelvis pre and post contrast

 

-

-

102.24

16693.75

55900

Nuclear medicine study - Bone regional pelvis

 

-

-

21.50

3510.52

55910

Nuclear medicine study - Bone tomography regional pelvis

 

-

-

13.41

2189.58

55920

Nuclear medicine study - with flow

 

-

-

6.02

982.95



 

 

 

 

 


Code 56130 (tomography) may be combined with 56100 or 56110 or 56120 (hip).

Code 56140 (stress) may be combined with 56100 or 56110 or 56120 (hip).

Code 56150 (arthrography) includes fluoroscopy and introduction of contrast (00140 may not be added).

Code 56160 (introduction of contrast into hip joint) to be used with 56310 (CT hip) and 56410 (MR hip) and includes fluoroscopy. The combination of 56150 and 56310 and 56410 is not supported except in exceptional circumstances with motivation.

Code 56300 (CT) study limited to small region of interest eg part of femur head

 

 

 

 

 



 

 

 

 

 

56100

X-ray of the left hip

 

 

 

3.18

519.23

56110

X-ray of the right hip

 

 

 

3.18

519.23

56120

X-ray pelvis and hips

 

 

 

6.02

982.95

56130

X-ray tomography - hip

 

 

-

4.30

702.10

56140

X-ray of the hip/s - stress study

 

 

-

4.38

715.17

56150

X-ray arthrography of the hip joint including introduction contrast

 

 

-

15.75

2571.66

56160

X-ray guidance and introduction of contrast into hip joint only

 

 

-

7.41

1209.90

56200

Ultrasound of the hip joints

 

-

-

6.50

1061.32

56300

CT of hip - limited

 

-

-

9.50

1551.16

56310

CT of hip - complete

 

-

-

27.37

4468.97

56320

CT of hip - complete with 3D recon

 

-

-

39.78

6495.28

56330

CT of hip with contrast

 

-

-

43.26

7063.49

56340

CT of hip pre and post contrast

 

-

-

47.88

7817.85

56400

MR of the hip joint/s, limited study

 

-

-

44.90

7331.27

56410

MR of the hip joint/s

 

-

-

64.10

10466.25

56420

MR of the hip joint/s, pre and post contrast

 

-

-

101.64

16595.78

56900

Nuclear medicine study - Bone regional pelvis

 

-

-

21.50

3510.52

56910

Nuclear medicine study - Bone limited static plus flow

 

-

-

27.53

4495.10

56920

Nuclear medicine study - Bone tomography regional

 

-

-

13.41

2189.58



 

 

 

 

 


Upper limbs

 

 

 

 

 



 

 

 

 

 


General

 

 

 

 

 


Code 60100 (stress only) is a stand-alone study and may not be combined with other codes

 

 

 

 

 


Code 60110 (tomography) may be combined with any one of the defined regional x-ray studies of the upper limb. Motivation may be required for more than one regional tomographic study per visit.

Code 60200 (U/S) may only be used once per visit.

Code 60300 (CT) limited study - limited to a small region of interest eg. part of humeral head.

 

 

 

 

 


Code 60400 (MR limited) may only be used once per visit.

 

 

 

 

 

60100

X-ray upper limbs - any region - stress studies only

 

-

-

4.52

738.03

60110

X-ray upper limbs - any region - tomography

 

-

-

4.30

702.10

60200

Ultrasound upper limb - soft tissue - any region

 

-

-

7.38

1205.01

60210

Ultrasound of the peripheral arterial system of the left arm including B mode, pulse and colour doppler

 

-

-

13.64

2227.14

60220

Ultrasound of the peripheral arterial system of the right arm including B mode, pulse and colour doppler

 

-

-

13.64

2227.14

60230

Ultrasound peripheral venous system upper limbs including pulse and colour doppler for deep vein thrombosis

 

-

-

12.54

2047.53

60240

Ultrasound peripheral venous system upper limbs including pulse and colour doppler

 

-

-

17.26

2818.21

60300

CT of the upper limbs limited study

 

-

-

9.50

1551.16

60310

CT angiography of the upper limb

 

-

-

78.28

12781.56

60400

MR of the upper limbs limited study, any region

 

-

-

44.80

7314.94

60410

MR angiography of the upper limb

 

-

-

74.66

12190.48

60500

Arteriogram of subclavian, upper limb arteries alone, unilateral

 

-

-

45.67

7457.00

60510

Arteriogram of subclavian, upper limb arteries alone, bilateral

 

-

-

82.67

13498.36

60520

Arteriogram of aortic arch, subclavian, upper limb, unilateral

 

-

-

56.75

9266.14

60530

Arteriogram of aortic arch, subclavian, upper limb, bilateral

 

-

-

88.11

14386.60

60540

Venography, antegrade of upper limb veins, unilateral

 

-

-

26.12

4264.87

60550

Venography, antegrade of upper limb veins, bilateral

 

-

-

49.43

8070.93

60560

Venography, retrograde of 49.43 8 070.93 upper limb veins, unilateral

 

-

-

31.01

5063.31

60570

Venography, retrograde of 31.01 5 063.31 upper limb veins, bilateral

 

-

-

54.81

8949.38

60580

Venography, shuntogram, dialysis 54.81 8 949.38 access shunt

 

-

-

23.79

3884.43

60900

Nuclear medicine study 23.79 3 884.43 - Venogram upper limb

 

-

-

37.12

6060.95



 

 

 

 

 


Shoulder

 

 

 

 

 


Code 61160 (arthrography) includes fluoroscopy and introduction of contrast (00140 may not be added).

Code 61170 (introduction of contrast into the shoulder joint) may be combined with 61300 and 61305 (CT), or 61400 and 61405 (MR).

The combination of 61160 (arthrography) and 61300 and 61305 (CT) or 61400 and 61405 (MR) is not supported

 

 

 

 

 

61100

X-ray of the left clavicle

 

-

-

3.04

496.37

61105

X-ray of the right clavicle

 

-

-

3.04

496.37

61110

X-ray of the left scapula

 

-

-

3.04

496.37

61115

X-ray of the right scapula

 

-

-

3.04

496.37

61120

X-ray of the left acromio-clavicular joint

 

-

-

3.14

512.70

61125

X-ray of the right acromio-clavicular joint

 

-

-

3.14

512.70

61128

X-ray of acromio-clavicular joints plus stress studies bilateral

 

-

-

7.68

1253.99

61130

X-ray of the left shoulder

 

 

 

3.48

568.21

61135

X-ray of the right shoulder

 

 

 

3.48

568.21

61140

X-ray of the left shoulder plus subacromial impingement views

 

 

 

5.92

966.62

61145

X-ray of the right shoulder plus subacromial impingement views

 

 

 

5.92

966.62

61150

X-ray of the left subacromial impingement views only

 

 

 

3.24

529.03

61155

X-ray of the right subacromial impingement views only

 

 

 

3.24

529.03

61160

X-ray arthrography shoulder joint including introduction of contrast

 

 

 

15.83

2584.72

61170

X -ray guidance and introduction of contrast into shoulder joint only

 

 

 

7.41

1209.90

61200

Ultrasound of the left shoulder joint

 

 

 

6.50

1061.32

61210

Ultrasound of the right shoulder joint

 

 

 

6.50

1061.32

61300

CT of the left shoulder joint - uncontrasted

 

 

 

24.36

3977.50

61305

CT of the right shoulder joint - uncontrasted

 

 

 

24.36

3977.50

61310

CT of the left shoulder - complete with 3D recon

 

 

 

24.36

6149.12

61315

CT of the right shoulder - complete with 3D recon

 

 

 

37.66

6149.12

61320

CT of the left shoulder joint - pre and post contrast

 

 

 

48.63

7940.31

61325

CT of the right shoulder joint - pre and post contrast

 

 

 

48.63

7940.31

61400

MR of the left shoulder

 

 

 

64.64

10554.42

61405

MR of the right shoulder

 

 

 

64.64

10554.42

61410

MR of the left shoulder pre and post contrast

 

 

 

101.04

16497.81

61415

MR of the right shoulder pre and post contrast

 

 

 

101.04

16497.81



 

 

 

 

 


Humerus

 

 

 

 

 

62100

X-ray of the left humerus

 

-

-

2.94

480.04

62105

X-ray of the right humerus

 

-

-

2.94

480.04

62300

CT of the left upper arm

 

-

-

24.36

3977.50

62305

CT of the right upper arm

 

-

-

24.36

3977.50

62310

CT of the left upper arm contrasted

 

-

-

39.97

6526.30

62315

CT of the right upper arm contrasted

 

-

-

39.97

6526.30

62320

CT of the left upper arm pre and post contrast

 

-

-

48.58

7932.14

62325

CT of the right upper arm pre and post contrast

 

-

-

48.58

7932.14

62400

MR of the left upper arm

 

-

-

64.20

10482.58

62405

MR of the right upper arm

 

-

-

64.20

10482.58

62410

MR of the left upper arm pre and post contrast

 

-

-

102.04

16661.09

62415

MR of the right upper arm pre and post contrast

 

-

-

102.04

16661.09

62900

Nuclear medicine study - Bone limited/regional static

 

-

-

21.50

3510.52

62905

Nuclear medicine study - Bone limited static plus flow

 

-

-

27.53

4495.10

62910

Nuclear medicine study - Bone tomography regional

 

-

-

13.41

2189.58



 

 

 

 

 


Elbow

 

 

 

 

 


Code 63120 (arthrography) includes fluoroscopy and introduction of contrast (00140 may not be added).

Code 63130 (introduction of contrast) may be combined with 63300 and 63305 (CT) or 63400 and 63405 (MR). The combination of 83120 (arthrography) and 63300 and 63305 or 63400 and 63405 (MR) is not supported except in exceptional circumstances with motivation.

 

 

 

 

 

63100

X-ray of the left elbow

 

-

-

3.14

512.70

63105

X -ray of the right elbow

 

-

-

3.14

512.70

63110

X-ray of the left elbow with stress

 

-

-

4.34

708.64

63115

X-ray of the right elbow with stress

 

-

-

4.34

708.64

63120

X-ray arthrography elbow joint including introduction of contrast

 

-

-

15.89

2594.52

63130

X-ray guidance and introduction of contrast into elbow joint only

 

-

-

7.41

1209.90

63200

Ultrasound of the left elbow joint

 

-

-

6.50

1061.32

63205

Ultrasound of the right elbow joint

 

-

-

6.50

1061.32

63300

CT of the left elbow

 

-

-

24.36

3977.50

63305

CT of the right elbow

 

-

-

24.36

3977.50

63310

CT of the left elbow - complete with 3D recon

 

-

-

37.66

6149.12

63315

CT of the right elbow - complete with 3D recon

 

-

-

37.66

6149.12

63320

CT of the left elbow contrasted

 

-

-

39.97

6526.30

63325

CT of the right elbow contrasted

 

-

-

39.97

6526.30

63330

CT of the left elbow pre and post contrast

 

-

-

48.63

7940.31

63335

CT of the right elbow pre and post contrast

 

-

-

48.63

7940.31

63400

MR of the left elbow

 

-

-

64.64

10554.42

63405

MR of the right elbow

 

-

-

64.64

10554.42

63410

MR of the left elbow pre and post contrast

 

-

-

101.04

16497.81

63415

MR of the right elbow pre and post contrast

 

-

-

101.04

16497.31

63905

Nuclear medicine only - Bone limited/regional static

 

-

-

21.50

3510.52

63910

Nuclear medicine study - Bone limited static plus flow

 

 

 

27.53

 

63915

Nuclear medicine study - Bone tomography regional

 

 

 

13.41

 



 

 

 

 

 


Forearm

 

 

 

 

 

64100

X-ray of the left forearm

 

-

-

2.94

480.04

64105

X-ray of the right forearm

 

-

-

2,94

480.04

64110

X-ray peripheral bone densiotometry

 

-

-

1.96

320.03

64300

CT of the left forearm

 

-

-

24.36

3977.50

64305

CT of the right forearm

 

-

-

24.36

3977.50

64310

CT of the left forearm contrasted

 

-

-

39.97

6526.30

64315

CT of the right forearm contrasted

 

-

-

39.97

6526.30

64320

CT of the left forearm pre and pot contrast

 

-

-

48.58

7932.14

64325

CT of the right forearm pre and post contrast

 

-

-

48.58

7932.14

64400

MR of the left forearm

 

-

-

64.20

10482.58

64405

MR of the right forearm

 

-

-

64.20

10482.58

64410

MR of the left forearm pre and post contrast

 

-

-

98.04

16007.97

64415

MR of the right forearm pre and post contrast

 

-

-

98.04

16007.97

64900

Nuclear medicine study - Bone limited/regional static

 

-

-

21.50

3510.52

64905

Nuclear medicine study - Bone limited static plus flow

 

-

-

27.53

4495.10

64910

Nuclear medicine study - bone tomography regional

 

-

-

13.41

2189.58



 

 

 

 

 


Hand and wrist

 

 

 

 

 


Code 65120 (finger) may not be combined with 65100 or 65105 (hands).

Codes 65130 and 65135 (wrists) may be combined with 65140 or 65145 (scaphoid) respectively if requested and additional views done.

Code 65160 (arthrography) includes fluoroscopy and the introduction of contrast (00140 may not be added).

Code 65170 (contrast) may be combined with 65300 and 65305 (CT) or 65400 and 65405 (MR). The combination of 65160 (arthrography) and 65300 and 65305 or 65400 and 65405 is not supported except in exceptional circumstances with motivation.

 

 

 

 

 

65100

X-ray of the left hand

 

-

-

3.08

502.90

65105

X-ray of the right hand

 

-

-

3.08

502.90

65110

X-ray of the left hand - bone age

 

-

-

3.08

502.90

65120

X-ray of a finger

 

-

-

2.67

435.96

65130

X-ray of the left wrist

 

-

-

3.18

519.23

65135

X-ray of the right  wrist

 

-

-

3.18

519.23

65140

X-ray of the left scaphoid

 

-

-

3.30

538.82

65145

X-ray of the right scaphoid

 

-

-

3.30

538.82

65150

X-ray of the left wrist, scaphoid and stress views

 

-

-

7.56

1234.40

65155

X-ray of the right wrist, scaphoid and stress view

 

-

-

7.56

1234.40

65160

X-ray arthrography wrist joint including introduction of contrast

 

-

-

15.93

2601.05

65170

X-ray guidance and introduction of contrast into wrist joint only

 

-

-

7.41

1209.90

65200

Ultrasound of the left wrist

 

-

-

6.50

1061.32

65210

Ultrasound of the right wrist

 

-

-

6.50

1061.32

65300

CT of the left wrist and hand

 

-

-

24.36

3977.50

65305

CT of the right wrist and hand

 

-

-

24.36

3977.50

65310

CT of the left wrist and hand - complete with 3D recon

 

-

-

37.66

6149.12

65315

CT of the right wrist and hand - complete with 3D recon

 

-

-

37.66

6149.12

65320

CT of the left wrist and hand contrasted

 

-

-

39.97

6526.30

65325

CT of the right wrist and hand contrasted

 

-

-

39.97

6526.30

65330

CT of the left wrist and hand pre and post contrast

 

-

-

48.63

7940.31

65335

CT of the right wrist and hand pre and post contrast

 

-

-

48.63

7940.31

65400

MR of the left wrist and hand

 

-

-

64.64

10554.42

65405

MR of the right wrist and hand

 

-

-

64.64

10554.42

65410

MR of the left wrist and hand pre and post contrast

 

-

-

101.04

16497.81

65415

MR of the right wrist and hand pm and post contrast  Nuclear Medicine study - bone limited /regional static

 

-

-

101.04

16497.81

65900

Nuclear Medicine study - bone limited/regional static

 

-

-

21.50

3510.52

65905

Nuclear Medicine study - bone limited static plus flow

 

-

-

27.53

4495.10

65910

Nuclear Medicine study - bone tomography regional

 

-

-

13.41

2189.58



 

 

 

 

 


Soft Tissue

 

 

 

 

 

69900

Nuclear medicine study - Tumour localisation planar, static

 

-

-

20.74

3386.43

69905

Nuclear medicine study - Tumour localisation planar, static multiple studies

 

-

-

35.17

5742.56

69910

Nuclear medicine study - Tumour localisation planar, static and SPECT

 

-

-

34.15

5576.01

69915

Nuclear medicine study - Tumour localisation planar, static, multiple studies and SPECT

 

-

-

47.56

7765.60

69920

Nuclear medicine study - Infection localisation planar, static

 

-

-

18.04

2945.57

69925

Nuclear medicine study - Infection localisation planar, static, multiple studies

 

-

-

31.45

5135.16

69930

Nuclear medicine study - Infection localisation planar, static and SPECT

 

-

-

31.45

5135.16

69935

Nuclear medicine study - Infection localisation, planar, static, muliple studies and SPECT

 

-

-

44.86

7324.74

69940

Nuclear medicine study - Regional lymph node mapping dynamic

 

-

-

6.02

982.95

69945

Nuclear medicine study - Regional lymph node mapping, static,

planar

 

-

-

24.10

3935.05

69950

Nuclear medicine study - Regional lymph node mapping, static,

planar, multiple

 

-

-

37.51

6124.63

69955

Nuclear medicine study - Regional lymph node mapping SPECT

 

-

-

13.41

2189.58

69960

Nuclear medicine study - Lymph node localisation with gamma probe

 

-

-

13.41

2189.58



 

 

 

 

 


Lower Limbs

 

 

 

 

 



 

 

 

 

 


General

 

 

 

 

 


Code 70100 (stress) is a stand alone study and may not be combined with other codes.

Code 70110 (tomography) may be combined with any one of the

defined regional x -ray studies of the lower limb. Motivation may be required for more than one regional tomographic study per visit.

Code 70200 (U /S) may only be billed once per visit.

Code 70300 ((CT) limited study - limited to a small region of interest eg part of condyle of the knee.

Codes 70310 and 70320 (CT angiography) may not be combined.

Code 70400 (MR limited) may only be used once per visit.

Code 70410 and 70420 (MR angiography) may not be combined.

 

 

 

 

 

70100

X-ray lower limbs - any region - stress studies only

 

-

-

4.52

738.03

70110

X-ray lower limbs - any regiona - tomography

 

-

-

4.30

702.10

70120

X-ray of the lower limbs full length study

 

-

-

6.46

1054.79

70200

Ultrasound lower limb - soft tissue - any region

 

-

-

7.38

1205.01

70210

Ultrasound of the peripheral arterial system of the left leg including B mode, pulse and colour Doppler

 

-

-

13.64

2227.14

70220

Ultrasound of the peripheral arterial system of the right leg including B mode, pulse and colour Doppler

 

-

-

13.64

2227.14

70230

Ultrasound peripheral venous system lower limbs including pulse  and colour doppler for deep vein thrombosis

 

-

-

13.64

2227.14

70240

Ultrasound peripheral venous system lower limbs including pulse and colour doppler in erect and supine position including all compression and reflux manoeuvres, deep and superficial systems  bilaterally

 

-

-

19.66

3210.08

70300

CT of the lower limbs limited study

 

-

-

9.50

1551.16

70310

CT angiography of the lower limb

 

-

-

79.43

12969.33

70320

CT angiography abdominal aorta and outflow lower limbs

 

-

-

98.34

16056.33

70400

MR of the lower limbs limited study

 

-

-

46.40

7576.19

70410

MR angiography of the lower limb

 

-

-

76.66

12517.04

70420

MR angiography of the abdominal aorta and lower limbs

 

-

-

118.86

19407.46

70500

Angiography of pelvic and lower limb arteries unilateral

 

-

-

40.59

6627.54

70505

Angiography of pelvic and lower limb arteries bilateral

 

-

-

75.92

12396.22

70510

Angiography of abdominal aorta, pelvic and lower limb vessels

unilateral

 

-

-

61.23

9997.63

70515

Angiography of abdominal aorta, pelvic and lower limb vessels

bilateral

 

-

-

85.66

13986.56

70520

Angiography translumbar aorta with full peripheral study

 

-

-

45.68

7458.63

70530

Venography, antegrade of lower limb veins, unilateral

 

-

-

25.46

4157.11

70535

Venography, antegrade of lower limb veins, bilateral

 

-

-

49.43

8070.93

70540

Venography, retrograde of lower limb veins, unilateral

 

-

-

31.17

5089.44

70545

Venography, retrograde of lower limb veins, bilateral

 

-

-

56.79

9272.67

70560

Lymphangiography, lower limb, unilateral

 

-

-

51.04

8333.81

70565

Lymphangiography, lower limb, bilateral

 

-

-

83.97

13710.62

70900

Nuclear medicine study - Venogram lower limb

 

-

-

37.12

6060.95



 

 

 

 

 


Femur

 

 

 

 

 

71100

X -ray of the left femur

 

-

-

2.94

480.04

71105

X -ray of the right femur

 

-

-

2.94

480.04

71300

CT of the left femur

 

-

-

24.52

4003.63

71305

CT of the right femur

 

-

-

24.52

4003.63

71310

CT of the left upper leg contrasted

 

-

-

41.83

6830.00

71315

CT of the right upper leg contrasted

 

-

-

41.83

6830.00

71320

CT of the left upper leg pre and post contrast

 

-

-

49.71

8116.65

71325

CT of the right upper leg pre and post contrast

 

-

-

49.71

8116.65

71400

MR of the left upper leg

 

-

-

64.80

10580.54

71405

MR of the right upper leg

 

-

-

64.80

10580.54

71410

MR of the left upper leg pre and post contrast

 

-

-

102.04

16661.09

71415

MR of the right upper leg pre and post contrast

 

-

-

102.04

16661.09

71900

Nuclear Medicine study - bone limited/regional static

 

-

-

21.50

3510.52

71905

Nuclear Medicine study - Bone limited static plus flow

 

-

-

27.53

4495.10

71910

Nuclear Medicine study - Bone tomography regional

 

-

-

13.41

2189.58



 

 

 

 

 


Knee

 

 

 

 

 


Codes 72140 and 72145 (patella) may not be added to 72100, 72105, 72110, 72115, 72130, 72135 (knee views) Code 72160 (arthrography) includes fluoroscopy and introduction of contrast (00140 may not be added).

Code 72170 (introduction of contrast) may be combined with 72300 and 72305 (CT) or 72400 and 72405 (MR), The combination of 72160 (arthrography) and 72300 and 72305 (CT) or 72400 and 72405 (MR) is not supported except in exceptional circumstances with motivation

 

 

 

 

 

72100

X-ray of the left knee one or two views

 

-

-

2.77

452.29

72105

X-ray of the right knee one or two views

 

-

-

2.77

452.29

72110

X-ray of the left knee, more than two views

 

-

-

3.32

542.09

72115

X-ray of the right knee, more than two views

 

-

-

3.32

542.09

72120

X-ray of the left knee including patella

 

-

-

4.62

754.35

72125

X-ray of the right knee including patella

 

-

-

4.62

754.35

72130

X-ray of the left knee with stress views

 

-

-

5.82

950.29

72135

X-ray of the right knee with stress views

 

-

-

5.82

950.29

72140

X-ray of left patella

 

-

-

2.77

452.29

72145

X-ray of right patella

 

-

-

2.77

452.29

72150

X-ray both knees standing - single view

 

-

-

2.80

457.18

72160

X-ray arthrography knee joint including introduction of contrast

 

-

-

15.81

2581.46

72170

X-ray guidance and introduction of contrast into knee joint only

 

-

-

7.41

1209.90

72200

Ultrasound of the left knee joint

 

-

-

6.50

1061.32

72205

Ultrasound of the right knee joint

 

-

-

6.50

1061.32

72300

CT of the left knee

 

-

-

24.52

4003.63

72305

CT of the right knee

 

-

-

24.52

4003.63

72310

CT of the left knee complete study with 3D reconstructions

 

-

-

35.93

5866.65

72315

CT of the right knee complete study with 3D reconstructions

 

-

-

35.93

5866.65

72320

CT of the left knee contrasted

 

-

-

41.83

6830.00

72325

CT of the right knee contrasted

 

-

-

41.83

6830.00

72330

CT of the left knee pre and post contrast

 

-

-

49.76

49.76

72335

CT of the right knee pre and post contrast

 

-

-

49.76

49.76

72400

MR of the left knee

 

-

-

64.10

64.10

72405

MR of the right knee

 

-

-

64.10

64.10

72410

MR of the left knee pre and posi contrast

 

-

-

100.84

16465.16

72415

MR of the right knee pre and post contrast

 

-

-

100.84

16465.16

72900

Nuclear Medicine study - Bone limited /regional static

 

-

-

21.50

3510.52

72905

Nuclear Medicine study - Bone limited static plus flow

 

-

-

27.53

4495.10

72910

Nuclear Medicine study - Bone tomography regional

 

-

-

13.41

2189.58



 

 

 

 

 


Lower Leg

 

 

 

 

 

73100

X-ray of the left lower leg

 

-

-

2.94

480.04

73105

X -ray of the right lower leg

 

-

-

2.94

480.04

73300

CT of the left lower leg

 

-

-

24.52

4003.63

73305

CT of the right lower leg

 

-

-

24.52

4003.63

73310

CT of the left lower leg contrasted

 

-

-

41.83

6830.00

73315

CT of the right lower leg contrasted

 

-

-

41.83

6830.00

73320

CT of the left lower leg pre and post contrast

 

-

-

49.71

8116.65

73325

CT of the right lower leg pre and post contrast

 

-

-

49.71

8116.65

73400

MR of the left lower leg

 

-

-

64.20

10482.58

73405

MR of the right lower leg

 

-

-

64.20

10482.58

73410

MR of the left lower leg pre and post contrast

 

-

-

102.04

16661.09

73415

MR of the right lower leg pm and post contrast

 

-

-

102.04

16661.09

73900

Nuclear Medicine study - bone limited/regional static

 

-

-

21.50

3510.52

73905

Nuclear Medicine study - bone limited static plus flow

 

-

-

27.53

4495.10

73910

Nuclear Medicine study - bone tomography regional

 

-

-

13.41

2189.58



 

 

 

 

 


Ankle and Foot

 

 

 

 

 


Code 74145 (toe) may not be combined with 74120 or 74125 (foot).

Code 71450 (sesamoid bones) may be combined with 74120 or 74125 (foot) if requested.

Codes 74120 and 74125 (foot) may only be combined with 74130 and 74135 (calcaneus) if specifically requested.

Code 74160 ( arthrography) includes fluoroscopy and introduction of contrast (00140 may not be added).

Code 74170 (introduction of contrast) may be combined with 74300 and 74305 (CT) or 74400 and 74405 (MR). The combination of 74160 (arthrography) and 74300 and 74305 (CT) or 74400 and

 

 

 

 

 

74100

X-ray of the left ankle

 

-

-

3.32

542.09

74105

X-ray of the right ankle

 

-

-

3.32

542.09

74100

X-ray of the left ankle with stress views

 

-

-

4.52

738.03

74115

X-ray of the right ankle with stress views

 

-

-

4.52

738.03

74120

X-ray of the left foot

 

-

-

2.80

457.18

74125

X-ray of the right foot

 

-

-

2.80

457.18

74130

X-ray of the left calcaneus

 

-

-

2.74

447.39

74135

X-ray of the right calcaneus

 

-

-

2.74

447.39

74140

X-ray of both feet - standing - single view

 

-

-

2.80

457.18

74145

X-ray of a toe

 

-

-

2.67

435.96

74150

X-ray of the sesamoid bones one or both sides

 

-

-

2.80

457.18

74160

X-ray arthrography ankle joint including introduction of contrast

 

-

-

15.91

2597.78

74170

X-ray guidance and introduction of contrast into ankle joint

 

-

-

7.46

1209.90

74210

Ultrasound of the left ankle

 

-

-

6.50

1061.32

74215

Ultrasound of the right ankle

 

-

-

6.50

1061.32

74220

Ultrasound of the left foot

 

-

-

6.50

1061.32

74225

Ultrasound of the right foot

 

-

-

6.50

1061.32

74290

Ultrasound bone densitometry

 

-

-

2.04

333.09

74300

CT of the left ankle/foot

 

-

-

24.52

4003.63

74305

CT of the right ankle/foot

 

-

-

24.52

4003.63

74310

CT of the left ankle/foot- complete with 3D recon

 

-

-

37.81

6173.62

74315

CT of the right ankle/foot- complete with 3D recon

 

-

-

37.81

6173.62

74320

CT of the left ankle/foot contrasted

 

-

-

41.83

6830.00

74325

CT of the right ankle/foot contrasted

 

-

-

41.83

6830.00

74330

CT of the left ankle/foot pre and post contrast

 

-

-

49.71

8116.65

74335

CT of the right ankle/foot pre and post contrast

 

-

-

49.71

8116.65

74400

MR of the left ankle

 

-

-

64.10

10466.25

74405

MR of the right ankle

 

-

-

64.10

10466.25

74410

MR of the left ankle pre and post contrast

 

-

-

100.64

16432.50

74415

MR of the right ankle pre and post contrast

 

-

-

100.64

16432.50

74420

MR of the left foot

 

-

-

64.20

10482.58

74425

MR of the right foot

 

-

-

64.20

10482.58

74430

MR of the left foot pre and post contrast

 

-

-

102.04

16661.09

74435

MR of the right foot pre and post contrast

 

-

-

102.04

16661.09

74900

Nuclear Medicine study - Bone limited/regional static

 

-

-

21.50

3510.52

74905

Nuclear Medicine study - Bone limited static plus flow

 

-

-

27.53

4495.10

74910

Nuclear Medicine study - Bone tomography regional

 

-

-

13.41

2189.58



 

 

 

 

 


Soft Tissue

 

 

 

 

 

79900

Nuclear Medicine study - Tumour localisation planar, static

 

-

-

20.74

3386.43

79905

Nuclear Medicine study - Tumour localisation planar, static, multiple studies

 

-

-

35.17

5742.56

79910

Nuclear Medicine study - Tumour localisation planar, static and SPECT

 

-

-

34.15

5576.01

79915

Nuclear Medicine study - Tumour localisation planar, static,  multiple studies & SPECT

 

-

-

47.56

7765.60

79920

Nuclear Medicine study - Infection localisation planar, static

 

-

-

18.43

3009.25

79925

Nuclear Medicine study - Infection localisation planar, static, multiple studies

 

-

-

31.84

5198.84

79930

Nuclear Medicine study - Infection localisation planar, static and SPECT

 

-

-

31.84

5198.84

79935

Nuclear Medicine study - Infection localisation planar, static, multiple studies and SPECT

 

-

-

45.25

7388.42

79940

Nuclear Medicine study - Regional lymph node mapping dynamic

 

-

-

6.02

982.95

79945

Nuclear Medicine study - Regional lymph node mapping, static,

planar

 

-

-

24.10

3935.05

79950

Nuclear Medicine study - Regional lymph node mapping, static, planar. multiple studies

 

-

-

37.51

6124.63

79955

Nuclear Medicine study - Regional lymph node mapping and SPECT

 

-

-

13.41

2189.58

79960

Nuclear Medicine study - Lymph node localisation with gamma probe

 

-

-

13.41

2189.58



 

 

 

 

 


Intervention

 

 

 

 

 



 

 

 

 

 


General

 

 

 

 

 


Codes 80600, 80605, 80610, 80620, 80630, 81660, 81680, 82600, 84660, 85640, 85645, 86610, 86615, 86620, 86630, (aspiration/biopsy/ablations etc) may be combined with the relevant guidance codes (fluoroscopy, ultrasound, CT, MR) as previously described.

The machine codes 00510, 00520, 00530, 00540, 00550, 00560

may not be combined with these codes.

If ultrasound guidance (00230) is used for a procedure which also attracts one of the machine codes (00510, 00520, 00530, 00540, 00550, 00560), it may not be billed for separately.

Codes 80640, 80645, 87682, 87683 include fluoroscopy. Machine fees may not be added.

All other interventional procedures are complete unique procedures describing a whole comprehensive procedure and combinations of different codes will only be supported when motivated.

 

 

 

 

 

80600

Percutaneous abscess, cyst drainage, any region

 

-

-

9.37

1529.93

80605

Fine needle aspiration biopsy, any region

 

-

-

4.22

689.04

80610

Cutting needle, trochar biopsy, any region

 

-

-

6.36

1038.46

80620

Tumour /cyst ablation chemical

 

-

-

25.37

4142.41

80630

Tumour ablation radio frequency, per lesion

 

-

-

21.21

3463.17

80640

Insertion of CVP line in radiology suite

 

-

-

8.99

1467.89

80645

Peripheral central venous line insertion

 

-

-

12.12

1978.95

80650

Infiltration of a peripheral joint, any region

 

-

-

6.40

1044.99


May be combined with relevant guidance (fluoroscopy, ultrasound, CT and MR). May not be combined with machine codes 00510, 00520, 00530, 00540, 00550, 00560 or 86610 (facet joint of Si joint or arthrogram codes.

 

 

 

 

 



 

 

 

 

 


Neuro intervention

 

 

 

 

 

81600

lntracranial aneurysm occlusion, direct

 

-

-

214.52

35026.83

81605

Intracranial arteriovenous shunt occlusion

 

-

-

254.82

41607.01

81610

Dural sinus arteriovenous shunt occlusion

 

-

-

264.33

43159.80

81615

Extracranial arteriovenous shunt occlusion

 

-

-

157.28

25680.68

81620

Extracranial arterial embolisation (head and neck)

 

-

-

163.12

26634.23

81625

Caroticocavemous fistula occlusion

 

-

-

192.29

31397.11

81630

Intracranial angioplasty for stenosis, vasospasm

 

-

-

126.92

20723.50

81632

Intracranial stent placement (including PTA)

 

-

-

133.72

21833.80

81635

Temporary balloon occlusion test

Code 81635 does not include the relevant preceding diagnostic study and may be combined with codes 10500, 10510, 10530,

10540, 10550.

 

-

-

83.42

13620.82

81640

Permanent carotid or vertebral artery occlusion (including occlusion test)

 

-

-

178.18

29093.23

81645

Intracranial aneurysm occlusion with balloon remodelling

 

-

-

216.35

35325.63

81650

Intracranial aneurysm occlusion with stent assistance

 

-

-

230.45

37627.88

81655

Intracranial thrombolysis, catheter directed

 

-

-

58.94

9623.72


Code 81655 may be combined with any of the other neuro interventional codes 81600 to 81650

 

 

 

 

 

81660

Nerve block, head and neck, per level

 

-

-

7.66

1250.72

81665

Neurolysis, head and neck, per level

 

-

-

20.14

3288.46

81670

Nerve block, head and neck, radio frequency, per level

 

-

-

19.04

3108.85

81680

Nerve block, coeliac plexus or other regions, per level

 

-

-

9.28

1515.24



 

 

 

 

 


Thorax

 

 

 

 

 

83600

Oesophageal stent insertion

 

-

-

8.82

1440.13

83605

GIT balloon dilation

 

-

-

30.36

4957.18



 

 

 

 

 


Gastrointestinal

 

 

 

 

 

83600

Oesophageal stent insertion

 

-

-

31.22

5097.60

83605

GIT balloon dilation

 

-

-

24.36

3977.50

83610

GIT stent insertion (non -oesophageal)

 

-

-

32.02

5228.23

83615

Percutaneous gastrostomy, jejunostomy

 

-

-

25.36

4140.78



 

 

 

 

 


Hepatobiliary

 

 

 

 

 

84600

Percutaneous biliary drainage, exrternal

 

-

-

33.98

5548.25

84605

Percutaneous external/internal biliary drainage

 

-

-

37.21

6075.65

84610

Permanent biliary stent insertion

 

-

-

51.22

8363.20

84615

Drainage tube replacement

 

-

-

20.22

3301.52

84620

Percutaneous bile duct stone or foreign object removal

 

-

-

49.98

8160.73

84625

Percutaneous gall bladder drainage

 

-

-

29.58

4829.82

84630

Percutaneous gallstone removal, including drainage

 

-

-

69.25

11307.14

84635

Transjugular liver biopsy

 

-

-

24.93

4070.57

84640

Transjugular intrahepatic Portosystemic shunt

 

-

-

119.47

19507.06

84645

Transhepatic Portogram including venous sampling, pressure studies

 

-

-

81.89

13371.00

84650

Transhepatic Portogram with embolisation of varices

 

-

-

100.81

16460.26

84655

Percutaneous hepatic tumour ablation

 

-

-

15.68

2560.23

84660

Percutaneous hepatic abscess, cyst drainage

 

-

-

13.20

2155.30

84665

Hepatic chemoembolisation

 

-

-

59.44

9705.36

84670

Hepatic arterial infusion catheter placement

 

-

-

60.30

9845.78



 

 

 

 

 


Urogenital

 

 

 

 

 

85600

Percutaneous nephrostomy, external drainage

 

-

-

29.97

4893.50

85605

Percutaneous double J stent insertion including access

 

-

-

40.82

6665.09

85610

Percutaneous renal stone, foreign body removal including access

 

-

-

66.79

10905.47

85615

Percutaneous nephrostomy tract establishment

 

-

-

29.27

4779.21

85620

Change of nephrostomy tube

 

-

-

15.90

2596.15

85625

Percutaneous cystostomy

 

-

-

16.52

2697.39

85630

Urethral balloon dilatation

 

-

-

14.24

2325.11

85635

Urethral stent insertion

 

-

-

31.22

5097.60

85640

Renal cyst ablation

 

-

-

11.92

1946.30

85645

Renal abscess, cyst drainage

 

-

-

15.16

2475.32

85655

Fallopian tube recanalisation

 

-

-

45.06

7357.40



 

 

 

 

 


Spinal

 

 

 

 

 

86600

Spinal vascular malformation embolisation

 

-

-

275.16

44928.12

86605

Vertebroplasty per level

 

-

-

22.30

3641.14

86610

Facet joint block per level, uni- or bilateral

 

-

-

9.54

1557.69


Code 86610 may only be billed once per level, and not per left and right side per level

 

 

 

 

 

86615

Spinal nerve block per level, uni- or bilateral

 

-

-

8.16

1332.36

86620

Epidural block

 

-

-

9.42

1538.10

86625

Chemonucleolysis, including discogram

 

-

-

18.32

2991.29

86630

Spinal nerve ablation per level

 

-

-

11.60

1894.05



 

 

 

 

 


Vascular

 

 

 

 

 


Code 87654 (Thrombolysis follow up) may only be used on the days following the initial procedure, 87650 (thrombolysis). If a balloon angioplasty and/or stent placement is performed at more that one defined anatomical site at the same sitting the relevant codes may be combined. However multiple balloon dilatations or stent placements at one defined site will only attract one procedure code.

 

 

 

 

 

87600

Percutaneous transluminal angioplasty: aorta, IVC

 

-

-

56.56

9235.12

87601

Percutaneous transluminal angioplasty: iliac

 

-

-

55.76

9104.49

87602

Percutaneous transluminal angioplasty: femoropopliteal

 

-

-

60.16

9822.92

87603

Percutaneous transluminal angioplasty: subpopliteal

 

-

-

73.34

11974.96

87604

Percutaneous transluminal angioplasty: brachiocephalic

 

-

-

67.12

10959.35

87605

Percutaneous transluminal angioplasty: subclavian, axillary

 

-

-

60.16

9822.92

87606

Percutaneous transluminal angioplasty: extracranial carotid

 

-

-

71.62

11694.11

87607

Percutaneous transluminal angioplasty: extracranial vertebral

 

-

-

73.30

11968.42

87608

Percutaneous transluminal angioplasty: renal

 

-

-

87.69

14318.02

87609

Percutaneous transluminal angioplasty: coeliac, mesenteric

 

-

-

87.69

14318.02

87620

Aorta stent -graft placement

 

-

-

120.75

19716.06

87621

Stent insertion (including PTA): aorta, IVC

 

-

-

73.87

12061.49

87622

Stent insertion (including PTA): iliac

 

-

-

76.37

12469.69

87623

Stent insertion (including PTA): femoropopliteal

 

-

-

77.97

12730.94

87624

Stent insertion (including PTA): subpopliteal

 

-

-

84.55

13805.32

87625

Stent insertion (including PTA): brachiocephalic

 

-

-

98.47

16078.18

87626

Stent insertion (including PTA): subclavian, axillary

 

-

-

86.69

14154.74

87627

Stent insertion (including PTA): extracranial carotid

 

-

-

106.99

17469.33

87628

Stent insertion (including PTA): extracranial vertebral

 

-

-

100.55

16417.80

87629

Stent insertion (including PTA): renal

 

-

-

98.59

16097.78

87630

Stent insertion (including PTA): coeliac, mesenteric

 

-

-

98.59

16097.78

87631

Stent -graft placement: iliac

 

-

-

76.37

12469.69

87632

Stent -graft placement: femoropopliteal

 

-

-

77.97

12730.94

87633

Stent -graft placement brachiocephalic

 

-

-

98.47

16078.18

87634

Stent -graft placement subclavian, axillary

 

-

-

82.77

13514.69

87635

Stent -graft placement: extracranial carotid

 

-

-

120.43

19663.81

87636

Stent -graft placement: extracranial vertebral

 

-

-

114.73

18733.11

87637

Stent-graft placement: renal

 

-

-

98.59

16097.78

87638

Stent-graft placement coeliac, mesenteric

 

-

-

98.59

16097.78

87650

Thrombolysis in angiography suite, per 24 hours

 

-

--

45.82

7481.49


Code 87650 may be combined with any of the relevant non neuro interventional angiography and interventional codes 10520, 20500, 20510, 20520, 20530, 20540, 32500,32530,44500, 44503, 44505, 44507, 44510, 44515, 44517, 44520, 60500, 60510, 60520, 60530, 70500, 70505, 70510, 70515, 87600 to 87638.

 

 

-

 

 

87651

Aspiration, rheolytic thrombectomy

 

-

-

77.67

12681.96

87652

Atherectomy, per vessel

 

-

-

91.89

15003.80

87653

or other line insertion

 

-

-

28.15

4595.33

87654

Thrombolysis follow -up

 

-

-

23.57

3848.51

87655

Percutaneous sclerotherapy, vascular malformation

 

-

-

21.10

3445.21

87660

Embolisation, mesenteric

 

-

-

100.43

16398.21

87661

Embolisation, renal

 

-

-

99.36

16223.50

87662

Embolisation, bronchial, intercostal

 

-

-

108.34

17689.76

87663

Embolisation. pulmonary arteriovenous shunt

 

-

-

103.22

16853.76

87664

Embolisation, abdominal, other vessels

 

-

-

101.44

16563.12

87665

Embolisation, thoracic, other vessels

 

-

-

97.60

15936.13

87666

Embolisation, upper limb

 

-

-

90.92

14845.42

87667

Embolisation, lower limb

 

-

-

92.14

15044.62

87668

Embolisation, pelvis, non-uterine

 

--

-

117.12

19123.35

87669

Embolisation, uterus

 

-

-

113.88

18594.33

87670

Embolisation, spermatic, ovaria veins

 

-

-

85.82

14012.69

87680

Inferior vena cava filter placement

 

-

-

61.84

10097.24

87681

Intravascular foreign body removal

 

-

-

85.03

13883.70

87682

Revision of access port (tunnelled or implantable)

 

-

-

14.12

2305.51

87683

Removal of access port (tunnelled or implantable)

 

-

-

11.12

1815.67

87690

Superior petrosal venous sampling

 

-

-

73.01

11921.07

87691

Pancreatic stimulation test

 

-

-

89.79

14660.91

87692

Transportal venous sampling

 

-

-

76.95

12564.40

87693

Adrenal venous sampling

 

-

-

55.01

8982.03

87694

Parathyroid venous sampling

 

-

-

86.66

14149.84

87695

Renal venous sampling

 

-

-

55.01

8982.03



 

 

 

 

 

 

 

 


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