A570

PDF page 325 / A197

GENERAL LISTINGS
   A475 Consultation............................................................................   192.30
     Comprehensive respiratory disease consultation
       This service is a consultation rendered by a specialist in respiratory disease who provides all
       the appropriate elements of a consultation and spends a minimum of 75 minutes in direct
       contact with the patient, exclusive of time spent rendering any other separately billable
       intervention to the patient.
   A470 Comprehensive respiratory disease consultation ...................            342.25
       Medical record requirements:
       The start and stop times must be recorded in the patient’s permanent medical record or the
       amount payable for the service will be adjusted to a lesser paying fee.
       [Commentary:
       1.A470 must satisfy all the elements of a consultation (see page GP16).
       2.Unless otherwise specified in the Schedule, the calculation of time for comprehensive
         respiratory diseases consultations excludes (1) time devoted to any other service or
         procedure for which an amount is payable in addition to the consultationand (2) non-patient-
         facing time such as such as time spent reviewing charts, imaging, or documentation, etc.]
   A575 Limited consultation ................................................................ 119.35
   A476 Repeat consultation ................................................................  119.35
   A473 Medical specific assessment ..................................................        102.60
   A474 Medical specific re-assessment..............................................           75.30
   A471 Complex medical specific re-assessment...............................                  89.40
   A478 Partial assessment .................................................................   45.25
   E078          - chronic disease assessment premium (see General
                   Preamble GP25) ................................................ add 50%
        Complex respiratory assessment
          This service is an assessment for the ongoing management of the following conditions of the
          respiratory system where the complexity of the condition requires the continuing management
          by a respirology specialist (47):
         a. chronic respiratory failure (i.e. a symptomatic patient with a PaO2 <60mmHg and/or or a
             PaCO2 >50mmHg);
         b. bronchiectasis with frequent infections;
         c. cystic fibrosis;
         d. active pulmonary or extrapulmonary disease due to mycobacterial tuberculosis complex
            (latent tuberculosis infection is excluded); or
         e. active pulmonary or extrapulmonary non-tuberculous mycobacterial disease (airway or
            tissue colonization without disease is excluded).
   A570 Complex respiratory assessment ........................................... 108.95
       Payment rules:
       1.A570 must include the elements of a medical specific re-assessment, or the amount payable
         will be adjusted to a lesser assessment fee.

PDF page 326 / A198

CONSULTATIONS AND VISITS
RESPIRATORY DISEASE (47)
    2.A570 is limited to 6 per patient, per physician, per 12 month period. Services in excess of this
      limit will be adjusted to a lesser assessment fee.
    3.E078 is not eligible for payment same patient same day as A570.
    [Commentary:
    A570 is not intended for the evaluation and/or management of uncomplicated respiratory
    disorders. For example, the applicable assessment service from the general listings should be
    claimed for assessment of patients for routine follow-up of uncomplicated chronic obstructive
    pulmonary disease (e.g. emphysema, chronic bronchitis).]

PDF page 327 / A199

CONSULTATIONS AND VISITS
 RESPIRATORY DISEASE (47)
        EMERGENCY OR OUT-PATIENT DEPARTMENT (OPD)
         Physician in hospital but not on duty in the Emergency Department when seeing patient(s) in
         the Emergency or OPD - use General Listings.
     NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES
      See General Preamble GP40 to GP48. For emergency calls and other special visits to in-
      patients, use General Listings and Premiums when applicable - see General Preamble GP65
      to GP78.
   C475 Consultation............................................................................ 185.80
   C470 Comprehensive respiratory disease consultation - subject to
           the same conditions as A470 .............................................             342.25
   C575 Limited consultation ................................................................    115.30
   C476 Repeat consultation ................................................................     115.30
   C473 Medical specific assessment ..................................................            99.15
   C474 Medical specific re-assessment..............................................              72.80
   C471 Complex medical specific re-assessment...............................                     86.40
   C570 Complex respiratory assessment – subject to the same
           conditions as A570 .............................................................      105.25
     Subsequent visits
   C472 - first five weeks........................................................ per visit           40.05
   C477 - sixth to thirteenth week inclusive (maximum 3 per patient
          per week)................................................................ per visit          40.05
   C479 - after thirteenth week (maximum 6 per patient per month)
           ............................................................................... per visit   40.05
     Subsequent visits by the Most Responsible Physician (MRP)
      See General Preamble GP44 to GP45 for terms and conditions.
   C122 - day following the hospital admission assessment ..............                               71.80
   C123 - second day following the hospital assessment ..................                              71.80
   C124 - day of discharge .................................................................           71.80
   C126 - day of discharge, medically complex patient (see A13 for
          terms and conditions) .........................................................              95.10
     Subsequent visits by the MRP following transfer from an Intensive Care Area
      See General Preamble GP46 for terms and conditions.
   C142 - first subsequent visit by the MRP following transfer from an
          Intensive Care Area............................................................ 71.80
   C143 - second subsequent visit by the MRP following transfer from
          an Intensive Care Area .......................................................  71.80
   C121 Additional visits due to intercurrent illness (see General
          Preamble GP43)..................................................... per visit                40.05
   C478 Concurrent care .......................................................... per visit           40.05
   C982 Palliative care (see General Preamble GP50)............ per visit                              40.05

Master, record 230. Record Layout PDF, page 1.

A57020260401999999990000000000000000000000000010895000000000000000000000000

Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.