E023

PDF page 114 / GP100

GENERAL PREAMBLE
   ANAESTHESIOLOGISTS’ SERVICES
  ANAESTHESIA FOR ocular SURGERY, EXAMINATION UNDER ANAESTHESIA, colonoscopy,
  sigmoidoscopy and cystoscopy
  For the purposes of E023C and E032C, anaesthesia means an anaesthesia service other than local
  infiltration, topical anaesthesia or procedural sedation rendered in support of the listed procedures.
  E023C and E032C replaces the listed basic units and time units for anaesthesia for these procedures.

PDF page 114 / GP100

Ocular Surgery, Cystoscopy, and Examination Under Anaesthesia
               E023C Anaesthesia service for E138, E139, E140, E141, E144, E145,
                        E146, E186, E187, E149, Z432, Z606, or Z607
                         ............................................. 6 basic units, plus time units.
      Colonoscopy and Sigmoidoscopy
   E032C Anaesthesia service for Z491, Z492, Z493, Z494, Z495, Z496,
                Z497, Z498, Z499, Z555 or Z580
                .............................................. 4 basic units, plus time units
        [Commentary:
        1.Deep sedation, general anaesthesia or regional anaesthesia, performed by an
          anaesthesiologist, are examples of anaesthesia that may be rendered for E023C and E032C.
        2.Anaesthesia extra units listed on GP97 are eligible for payment with E023C and E032C.
        3.Local infiltration or topical anaesthesia used as an anaesthetic for any procedure is not
          eligible for payment.]
        Note:
        For the purposes of anaesthesia services the following definitions apply:
        1.Procedural Sedation is a drug-induced depression of consciousness during which patients
          respond purposefully to verbal commands, either alone or accompanied by light tactile
          stimulation. No interventions are required to maintain a patent airway, and spontaneous
          ventilation is adequate. Cardiovascular function is usually maintained.
        2.Deep Sedation is a drug-induced depression of consciousness during which patients cannot
          be easily aroused but respond purposefully following repeated or painful stimulation. The
          ability to independently maintain ventilatory function may be impaired. Patients may require
          assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate.
          Cardiovascular function is usually maintained.
        3.General Anaesthesia is a drug-induced loss of consciousness during which patients are not
          arousable, even by painful stimulation. The ability to independently maintain ventilatory
          function is often impaired. Patients often require assistance in maintaining a patent airway,
          and positive pressure ventilation may be required because of depressed spontaneous
          ventilation or drug-induced depression of neuromuscular function. Cardiovascular function
          may be impaired.
  ANAESTHESIA ADMINISTERED BY SAME PHYSICIAN PERFORMING A PROCEDURE
    1. Except as described in paragraph 2, when a physician administers an anaesthetic, nerve block
       and/or other medication prior to, during, immediately after or otherwise in conjunction with a
       diagnostic, therapeutic or surgical procedure which the physician performs on the same patient,
       the administration of the anaesthetic, nerve block and/or other medication is not eligible for
       payment.

PDF page 420 / J6

Examination under anaesthesia (EUA) (when sole procedure performed)
A. While this may be performed for diagnostic purposes, the specific elements are those for a
   therapeutic procedure.
B. EUA is payable only if sole procedure performed by examining physician. EUA claimed in
   conjunction with any other procedure is payable at nil.
C. Claims for EUA submitted without the applicable diagnostic code are payable at nil.
        Note:
        Despite paragraph b. listed under Basic Units on GP94, no anaesthesia service other than
        E023C is eligible for payment when rendered in support of Z432.
        [Commentary:
        Refer to E023C on GP100 for anaesthesia services rendered in support of Z432.]
  Z432 EUA with or without intubation, and may include removal of
         vaginal foreign body ...........................................................                54.10
  Z430 Provision of anaesthetic services for patients undergoing
         magnetic resonance imaging .............................................                          -             6

PDF page 771 / Y5

Payment rules:
                                          1.Time units and anaesthesia extra units listed on GP97 are not eligible for payment with
                                            anaesthesia services for E138C, E139C, E140C, E141C, E144C, E145C or E146C.
                                          2.E003C is not payable for anaesthesia services rendered for E138, E139, E140, E141, E144,
                                            E145 or E146.
                                          3.E145 and E146 are only eligible for payment for revisions to previously implanted artificial
                                            intraocular lens.
                                          4.E950 is only eligible for payment with E144 when dislocated implanted artificial intraocular
                                            lens is removed and replaced during same surgery.
                                          5.E146 is not eligible for payment with E140, E141 or E144.
                                          [Commentary:
                                          1.Refer to E023C on GP100 for anaesthesia services other than procedural sedation rendered
                                            in support of E138, E139, E140, E141, E144, E145 and E146.
                                          2.Local infiltration or topical anaesthesia used as an anaesthetic for any procedure is not
                                            eligible for payment.]

PDF page 773 / Y7

OCULAR SURGICAL PROCEDURES
 VITREOUS
                                                                                 Asst      Surg      Anae
         11.E149 is not eligible for payment at the time of surgery when the agent administered (e.g.
           antibiotics or steroids) is in relation to the condition being addressed by the primary operative
           procedure. E149 is only eligible for payment in addition to the primary operative procedure
           where there is a clearly separate unrelated diagnosis and E149 is the primary treatment for
           the separate unrelated condition.
         [Commentary:
         1.Current research supports “treat and extend” injection protocols with most studies supporting
           that an average of approximately 8 injections per year will control disease. Patients should
           only receive more than 8 injections per year in the presence of clinical and diagnostic
           evidence of disease instability.
         2.Refer to E023C on GP100 for anaesthesia services other than procedural sedation rendered
           in support of E186, E187, or E149.
         3.Local infiltration or topical anaesthesia used as an anaesthetic for any procedure is not
           eligible for payment.]

Master, record 890. Record Layout PDF, page 1.

E02320260401999999990000000000000000000000000000000000000095760000000957600

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.