E060

PDF page 264 / A136

CONSULTATIONS AND VISITS
      NEPHROLOGY (16)
                 GENERAL LISTINGS
               A165 Consultation............................................................................               180.75
                 Comprehensive nephrology consultation
                   This service is a consultation rendered by a specialist in nephrology who provides all the
                   appropriate elements of a consultation and spends a minimum of seventy-five (75) minutes of
                   direct contact with the patient exclusive of time spent rendering any other separately billable
                   intervention to the patient.
               A160 Comprehensive nephrology consultation................................         342.25
                   Medical record requirements:
                   For A160, 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.A160 must satisfy all the elements of a consultation (see page GP16).
                   2.Unless otherwise specified in the Schedule, the calculation of the 75 minute minimum time
                     for comprehensive nephrology consultations excludes (1) time devoted to any other service
                     or procedure for which an amount is payable in addition to the consultation and (2) non-
                     patient-facing time such as such as time spent reviewing charts, imaging, or documentation,
                     etc.]
               A865 Limited consultation ................................................................ 116.75
               A166 Repeat consultation ................................................................  116.75
               A163 Medical specific assessment ..................................................         95.95
               A164 Medical specific re-assessment..............................................           72.00
               A161 Complex medical specific re-assessment...............................                  83.40
               A168 Partial assessment .................................................................   44.75
                 Post Renal Transplant Assessment Premium
                   Post renal transplant assessment premium is payable in addition to the amount payable for an
                   assessment.
               E060 Post Renal Transplant Assessment Premium........... Add 50%
                   Payment rules:
                   All of the following criteria apply:
                                          1.The assessment is a:
                                             a.medical specific assessment (A163);
                                             b.medical specific re-assessment (A164);
                                             c.complex medical specific re-assessment (A161); or
                                             d.partial assessment (A168);
                                          2.The service is rendered by a physician with a specialty designation in (16) Nephrology;
                                          3.The assessment is not eligible for payment when rendered in an emergency department or
                                            emergency department equivalent or to a hospital inpatient;
                                          4.The purpose of the assessment is post-transplant care; and
                                          5.The patient is within the first three years of having received their renal transplant.

Master, record 909. Record Layout PDF, page 1.

E06020200401999999990000000000000000000000000000001000000000000000000000000

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.