E141

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 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 772 / Y6

Injections and/or paracentesis
# E186 Intravitreal injection of medication for the treatment of wet
           macular degeneration, left eye ............................................               nil          90.00          5
# E187 Intravitreal injection of medication for the treatment of wet
           macular degeneration, right eye..........................................                 nil          90.00          5
# E149 Vitreous injection or aspiration, posterior with needle for culture
          and/or injection of medication, other than for macular
          degeneration .......................................................................       nil          90.00          5
# E175    - therapeutic paracentesis, to E186, E187, or E149 .....add                                             20.00
# E142 Preretinal membrane peeling or segmentation to include
            vitrectomy, complete and by posterior approach, with or
            without vitreous exchange (air, gas, or artificial vitreous
            substance) .......................................................................... 6 920.00 6
      Payment rules:
      1.E186 and E187 are each limited to 12 per patient per 12-month period. Services in excess of
        this limit are only eligible for payment in exceptional circumstances where warranted by
        clinical conditions. Physicians must document the appropriate clinical indications for services
        in excess of the limit on the patient’s permanent medical record.
         2.Time units and anaesthesia extra units listed on GP97 are not eligible for payment with
           anaesthesia services for E186C, E187C, or E149C.
         3.E003C is not payable for anaesthesia services rendered for E186, E187, or E149.
         4.If paracentesis is performed through the same site as E186, E187, or E149, E175 is not
           eligible for payment.
         5.E148, E142, E149, E186, E187, E175, Z851 are not eligible for payment with E112
         6.E940 is not eligible for payment with E142 or E148.
         7.E154 is not eligible for payment with E142 except when extensive pan-retinal laser
           coagulation is required to treat underlying pathology resulting in two separate procedures
           being performed and each are documented in the medical record.
         8.E151 is only eligible for payment with E142 or E148 when laser is performed to treat a retinal
           detachment with presence of subretinal fluid, in association with the vitrectomy.
         9.E141 is only eligible for payment with E142 or E148 when removal of the lens fragments in
           the posterior vitreous substance requires the use of a separate instrument (fragmatome unit).
         10.E148 and E142 include the removal of silicone oil along with residual vitreous, if performed.

PDF page 777 / Y11

Blepharoplasty
# E200 - excision of skin, with or without partial excision of the
          orbicularis oculi muscle - one lid ........................................           82.80 6
# E201 - same as E200 plus removal of orbital fat and/or major lid
          fold reconstruction - one lid ................................................     6 205.55 7
      Note:
      Blepharoplasty is only insured in those circumstances described in the Appendix D - prior
      approval of the Ministry of Health is required.
# E211 Lid lengthening procedure ......................................................      6 288.35 6
# E953    - with scleral graft ......................................................... add    80.90
# E222 Primary closure of full thickness lid defect..............................                 6      290.00      6
# E942    - with cantholysis.......................................................... add                53.20
# E943    - with releasing rotation flap including cantholysis ....... add                                89.45
# E223 Tarsoconjunctival flap and skin graft (Hughes) .......................                     6      484.35      7
# E224 - second stage ......................................................................             108.45      7
# E225 Lower or upper eyelid bridge flap ...........................................              6      484.35      6
# E226 - second stage ......................................................................             108.45      6
# E227 Temporal rotation flap .............................................................       6      514.80      6
# E944   - with free posterior lamellar graft................................. add                       175.15
# E228 Free tarsal, scleral or cartilage graft with local skin
         mobilization ........................................................................    6      535.80      7
# E229 Free composite eyelid graft ....................................................           6      535.80      7
# E230 Medial canthoplasty (skin and muscle)...................................                   6      257.90      6
    Medial canthal tendon
# E231 - tendon repair only...............................................................        6      267.35      7
# E232 - fixation to bone ...................................................................     6      412.05      6
# E233   - when done in conjunction with another procedure..... add                                      153.25
    Lateral canthal surgery
# E234 Canthotomy ............................................................................            51.45
      Note:
      Not to be claimed with E140 or E141.
6

Master, record 967. Record Layout PDF, page 1.

E14120260401999999990000505450000000774600000000000000000079800000000798000

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.