E686

PDF page 548 / SP6

SURGICAL PREAMBLE
PREAMBLE
 24. Morbidly obese patients
     E676 is eligible for payment once per patient per physician in addition to the amount eligible for
     payment for the major surgical procedure(s) where a morbidly obese patient undergoes major
     surgery to the neck, thorax, peritoneal cavity, retroperitoneum, pelvis, or hip and:
    a. the patient has a Body Mass Index (BMI) greater than 40
    b. the surgery is rendered under general anaesthesia using either an open technique for the
       neck, thorax, or hip, or an open or laparoscopic technique for the peritoneal cavity, pelvis,
       retroperitoneum; and
    c. the principal surgical technique is neither aspiration, core or fine needle biopsy, dilation,
       endoscopy, mediastinoscopy, thoracoscopy, cautery, ablation nor catheterization.
E676A Morbidly obese patient, surgeon, to procedural fee(s)...... add                      25%
E676B Morbidly obese patient, surgical assistant, to major procedure
        add                                                                               6 units
     Note:
     E676A/B is only payable with the following procedures: D043, D046, D047, D052, E090, E499,
     E500, E505, E546, E589, E593, E626, E627, E655, E664, E673, E686, E697, E704, E706,
     E707, E708, E709, E711, E712, E713, E714, E718, E721, E722, E725, E728, E729, E731,
     E733, E734, E735, E736, E737, E738, E739, E743, E745, E748, E752, E754, E762, E764,
     E765, E766, E767, E768, E769, E771, E794, E796, E852, E853, E854, E855, E857, E860,
     E880, E882, E883, E884, E885, F100, F101, F135, M081, M082, M084, M090, M099, M100,
     M142, M143, M144, P018, P041, P042, P050, P055, P056, P057, P058, P059, P060, R108,
     R109, R216, R241, R269, R330, R423, R439, R440, R443, R470, R481, R488, R491, R553,
     R569, R590, R627, R628, R639, R686, R786, R800, R802, R803, R805, R806, R807, R811,
     R814, R815, R817, R823, R825, R826, R834, R839, R852, R855, R856, R858, R860, R861,
     R910, R885, R905, R913, R914, R915, R932, R933, R934, R935, R936, R937, S089, S090,
     S114, S115, S116, S117, S118, S120, S121, S122, S123, S124, S125, S128, S129, S131,
     S132, S133, S134, S137, S138, S139, S140, S149, S150, S154, S157, S158, S159, S160,
     S162, S164, S165, S166, S167, S168, S169, S170, S171, S172, S173, S175, S176, S177,
     S180, S182, S183, S184, S185, S187, S188, S189, S191, S192, S193, S194, S195, S196,
     S197, S199, S204, S207, S213, S214, S215, S217, S218, S222, S227, S265, S266, S267,
     S269, S270, S271, S274, S275, S276, S278, S280, S281, S282, S285, S287, S291, S292,
     S294, S295, S297, S298, S299, S300, S301, S302, S303, S304, S305, S306, S307, S308,
     S309, S310, S311, S312, S313, S314, S315, S318, S319, S321, S323, S325, S329, S332,
     S340, S342, S343, S344, S345, S405, S411, S416, S420, S422, S424, S427, S431, S432,
     S433, S434, S435, S436, S438, S440, S441, S445, S446, S447, S448, S449, S450, S451,
     S452, S453, S454, S455, S457, S460, S461, S462, S465, S466, S467, S468, S471, S482,
     S483, S488, S490, S491, S512, S513, S546, S549, S561, S590, S650, S651, S652, S710,
     S714, S727, S728, S729, S731, S733, S735, S736, S738, S739, S740, S741, S743, S745,
     S747, S748, S750, S751, S757, S758, S759, S760, S761, S763, S764, S766, S775, S776,
     S778, S780, S781, S782, S784, S788, S789, S790, S792, S793, S795, S798, S799, S800,
     S813, Z427, Z526, Z552, Z553, Z564, Z569, Z577, Z594, Z737, Z738

PDF page 705 / S23

APPENDIX
# S204 Incision and drainage of abscess ...........................................                  6      273.60    7
# S207 Appendectomy with or without perforation.............................. 6 524.60                                7
      Payment rules:
      1.S204, S313, S314, Z594 and E686 are not eligible for payment with S207.
         [Commentary:
         S207 is to be claimed for an appendectomy regardless of whether the appendix is intact or
         ruptured.]

PDF page 717 / S35

Peritoneal abscess
# S313 - subphrenic..........................................................................        7     370.95    7
# S314 - abdominal...........................................................................        6     301.10    7
# Z569 Pelvic abscess, incision and drainage - rectal or vaginal
         approach ............................................................................             122.05    7
# Z594 Percutaneous abdominal abscess drainage including daily
         supervision, for one or more abscesses within the same
         abdominal quadrant or the pelvis .......................................                          508.80
# E686   - within each other abdominal quadrant, or the pelvis (if the
           initial abscess was not in the pelvis) .......................... add                           144.10
   Z595 Replacement of drainage catheter in abdominal abscess ......                                        54.05
# Z574 Removal of infected sutures from abdominal wall or re-
         exploration of wound for bleeding - general anaesthetic....                                 6      94.85    7
# S311 Umbilical vein intra-abdominal dissection and catheterization    6       232.50      6
      Note:
      For vascular newborn - see Diagnostic & Therapeutic Procedures - Vascular Cannulation.
# S320 Insertion of antabuse into abdominal wall...............................                             58.15
    Insertion of peritoneo-jugular shunt for ascites
# S203 - primary ...............................................................................     7     281.85    7
# S209 - revision ...............................................................................    7     237.00    7
# S310 Insertion of intraperitoneal chemotherapy port by laparotomy
          or laparoscopy.................................................................... 6 215.10 6
# S315 Removal of intraperitoneal chemotherapy port by laparotomy
          or laparoscopy.................................................................... 6 215.10 6
      Payment rules:
      S310 or S315 are not eligible for payment in addition to any open or laparoscopic abdominal
      procedure.

Master, record 1382. Record Layout PDF, page 1.

E68620250401999999990000144100000000000000000000000000000000000000000000000

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.