E694

PDF page 716 / S34

INCISION
# Z563 Needle biopsy of peritoneum ..................................................                                52.40
# Z564 Open lavage of peritoneal cavity for diagnosis without manual
         exploration of peritoneal cavity...........................................                                 73.60          7
# S312 Laparotomy, with or without biopsy or for Hirschsprung’s
         disease (except biopsies of stomach, liver, pancreas and
         multiple para-aortic lymph nodes) ......................................                        6         485.25           7
# S324 Temporary abdominal closure with or without peritoneal
         washout ..............................................................................          6         376.25           7
         Note:
         1.S312 - use for division or removal of adhesions, if no other abdominal surgery performed -
           may not be claimed with other intra-abdominal procedures (except for IOP).
         2.S324 is only eligible for payment when rendered as a standalone procedure
         3.S324 is not eligible for payment:
            a.When definitive fascial closure is achieved at the same operative episode
            b.For superficial wound management or application of negative pressure therapy only
# E745         - insertion of tubes and post-operative continuous peritoneal
                 lavage when combined with any other abdominal
                 procedure................................................................... add                    94.85
    Laparotomy
# S321 - for acute trauma .................................................................              6         671.65           6
# E733   - with repair of intestine - single ................................... add                               162.90
# E734   - multiple and/or with resection .................................... add                                 241.55
# E735   - with splenectomy (partial or complete) ...................... add                             4         325.80
# E736   - with repair of lacerated liver ....................................... add                    4         214.95
# E739   - with repair of diaphragm ............................................ add                     4         139.60
# E723   - with repair of lacerated spleen ................................... add                       4         325.85
# E693   - with repair of ruptured bladder ................................... add                       4           -
# E694   - with nephrectomy....................................................... add                   4           -

Master, record 1390. Record Layout PDF, page 1.

E69420260401999999990000000000000000516400000000000000000000000000000000000

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.