E940

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.

Master, record 1625. Record Layout PDF, page 1.

E94020250401999999990000105000000000000000000000000000000000000000000000000

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.