G205

PDF page 72 / GP58

COUNSELLING
  Definition/Required elements of service:
  Counselling is a patient visit dedicated solely to an educational dialogue with a physician. This service
  is rendered for the purpose of developing awareness of the patient’s problems or situation and of
  modalities for prevention and/or treatment, and to provide advice and information in respect of
  diagnosis, treatment, health maintenance and prevention.
                                          [Commentary:
                                          1.Advice given to a patient that would ordinarily constitute part of a consultation, assessment,
                                            or other treatment, is included as a common or constituent element of the other service, and
                                            does not constitute counselling.
       2.Detention time may be payable following a consultation or assessment when a physician is
         required to spend considerable extra time in treatment or monitoring of the patient. See
         GP29 for further information.]
  Payment rules:
    1. With the exception of the codes listed in the below, no other services are eligible for payment
       when rendered by the same physician the same day as any type of counselling service:
       E080, G010, G039, G040, G041, G042, G043, G202, G205, G365, G372, G384, G385, G394,
       G462, G480, G489, G482, G538, G590, G593, G840, G841, G842, G843, G844, G845, G846,
       G847, G848, G849, H313, K002, K003, K008, K014, K015, K031, K035, K036, K038, K682,
       K683, K684, K730
                    2. Individual and group counselling services are limited to 3 units per patient per physician per
                       year at the higher fee (K013 or K040 respectively); the amount payable for services rendered in
                       excess of this limit will be adjusted to a lesser fee (K033 or K041 respectively).
                    3. If the patient does not have a pre-booked appointment, the amount payable for this service will
                       be adjusted to a lesser assessment fee.
  A. Individual Counselling
  Definition:
  Individual counselling is counselling rendered to a single patient.
  B. Group Counselling
  Definition:
  Group Counselling is counselling rendered to two or more patients with a similar medical condition or
  situation.
  Payment rules:
     1. Group counselling is only eligible for payment when all of the following conditions are fulfilled:

PDF page 418 / J4

DIAGNOSTIC AND THERAPEUTIC PROCEDURES
ALLERGY
                                                                                                               Fee
     Note:
     If a patient presents for an allergy injection and has an acute infectious condition, albeit of the
     respiratory system, or some other unrelated condition which would have otherwise required a
     separate office visit, the physician is entitled to claim the appropriate assessment fee as well as
     the injection fee. If a patient requires a brief assessment of his allergic condition as well as the
     allergy injection, the physician should claim the injection and the basic fee, in which case the
     specific elements of the service include those of an assessment (see General Preamble
     GP15).
# G185 Drug(s) desensitisation - in a hospital where full
           cardioresuscitative equipment is readily available because a
           significant risk of life-threatening anaphylaxis exists. The
           service must be performed under direct and ongoing
           physician attendance.......................................................... 184.95
+ G200 Acute desensitisation, e.g. ATS, penicillin ..............................           8.65
+ G201 Direct nasal tests, to a maximum of 3 per year .......... per test                                         1.60
    Hyposensitisation
  G202 - each injection .....................................................................                    7.15
  G212 - when sole reason for visit (including first injection) ............                                    12.85
         Payment rules:
         G202 is limited to a maximum of 2 when an assessment is eligible for payment for the same
         visit and a maximum of 1 in addition to the injection included in G212 when sole reason for visit.
  G205 Insect venom desensitisation (immunotherapy) - per injection
          (maximum of 5 per day). In addition to G205, after the initial
          major assessment only, a minor or partial assessment may
          be claimed once per day if rendered ..................................                                13.15
    Ophthalmic tests
+ G203 - direct, to maximum of 3 per year............................ per test                                   1.60
+ G204 - quantitative .........................................................................                 12.40
    Patch test
  G206 - maximum of 90 per patient, per year ..................... per test                                       2.39
  G198 - for industrial or occupational dermatoses, to a maximum of
          125 per patient, per year ........................................ per test                             2.39
+ G207 Bronchial provocative testing - per session, to a maximum of 6
         per year ..............................................................................                14.15
    Provocation testing
     For foods, food additives and medications, by blinded or open technique, maximum 5 testing
     sessions per 12 month period.
  G208 Provocation testing .................................................... per unit 21.90
     Payment rules:
     1. G208 is a time base service. Unit means one hour or major part thereof.
         2. In the event the allergic response is respiratory, only one pulmonary function test is eligible
           for payment the same day as G208.

Master, record 1919. Record Layout PDF, page 1.

G20520250401999999990000013150000000000000000000000000000000000000000000000

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.