J202

PDF page 403 / G7

DIAGNOSTIC ULTRASOUND
 VASCULAR SYSTEM
                                                                                                     H      P
     Transcranial doppler assessment of intracranial circulation
   J189 Transcranial doppler assessment of intracranial circulation ...                              -      23.65
   J186      - assessment with power mode doppler ...............................                           32.50
   J187      - prolonged study requiring at least 50 minutes....................                            32.50
   J188      - follow-up study within 4 weeks of J186 or J187 requiring at
               least 50 minutes .................................................................           25.00
         Payment rules:
         1.J189 is not eligible for payment with J186, J187 or J188 same patient same day.
         2.Only one of J186, J187 or J188 are payable same patient, same physician, same day.
     Extra-cranial vessel assessment - above the aortic arch
       Bilateral carotid and/or subclavian and/or vertebral arteries only
   J190 - doppler scan or B scan, includes frequency/spectral
            analysis, if rendered ...........................................................       42.65   17.10
   J201      - duplex scan i.e. simultaneous real time, B-mode imaging
               and frequency/spectral analysis .........................................            55.05   24.65
       Note:
       Only one of J190 or J201 is eligible for payment per patient per day.
       Peripheral vessel assessment
       (distal to inguinal ligament or axilla), artery and/or vein evaluation per extremity.
       Not to be billed routinely with J190.
   J193 - doppler scan or B scan, includes frequency/spectral
            analysis, if rendered, unilateral........................................... 22.05 14.30
   J202      - duplex scan i.e. simultaneous real time, B-mode imaging
               and frequency/spectral analysis, unilateral ........................                 28.50   16.60
         Note:
         Only one of J193 or J202 is eligible for payment per extremity per patient per day.

PDF page 674 / Q16

CARDIOVASCULAR SURGICAL PROCEDURES
ARTERIES
                                                                                                            Asst          Surg         Anae
    Mesenteric or celiac artery repair
# R811 - aneurysm.............................................................................                10          410.85         10
# R935 - removal of band only ...........................................................                     10          410.85         10
# R936 - endarterectomy or graft .......................................................                      10         1404.45         10
      Note:
      Use R935 for excision of celiac ganglion.
# R940 Pulmonary thromboendarterectomy (PTE) - includes
         circulatory arrest with hypothermia......................................                            18         2728.40         28
    Aorto-Iliac repair
# R814 - embolectomy or thrombectomy of bifurcation (aorta or graft)                                          10          461.50         10
# R858 Removal of infected aortic graft (stem and/or limbs, unilateral
         or bilateral)* .........................................................................             10         1082.60         17
# E664   - closure of duodenum ..................................................add                                      127.05
# E986         - suprarenal or supraceliac aortic cross clamp, to R858
                 ....................................................................................add                  250.00
         Note:
         * Arterial reconstruction extra.
# R805 Renal artery - aneurysm - reconstruction or excision with graft                                        10          867.35         10
# R806 Renal artery repair ...................................................................                10          867.35         10
# R807 Splenic artery aneurysm - reconstruction or excision with graft                                        10          411.05         10
# R786 Iliac repair to include internal iliac aneurysm ...........................                            10          805.65         10
# R937 Ilio-femoral bypass graft ..........................................................                   10          805.65         10
    Per-obturator ilio-femoral graft
# R860 - with saphenous vein............................................................                      10          898.55         10
# R861 - with prosthetic graft .............................................................                  10          876.85         10
    Profundoplasty
# R855 Common femoral/profunda femoris repair - as sole procedure                                             10          559.20         10
# R856 Extended profundoplasty.........................................................                       10          818.80         10
# R933 Axillo-femoral, femoro-femoral or axillo-axillary graft...............                                 10          656.55         10
# R932 Axillo-bilfemoral graft ...............................................................                10         1200.00         10
# R934 Aorto-femoral unilateral graft ...................................................                     10          867.35         17
# R808 Femoral aneurysm - reconstruction or excision with graft .......                                       10          600.30         10
# R873 Thrombin injection of femoral artery pseudoaneurysm ...........                                                     68.20         6
     Note:
     J202 is payable when rendered in conjunction with R873.
# R864 Repair of false aneurysm at groin anastomosis ......................                                   10          893.20         10

Master, record 2594. Record Layout PDF, page 1.

J20220260401999999990000000000000000331000000000000000000016600000000166000

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.