M012

PDF page 643 / P3

RESPIRATORY SURGICAL PROCEDURES
 NOSE
                                                                                                      Asst    Surg     Anae
    RECONSTRUCTION
# M012 Septoplasty.............................................................................               293.95    10
# M013 Partial septorhinoplasty (excluding osteotomies) ...................                                   526.00    10
# M014 Septorhinoplasty.....................................................................           6      541.65    10
# E841   - with autologous bone or cartilage graft - from site(s) other
           than nose, to a maximum of two, to M014 ................. add                                      226.80
# E842   - with non-autologous graft or implant, to M014........... add                                        58.60
# E642   - if performed by external approach using transverse
           columellar and rim incisions with elevation of nasal tip skin
           flap, to M012, M013 or M014 ..................................... add                              119.20
# E840   - with repair of septal perforation, to M012, M013 or M014
            ................................................................................... add           119.20
# R319 Graft to nose - autologous, bone or cartilage (without
         septorhinoplasty) ................................................................            6      360.45    7
# R320 non-autologous or prosthetic implant (without
         septorhinoplasty) ................................................................            6      232.00    7
         Note:
         M013, M014, R319, R320 - These procedures require written prior authorization by a Ministry
         of Health medical consultant. (see Surgical Preamble, paragraph 17).

PDF page 814 / AD6

15. Septorhinoplasty
     This is an insured service when the rhinoplasty component is necessary to obtain an adequate
     airway or; for persons aged 16 years and under, at the time of trauma and for whom the
     rhinoplasty is completed, or is part of a preplanned staged repair which is commenced, at any
     time following trauma and prior to the age of 19 years; or, for persons aged 17 years and older
     at the time of trauma and for whom the rhinoplasty is completed, or is part of a preplanned
     staged repair which is commenced, within 2 years following trauma. (see Paragraph 6 of this
     Appendix).
     In cases where a septoplasty is necessary to improve function and a rhinoplasty is done for
     cosmetic purposes, the Ministry of Health will pay the part of the operation that was medically
     necessary (e.g. if a septorhinoplasty is performed and a septoplasty was necessary to improve
     the airway, the Ministry of Health will pay M012 and the surgeon is entitled to claim the
     difference from the patient). However, if a septorhinoplasty is approved by the Ministry, no
     extra charge may be made to the patient.
     Prior authorization from the Ministry of Health is required. A description of the external
     deformity should be provided.
  16. Excision of excess fatty tissue and/or skin
     a. Panniculectomy is only insured in the following circumstances and when prior authorization
        of payment is obtained from the MOH:

Master, record 3640. Record Layout PDF, page 1.

M01220260401999999990000293950000000000000000000000000000159600000001596000

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.