N107

PDF page 320 / A192

Consultation
       A diagnostic radiology consultation is the service rendered when:
      a. radiographs or ultrasounds made at one institution or facility are referred to a radiologist at a
          different institution or facility for his/her written opinion. In this case, the specific elements are
          as for diagnostic radiology professional component (see page D1);
      b. a radiologist is required to make a special visit at evening or night (17:00h to 07:00h) or on a
         Saturday, Sunday or holiday to consult on the advisability of performing a diagnostic
         radiological procedure which eventually is not done. In this case, the specific elements are
         the same as for consultations; or
      c. when a radiologist is required to render an opinion prior to an interventional procedure and
         all of the following requirements are met. In this case, the specific elements are the same as
         for consultations:
           i.   the consultation is performed in an area remote from the radiologist’s normal procedural
                suite;
           ii. the requirements for a consultation are met;
           iii. the consultation is not solely for the purpose of clarifying or obtaining consent; and
           iv. the associated procedure is one of the following: J021, J025, J040, J041, J046, J048,
               J049, J050, J055, J056, J057, J058, J059, J063, J065, J066, N107, N118, N122, N125,
               S233, Z446, Z456, Z562, Z594.
 A335 Consultation............................................................................                 57.90
       Payment rules:
       1.A diagnostic radiology consultation is not eligible for payment when radiographs made in a
         different institution or facility are used for comparison purposes with radiographs or
         ultrasounds made in the consultant’s institution or facility.
       2.A335 is not eligible for payment for CT and MRI services.
       [Commentary:
       For a second opinion by a radiologist of CT and MRI studies, see A330 and A332 respectively.]

PDF page 386 / E2

[Commentary:
        1.For Extracranial approach to include balloon catheter techniques see N107 in Neurological
          Surgical Procedures.
        2.For Carotid-cavernous fistula; extracranial approach to include balloon catheter techniques
          see N118 in Neurological Surgical Procedures.]
# J058 Vascular stenting ....................................................................                   101.55          6
      Note:
      J058 claimed same patient same day as G298 is payable at nil.
# J066 Renal angioplasty ...................................................................                    773.25          6
    Carotid angiogram
# J031 - direct puncture....................................................................                    137.75          6
# J025 Transluminal angioplasty including angiography (if anatomy is
          known), with or without pressure measurements - one or
          more site(s) or vessel(s).....................................................                        610.10          6
         Note:
         1.If anatomy unknown at time of procedure, claim J021 and/or J022 at 50%. For simultaneous
           bilateral punctures and angioplasties, the amount payable for the second angioplasty is
           reduced by 50%.
         2.J021 & J022 may not be claimed with J025 if anatomy is known.
# J067 Spinal angiography for AV malformation, per vessel, maximum
         of 12 vessels per side.........................................................                          67.45         6
# J048 Percutaneous trans-hepatic catheter portal venography ........                                           476.65          6

PDF page 755 / X3

NEUROLOGICAL SURGICAL PROCEDURES
 CRANIAL
                                                                             Asst     Surg      Anae
         2.“Flow-diverter devices” refer to endovascular implants designed to be deployed within the
           parent artery across the neck of an aneurysm to redirect blood flow away from the aneurysm
           sac.]
    Cerebral arteriovenous malformation
     Endovascular approach for obliteration
# N107 Endovascular approach to include balloon catheter or
         embolization techniques for arteriovenous malformation ...                               15   1456.95   15
    Carotid-cavernous fistula
# N118 Endovascular approach to include balloon catheter or
          embolization techniques for dural arteriovenous fistula
          including carotid cavernous fistula .....................................               15    952.05   15
    Endovascular thrombectomy (EVT)
# N131 Endovascular thrombectomy for acute ischemic stroke
          secondary to large vessel occlusion...................................    15 1456.95 15
# E987    - with intracranial stent, to N131................................... add     600.00
# E988    - with extracranial stent, to N131.................................. add      450.00
      Payment rules:
      1.N131 includes all components of the EVT including vascular access, catheter placement,
        angiography, any image guidance, mechanical thrombectomy and revascularization
        assessment.
         2.Obtaining and interpreting any images in conjunction with N131 are not eligible for payment
           to any physician. No other ‘X’ or ‘J’-prefix services are eligible for payment during the same
           operative session.
         3.E987 and E988 are payable once per eligible fee code per EVT session regardless of the
           number of stents deployed
    SPONTANEOUS INTRACEREBRAL HAEMORRHAGE
    Craniotomy plus removal
# N104 - supratentorial......................................................................     15   1416.40   15
# N157 - infratentorial........................................................................   15   1704.00   15
# N120 Burr hole plus drainage...........................................................         15    481.90   15
    INTRACRANIAL CYST
    Craniotomy plus evacuation
# N158 - supratentorial......................................................................     15    968.50   15
# N159 - infratentorial........................................................................   15   1065.05   15
      Note:
      N158, N159 to include interventriculostomy.
# N160 Burr hole plus aspiration .........................................................        15    426.95   15

Master, record 3717. Record Layout PDF, page 1.

N10720260401999999990001456950000001936500000000000000000239400000002394000

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.