N115

PDF page 501 / J87

Definition/Required elements of service:
This is the service rendered by the neurosurgery specialist most responsible for management of a
critically ill hospital in-patient with an acquired acute brain injury, where the neurosurgeon provides
management:
         a. post-operatively for a patient who has received an endovascular intracranial surgical
            procedure during the same hospital admission but only if that procedure was not performed
            by any neurosurgeon; or
         b. for a patient who has not received an intracranial surgical procedure during the same
            hospital admission with the exception of Z820, Z812, N115, N139, N174, Z824, Z802, Z825,
            Z803.
          [Commentary:
          1.Examples of acquired acute brain injury include acutely raised intracranial pressure,
            subarachnoid, intracerebral or intraventricular haemorrhage, cerebritis, cerebral abscess,
            malignant cerebral edema, acute hydrocephalus, ventriculitis and trauma.
          2.If a neurosurgeon renders an intracranial surgical procedure not on the exception list above,
            Acquired Acute Brain Injury Management is not payable for a post-operative patient to any
            physician.]
This service has the same specific elements as consultations and assessments.
In addition the service may include the following elements:
         a. An initial consultation or assessment and such subsequent assessments as may be
            indicated, including ongoing monitoring of the patient's condition and intervening as
            appropriate;
         b. management of coma and monitoring the life support systems to ensure optimum
            neurological perfusion and oxygenation;
         c. management of intracranial pressure (excluding insertion of I.C.P. or brain oxygen/pH
            measuring device) including monitoring, interpretation and drainage of cerebrospinal fluid
            when indicated;
         d. monitoring and management of cerebral vasospasm;
         e. prophylaxis and management of seizures;
         f. making arrangements for any related assessments, procedures or therapy, related to the
            patient’s acute neurological deterioration, including decompressive craniectomy, cerebral
            angioplasty or evacuation of intracranial space occupying lesions;
         g. clinical and radiological assessment of the cervical spine and spinal cord for the
            determination of spinal stability;
         h. performance and/or arranging tests for the establishment of a diagnosis of brain death
         i. making referrals, when appropriate, to organ procurement professionals
         j. all related discussion, counselling and interviews with the patient’s relative(s), patient's
            representative or other caregiver(s);
         k. All related case conferences.

PDF page 756 / X4

NEUROLOGICAL SURGICAL PROCEDURES
CRANIAL
                                                                                                       Asst         Surg         Anae
    INTRACRANIAL ABSCESS
# N117 Craniotomy .............................................................................          15       1631.15          15
    Burr hole
# N115 - aspiration............................................................................          7          578.85          7
# Z818 - subsequent aspiration through existing burr hole within 30
          days ....................................................................................                 215.35
# Z813 - plus needling of brain for biopsy.........................................                      7          560.85          7
# N127 Re-opening of craniotomy for post-operative haematoma or for
         removal of bone flap...........................................................                 11        518.85          11
# N113 Craniotomy for brain biopsy (other than for tumour)...............                                11       1019.15          11
# N130 Craniotomy plus midline commissurotomy .............................                              15       1014.85          15
# N109 Hemispherectomy...................................................................                15       1878.35          15
# N110 Lobectomy and/or excision of cortical scar for epilepsy .........                                 15       2432.45          15
# N128 Repair of encephalocoele .......................................................                  15        924.70          15
# N129 Posterior fossa decompression for Arnold Chiari malformation                                      15       1577.05          15
# E901   - with operating microscope, to N129........................... add                                       252.40
# N126 Intra-oral approach to lesions of the skull base and upper
          cervical spine......................................................................           15       1442.95          15
# N123 Stereotaxis - intracranial (to include ventriculography)...........                               11         623.20         11
# E931   - with implantation (and removal) of radioactive sources into
           brain tumour.............................................................. add                           222.85
# E896   - sophisticated micro-electrode recording during
           stereotaxis, to N123 ................................................... add                             400.40
       Functional stereotaxy
        Payable for neuroablative and implantation therapy for treatment of movement disorders of
        basal ganglia and connections (e.g. Parkinson’s disease). Must include pre-operative planning,
        application of stereotactic frame, intra-operative imaging, micro-electrode placement and
        recording, ablation of lesion and/or electrode implantation.
# N124 Functional stereotaxy.............................................................. 9 2194.70                               11
     Note:
     N123 performed in conjunction with N124 is an insured service payable at nil.
# N119 Intracranial implantation of chronic surface electrodes...........                                11       1364.90          11
# Z823 Implantation or revision of stimulation pack or leads (peripheral
          nerve, brain) .......................................................................           8         434.95          8
# Z824 Removal of chronic surface or depth electrodes ....................                                          266.60
# Z802 Ventricular puncture through previous burr hole or fontanelle or
         puncture and/or aspiration of cisterna ................................                                      81.65         7

Master, record 3725. Record Layout PDF, page 1.

N11520260401999999990000578850000000903700000000000000000111720000001117200

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.