N139

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 758 / X6

CRANIO-CEREBRAL INJURIES
  UVC Non-operative care .................................................................                      visit. fee
    Reduction of skull fracture
# N139 - simple, depressed ..............................................................              7          634.90          7
# N140 - compound...........................................................................           11        1098.45          11
# E912   - with repair of dural laceration..................................... add                               233.30
    Extracerebral haematoma and/or hygroma
# N143 Drainage by burr hole(s) - unilateral .......................................                    7         647.80           7
# N144 Drainage and/or removal by craniotomy.................................                          11         999.30          11
    CEREBRAL INJURY
# N148 Removal of intracerebral haematoma and/or debridement of
         traumatized brain (includes management of any skull
         fracture) ..............................................................................      15        1341.55         15
         Note:
         N143 is not eligible for payment in addition to N144 or N148 for the same craniotomy
         procedure.
# N149 Removal of foreign body from brain........................................                      15         968.50         15
# N150 C.S.F. leak - intracranial repair (to include trans-sphenoidal
         approach) ...........................................................................         15        1065.45         15
# N200 Decompressive craniectomy (frontal, sub-temporal) .............. 11    1018.45      11
     Note:
     Claims for N200 with N153 rendered for the same patient should be submitted using the
     manual review indicator and accompanied by supporting documentation.

Master, record 3743. Record Layout PDF, page 1.

N13920260401999999990000634900000000903700000000000000000111720000001117200

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.