N174

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.

Master, record 3769. Record Layout PDF, page 1.

N17420260401999999990000585900000000903700000000000000000111720000001117200

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.