P014

PDF page 109 / GP95

REPLACEMENT ANAESTHESIOLOGIST
When one anaesthesiologist starts a procedure and is replaced by another anaesthesiologist (“the
replacement anaesthesiologist”) during a surgical procedure or delivery:
         a. the amount payable to the first anaesthesiologist is calculated by adding the listed
            procedural basic units plus time units for the time the first anaesthesiologist is in attendance;
         b. except in the case of continuous conduction anaesthesia, the service provided by the
            replacement anaesthesiologist constitutes E005C based on the actual number of time units
            and 6 basic units.
          Note:
          E005C qualifies for the premiums E400C or E401C only if the case commences after hours
          (see GP94).
          [Commentary:
          1.Each anaesthesiologist must indicate, as part of the medical record, his/her starting and
            finishing times.
          2.For continuous conduction anaesthesia, the replacement anaesthesiologist submits claims
            using the applicable continuous conduction anaesthesia fee code.]
OBSTETRICS – CONTINUOUS CONDUCTION ANAESTHESIA
P014C, introduction of a catheter for labour analgesia, including the first dose of medication with or
without any combined spinal-epidural injection(s), has a value of 7 basic units.

PDF page 204 / A76

Limited consultation for acute pain management
     A limited consultation for acute pain management is a consultation which takes place when a
     physician is requested by another physician to see a hospital in-patient because of the
     complexity or severity of the acute pain condition.
 A215 Limited consultation for acute pain management in association
          with special visit to hospital in-patient ................................ 69.75
     Payment rules:
     1.The routine pre-anaesthetic evaluation of the patient required by Reg 965 of the Public
       Hospitals Act does not constitute a consultation, regardless of where and when this
       evaluation is performed.
       2.For A210 the start and stop time of the service must be recorded in the patient’s permanent
         medical record
       3.A215 is not eligible for payment:
          a.with P014C - introduction of catheter for labour analgesia, including the first dose of
            medication with or without any combined spinal-epidural injection(s);
          b.for management of routine post-operative pain; or
          c.for referrals from another anaesthesiologist.
       [Commentary:
       1.The general anaesthesia service includes a pre-anaesthetic evaluation, with specific
         elements as for assessments (see GP15) which does not constitute a consultation
       2.P014C - is an anaesthesia service, therefore the pre-anaesthetic evaluation is included in the
         service and is not payable as a limited consultation for acute pain management or as any
         other consultation or assessment.]

PDF page 484 / J70

DIAGNOSTIC AND THERAPEUTIC PROCEDURES
NERVE BLOCKS FOR ACUTE PAIN MANAGEMENT
PREAMBLE
  1. Nerve blocks listed in this section are eligible for payment only when rendered for acute pain
     management, including peri-operative or post-operative pain management as described below
     and where the nerve block has a duration of action of more than 4 hours. Acute pain is defined
     as pain that occurs with sudden onset and that is expected to resolve within 6 weeks.
  2. Nerve blocks rendered for acute pain with a duration of action of less than 4 hours, topical
     anaesthesia or local infiltration used as an anaesthetic for any procedure, are not eligible for
     payment.
  3. Except as described in paragraph 4, when a physician administers an anaesthetic, nerve block
     and/or other medication prior to, during, immediately after or otherwise in conjunction with a
     diagnostic, therapeutic or surgical procedure which the physician performs on the same patient,
     the administration of the anaesthetic, nerve block and/or other medication is not eligible for
     payment.
  4. A major or minor peripheral nerve block, major plexus block, neuraxial injection (with or without
     catheter) or intrapleural block (with or without catheter) for post-operative pain control (with a
     duration of action more than 4 hours) is eligible for payment as G224 when rendered in
     conjunction with a procedure which the physician performs on the same patient.
  5. When a physician renders an anaesthesia service in support of a procedure performed by
     another physician, a peripheral nerve block, plexus block, neuraxial injection or intrapleural
     injection using short-acting medication (with a duration of action less than 4 hours) is not
     eligible for payment in addition to the C-suffix anaesthesia service.
  6. When a physician renders an anaesthesia service in support of a procedure performed by
     another physician, a peripheral nerve block, plexus block, neuraxial injection or intrapleural
     injection, listed in this section and performed for post-operative analgesia (with a duration of
     action more than 4 hours) is eligible for payment in addition to the C-suffix anaesthesia service.
      [Commentary:
      1.For the purposes of paragraph 6, only peripheral nerve blocks, plexus blocks, neuraxial
        injections or intrapleural injections listed in this section are eligible for payment. Nerve blocks
        listed elsewhere in the Schedule are not payable for acute pain management.
      2.For obstetrical continuous conduction anaesthesia, see P014C and P016C, listed in the
        Obstetrics section.]
  7. With the exception of a bilateral pudendal block (where only one service is eligible for payment)
     a nerve block is payable once per region per side where bilateral procedures are performed.
  8. Notwithstanding maximums applicable to individual nerve block services, there is an overall
     maximum of 8 per patient per day for any combination of nerve blocks. The ninth and
     subsequent nerve blocks per patient per day are not eligible for payment. Nerve blocks which
     are defined as a bilateral procedure are counted as two services for the purpose of the overall
     daily maximum.
  9. Professional and/or technical fees for obtaining and/or interpreting images for the purpose of
     guidance (e.g. nerve stimulation, ultrasound, fluoroscopy) are not eligible for payment in
     addition to the injection services listed in this section.
  10. For anaesthesia services in support of a nerve block or interventional pain injection procedure
      performed by another physician, see General Preamble.
  11. Injection services listed elsewhere in the Schedule are not eligible for payment in addition to
      injections listed in this section for the same injection procedure.

PDF page 495 / J81

Percutaneous nerve block catheter insertion for continuous infusion analgesia
   G279 Percutaneous nerve block catheter insertion..........................          80.00
      Payment rules:
      1. G279 is eligible for payment in addition to the applicable peripheral nerve or plexus block.
          2. No guidance (e.g. nerve stimulation, ultrasound) used for percutaneous nerve block catheter
            insertion is eligible for payment.
          [Commentary:
          Maintenance of the catheter may constitute a subsequent visit subject to the limits as outlined
          on General Preamble GP43.]
   G218 Ilioinguinal and iliohypogastric nerves ....................................                  54.65
   G219 Infraorbital...............................................................................   34.20
   G220 Intercostal nerve .....................................................................       34.20
   G221     - for each additional one............................................... add              16.95
   G258 Intrapleural block (single injection) .........................................               44.25
   G257 Intrapleural block (with the introduction of a catheter for the
           purpose of continuous analgesia) ......................................                    77.25
   G225 Mental branch of mandibular nerve ........................................                    34.20
   G250 Maxillary or mandibular division of trigeminal nerve ...............                          75.10
     Obturator nerve
   G241 - unilateral.............................................................................     54.65
   G242 - bilateral...............................................................................    82.45
   G227 Other cranial nerve block........................................................             54.65
   G228 Paravertebral nerve block of cervical, thoracic or lumbar or
          sacral or coccygeal nerves.................................................                 34.10
   G123   - for each additional one (to a maximum of 4).............. add                             17.10
     Pudendal
   G229 - unilateral.............................................................................  54.65
   G240 - bilateral............................................................................... 82.45
      Note:
      For obstetrical continuous conduction anaesthesia, see P014 and P016, listed in the Obstetrics
      section of the Schedule.

PDF page 539 / K9

OBSTETRICS
 OBSTETRICAL ANAESTHESIA
                                                                                                   Asst   Surg   Anae
# P013       Obstetrical anaesthesia ...........................................................           -      6
       Continuous conduction anaesthesia - see General Preamble GP95
# P014C  - introduction of catheter for labour analgesia, including the
           first dose of medication with or without any combined spinal-
           epidural injection(s) .............................................................             -      7
# P016C - maintenance of obstetrical epidural anaesthesia (one unit for
           each ½ hour to a maximum of 12) ......................................                          -
# E100C attendance at delivery .............................................................               -      4

PDF page 539 / K9

Payment rules:
         1.Anaesthesia extra units listed on GP97 are not eligible for payment with P014C except for
           E010C, E022C and E017C.
         2.Z804 is not eligible for payment with P014C or P016C.
         3.Anaesthesia extra units listed on GP97 are not eligible for payment with P016C or E100C.
         4.E100C time units are payable for time spent in constant attendance at delivery, exclusive of
           time spent engaged in any separately payable services except for P016C. Start and stop
           times must be recorded in the patient’s permanent medical record.
         5.E100C time units for attendance at delivery are calculated as 4 basic units and 1 unit for
           each ¼ hour.
         6.In instances where more than one anaesthesiologist is required to provide maintenance of
           obstetrical epidural anaesthesia sequentially, P016C is limited to a maximum of 12 units per
           patient, per physician, per day.
         [Commentary:
         Anaesthesia extra units listed on GP97 are eligible for payment with other C-suffix anaesthesia
         service rendered the same day as P014C/P016C/E100C, unless otherwise listed.]
         Medical record requirements:
         Where P016C is claimed by more than one anaesthesiologist per patient, per day, the medical
         records must document that care was provided by each anaesthesiologist sequentially.

Master, record 3946. Record Layout PDF, page 1.

P01420260401999999990000000000000000000000000000000000000015960000000159600

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.