P042

PDF page 104 / GP90

SECOND ASSISTANT
Payment rules:
When more than one assistant was required for a surgical procedure, unless the service is listed
below, the second assistant’s service is only eligible for payment following authorization by a medical
consultant and requires submission of a letter from the surgeon outlining the reason the second
assistant was required. The amount payable for the second assistant is calculated in the same
manner as the amount payable for the first assistant.
Services where a second assistant's services are payable and authorization is not required:
D043, D046, D047, D052, D060, E645, F135, M112, M117, M134, M142, N539, N540, P042, P051,
P052, P056, P059, R008, R009, R013, R014, R015, R016, R055, R056, R064, R065, R067, R069,
R134, R135, R136, R140, R182, R240, R241, R244, R326, R327, R334, R393, R438, R440, R441,
R483, R487, R545, R553, R568, R593, R594, R617, R645, R701, R702, R704, R712, R713, R714,
R715, R718, R726, R727, R728, R729, R732, R733, R734, R735, R737, R739, R742, R743, R746,
R747, R749, R764, R770, R771, R772, R773, R774, R786, R799, R800, R801, R802, R803, R804,
R811, R815, R817, R818, R830, R832, R858, R863, R870, R872, R874, R876, R927, R929, R920,
R930, S005, S007, S079, S090, S091, S092, S096, S098, S099, S120, S125, S189, S210, S211,
S213, S214, S267, S270, S271, S274, S275, S294, S295, S298, S300, S321, S416, S429, S440,
S441, S453, S454, S462, S484, S750, S757, S758, S759, S816
       [Commentary:
       E003B is not eligible for payment for second assistant services.]

PDF page 536 / K6

#
                                                 OBSTETRICS
    LABOUR - DELIVERY
                                                                                         Asst         Surg         Anae
    # P006 Vaginal .....................................................................................    512.65
    # P020 Operative delivery, defined as any of: i) forceps or vacuum-
              assisted delivery, ii) breech delivery, or iii) shoulder dystocia
              using advanced maneuvers ................................................                     535.60 6
    # E502    - vaginal birth after caesarean section (VBAC) whether
                successful or unsuccessful .........................................add                      51.00
          [Commentary:
          P006 and P020 include the repair of a tear or episiotomy extension, first or second degree,
          when rendered.]
    # P018 Caesarean section...................................................................          6  579.80 7
    # P041 Caesarean section including tubal interruption........................                        6  609.20 7
    # P042 Caesarean section including hysterectomy .............................                        8 1004.60 8
    # E500    - for the third and each subsequent delivery, subject to the
                payment rules set out below, for each additional delivery, to
                P006, P018, P020, P041 or P042...............................add                            148.60
    # E499    - for the second caesarian delivery, subject to the payment
                rules set out below, to P018, P041 or P042 ...............add                               397.75
          Payment rules:
          1.For vaginal deliveries of two or more infants, P006 or P020 as appropriate is eligible for
            payment for the first delivery, in addition to 85% of P006 or P020 as appropriate for the
            second delivery, and E500 for the third and each subsequent delivery.
           2.For vaginal delivery of the first infant followed by caesarean section, one of P018, P041 or
             P042 as appropriate is eligible for payment, in addition to 85% of P006 or P020 as
             appropriate, and E500 for the third and each subsequent delivery.
           3.For multiple deliveries by caesarean section only (with or without trial of labour), one of P018,
             P041 or P042 as appropriate is eligible for payment, in addition to E499 for the second
             delivery and E500 for the third and each subsequent delivery.
           4.Despite payment rules above, for spontaneous vaginal deliveries between 20 and 23 weeks
             gestational age, only P006 is eligible for payment, regardless of the number of fetuses
             delivered.
           5.Despite payment rules above, for multiple deliveries by caesarean section only between 20
             and 23 weeks gestational age, only one of P018, P041 or P042 as appropriate is eligible for
             payment, in addition to E499 for the second delivery. E500 is not eligible for payment for the
             third or subsequent deliveries.
           6.For delivery of one or more fetuses known to be stillborn in addition to delivery of one or more
             live fetuses, only the delivery of live fetuses is eligible for payment in accordance with the
             payment rules above. If all fetuses are known to be stillborn, only one of P006, P018, P020,
             P041 or P042 as appropriate, is eligible for payment.
        Attendance at labour
      P038   - when patient transferred to another centre for delivery ....                           211.20
         Attendance at labour and delivery
          Payable to a physician other than an obstetric consultant for attending labour and delivery
          when the physician either assists at vaginal delivery or surgery, gives anaesthetic at a
          caesarean section or operative delivery, or resuscitates the newborn.

PDF page 548 / SP6

SURGICAL PREAMBLE
PREAMBLE
 24. Morbidly obese patients
     E676 is eligible for payment once per patient per physician in addition to the amount eligible for
     payment for the major surgical procedure(s) where a morbidly obese patient undergoes major
     surgery to the neck, thorax, peritoneal cavity, retroperitoneum, pelvis, or hip and:
    a. the patient has a Body Mass Index (BMI) greater than 40
    b. the surgery is rendered under general anaesthesia using either an open technique for the
       neck, thorax, or hip, or an open or laparoscopic technique for the peritoneal cavity, pelvis,
       retroperitoneum; and
    c. the principal surgical technique is neither aspiration, core or fine needle biopsy, dilation,
       endoscopy, mediastinoscopy, thoracoscopy, cautery, ablation nor catheterization.
E676A Morbidly obese patient, surgeon, to procedural fee(s)...... add                      25%
E676B Morbidly obese patient, surgical assistant, to major procedure
        add                                                                               6 units
     Note:
     E676A/B is only payable with the following procedures: D043, D046, D047, D052, E090, E499,
     E500, E505, E546, E589, E593, E626, E627, E655, E664, E673, E686, E697, E704, E706,
     E707, E708, E709, E711, E712, E713, E714, E718, E721, E722, E725, E728, E729, E731,
     E733, E734, E735, E736, E737, E738, E739, E743, E745, E748, E752, E754, E762, E764,
     E765, E766, E767, E768, E769, E771, E794, E796, E852, E853, E854, E855, E857, E860,
     E880, E882, E883, E884, E885, F100, F101, F135, M081, M082, M084, M090, M099, M100,
     M142, M143, M144, P018, P041, P042, P050, P055, P056, P057, P058, P059, P060, R108,
     R109, R216, R241, R269, R330, R423, R439, R440, R443, R470, R481, R488, R491, R553,
     R569, R590, R627, R628, R639, R686, R786, R800, R802, R803, R805, R806, R807, R811,
     R814, R815, R817, R823, R825, R826, R834, R839, R852, R855, R856, R858, R860, R861,
     R910, R885, R905, R913, R914, R915, R932, R933, R934, R935, R936, R937, S089, S090,
     S114, S115, S116, S117, S118, S120, S121, S122, S123, S124, S125, S128, S129, S131,
     S132, S133, S134, S137, S138, S139, S140, S149, S150, S154, S157, S158, S159, S160,
     S162, S164, S165, S166, S167, S168, S169, S170, S171, S172, S173, S175, S176, S177,
     S180, S182, S183, S184, S185, S187, S188, S189, S191, S192, S193, S194, S195, S196,
     S197, S199, S204, S207, S213, S214, S215, S217, S218, S222, S227, S265, S266, S267,
     S269, S270, S271, S274, S275, S276, S278, S280, S281, S282, S285, S287, S291, S292,
     S294, S295, S297, S298, S299, S300, S301, S302, S303, S304, S305, S306, S307, S308,
     S309, S310, S311, S312, S313, S314, S315, S318, S319, S321, S323, S325, S329, S332,
     S340, S342, S343, S344, S345, S405, S411, S416, S420, S422, S424, S427, S431, S432,
     S433, S434, S435, S436, S438, S440, S441, S445, S446, S447, S448, S449, S450, S451,
     S452, S453, S454, S455, S457, S460, S461, S462, S465, S466, S467, S468, S471, S482,
     S483, S488, S490, S491, S512, S513, S546, S549, S561, S590, S650, S651, S652, S710,
     S714, S727, S728, S729, S731, S733, S735, S736, S738, S739, S740, S741, S743, S745,
     S747, S748, S750, S751, S757, S758, S759, S760, S761, S763, S764, S766, S775, S776,
     S778, S780, S781, S782, S784, S788, S789, S790, S792, S793, S795, S798, S799, S800,
     S813, Z427, Z526, Z552, Z553, Z564, Z569, Z577, Z594, Z737, Z738

Master, record 3965. Record Layout PDF, page 1.

P04220260401999999990001004600000001032800000000000000000127680000001276800

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.