R009

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 569 / M19

INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
 SKIN AND SUBCUTANEOUS TISSUE
                                                                                                    Asst   Surg     Anae
       D. Myocutaneous, myogenous or fascia-cutaneous flaps
     Note:
     To include closure of donor site defect by any means.
# R005 Sterno-mastoid, tensor fascia lata, gluteus maximus, gracilis,
          sartorius, rectus femoris, gastrocnemius (medial and
          lateral), trapezius................................................................        6     545.00    6
# R006 Pectoralis major ...................................................................... 6 734.95              6
# R155 Latissimus dorsi or unilateral rectus abdominus.....................                    6 734.95              6
     Note:
     R006 is not eligible for payment for post-mastectomy breast reconstruction.
# R008 Lower transverse rectus abdominus flap ................................                       6     984.55    8
      Repair of abdominal defect
# Z196 - different surgeon ................................................................                377.65
# E523   - same surgeon, to other procedure............................. add                               321.00
# R009 Myocutaneous - osseous flaps e.g. pectoralis major
         myocutaneous flap with rib graft, trapezius flap with scapula
         spine...................................................................................    6     783.40    8
# R007 Other - (see General Preamble GP12) ...................................                      I.C    I.C      I.C
       SKIN GRAFTS
    A. Split thickness grafts (for burn grafts see pages M10 & M11)
# R084 Very minor, very small areas, e.g. trauma ..............................        92.30 7
# R085 Minor, medium sized areas, e.g. small or skin ulcer, breast, etc             6 140.25 6
# R086 Intermediate, large areas, e.g. trunk, arms, legs ....................       6 259.10 7
# R087 Major, complex areas, e.g. face, neck, hands ........................        6 388.00 7
# R088 Extensive major, very large area(s) ........................................ 6 567.95 6
     Note:
     The medical record must demonstrate the appropriateness of code claimed relative to size.

Master, record 4272. Record Layout PDF, page 1.

R00920260401999999990000783400000000774600000000000000000127680000001276800

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.