R143

PDF page 577 / M27

INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
 OPERATIONS OF THE BREAST
                                                                             Asst      Surg      Anae
         3.R158 is only eligible for payment when
              a.resected breast volume exceeds 15% of ipsilateral breast parenchyma, or
              b.when the tumour is resected from the upper inner quadrant or the lower pole of the
                breast.
         4.R158 is only eligible for payment when the operative report documents purposeful skin
            excision, glandular rotations, pre-emptive nipple recentralization, and de-epithelialization
            techniques that preserve the blood supply to the nipple-areolar complex and parenchyma.
         5.R159 is only eligible for payment when
              a.resected breast volume exceeds 25% of ipsilateral breast parenchyma, and
              b.the operative report documents the use of reduction mammoplasty techniques sufficient
                to achieve cosmesis.
         6.R159 include glandular pedicles coupled with large mobilizations, transpositions, and
            rotations of residual breast tissue if performed.
         7.R102, R158 or R159 are not eligible for payment when
              a.additional ipsilateral breast reconstructive procedure(s) are performed on the same day
                by a second surgeon, or
              b.the procedure is part of a pre-planned staged breast reconstruction.
         8.R143 is not eligible for payment on the same day as R102
         [Commentary:
         It is anticipated that contralateral balancing procedures will not be required when R102 is
         performed.]

PDF page 578 / M28

Post-mastectomy breast reconstruction
  # R119 Breast mound creation by prosthesis as sole procedure........                                         6         350.00          7
  # R118 Breast skin reconstruction by local flaps or grafts, includes
           Wise pattern skin flaps and de-epithelialized skin flaps .....                                      6         405.60          6
  # E529   - with breast mound creation by prosthesis, to R118 ... add                                                   102.45
  # R156 Breast mound creation by insertion of tissue expander,
           includes creation of submuscular pocket ...........................                                 6         425.00          6
  # E513   - breast mound creation by soft tissue, includes flap
             insetting and shaping for autogenous reconstruction, to
             R118, R125, R064, R008 or R155 ............................. add                                            297.50
  # E514   - immediate breast reconstruction following mastectomy, to
             R125, R064, R156, R008, R118, or R155 ................. add                                                 200.00
                                          Note:
                                          1.Z132 is not eligible for payment with R156.
                                          2.E513 is not eligible for payment with E529.
                                          3.E514 is only eligible for payment if post-mastectomy breast reconstruction is performed
                                            immediately following mastectomy during the same anaesthesia.
  # R114 Revision of breast mound .......................................................                     6          230.30          7
  # R120 Nipple-areola reconstruction by grafts and/or flaps ................                                 6          300.00          7
  # R142 Nipple-areola tattooing - unilateral..........................................                       nil        175.00          nil
  # R143 Contralateral balancing mastopexy or reduction, to include
           nipple transplantation or grafting, if rendered.....................                                6         472.15          6
  # R144 Contralateral balancing augmentation mammoplasty.............       6        350.00       6
       Note:
       1.R143 and R144 are only eligible for payment when performed for post-mastectomy breast
         reconstruction. Prior authorization of payment from the Ministry of Health is not required.
                                          2.R110 and R112 are not eligible for payment with R143 or R144.
                                          [Commentary:
                                          1.For reduction or augmentation mammoplasty performed for reasons other than a balancing
                                            procedure related to post-mastectomy breast reconstruction, see R110 and R112
                                            respectively. Prior authorization of payment from the ministry is required.
                                          2.See the applicable service for post-mastectomy breast reconstruction by myocutaneous
                                            flaps or free flaps.]
      Reduction mammoplasty and augmentation mammoplasty (other than post-mastectomy
      breast reconstruction)
  # R110 Reduction mammoplasty (female, to include nipple
            transplantation or grafting, if rendered) - unilateral ............ 6 472.15 7
  # R112 Augmentation mammoplasty - unilateral ................................ 6 350.00 7

Master, record 4398. Record Layout PDF, page 1.

R14320260401999999990000472150000000774600000000000000000095760000000957600

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.