R150

PDF page 566 / M16

INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
SKIN AND SUBCUTANEOUS TISSUE
                                                                              Asst        Surg          Anae
    Zone 1 repair of digit
      A complex repair of zone 1 of the digit is repair of an injury without soft tissue loss that requires
      a minimum of 20 minutes of time to perform the repair procedure.
  Z189 Complex repair, digit, zone 1 repair, without soft tissue loss,
          per digit............................................................................... 101.15
       Note:
       1.Other repair fee codes are not eligible for payment in addition to Z189 for the same zone 1
         injury.
       2.For digit tip amputations or a zone 1 injury with soft tissue loss that would requirement
         advancement, graft or other surgical method of closure, see specific listings for surgical
         repair in the Integumentary System or Musckuloskeletal System Surgical Procedures
         sections of this Schedule.
       Payment rules:
       1.Wound and ulcer debridement services, Z128, Z129, and Z114 are not eligible for payment in
         addition to Z187, Z188 or Z189 for the same repair.
       2.Z187, Z188, and Z189 include removal of any foreign bodies in the wound, irrigation and
         debridement when rendered.
       3.Plastic Surgery Procedure services (i.e. R150, R151, R152, R153 and R154) are not eligible
         for payment for any laceration repair.
       Medical record requirements:
       Z187, Z188, and Z189 are only eligible for payment where the minimum time requirements
       involved in the repair service are documented in the patient's permanent medical record. The
       time requirement includes time to perform the repair exclusive of time spent rendering any
       other separately billable service.
       [Commentary:
       For laceration repairs that do not meet the above criteria for a complex laceration repair, see
       Repair of Lacerations listings on page M15.]
    Muscle repair
# R525 - Simple muscle repair(s) to include repair of involved skin .           6           97.05          7
# R528 - Complex (see General Preamble GP12)............................        6           I.C            6

PDF page 574 / M24

skin
            INTEGUMENTARY SYSTEM SURGICAL PROCEDURES
       SKIN AND SUBCUTANEOUS TISSUE
                                                                                                 Asst         Surg          Anae
           PLASTIC SURGERY PROCEDURES
            [Commentary:
            The setting of benefits covering the various procedures of plastic surgery is a very difficult
            problem. Since many procedures are divided into stages which have to be considered in
            assessing a fee, it is felt that all such plastic surgical procedures should be classed by the
            responsible specialist as very minor, intermediate, major or extensive major. Benefits should be
            claimed according to procedures set forth in the tariff, except in cases which are difficult to
            define, in which case “I.C” should be the basis of the claim.]
       The minimum benefit for each would be as follows:
  # R150 Very minor...............................................................................       92.30 6
  # R151 Minor....................................................................................... 6 140.25 6
  # R152 Intermediate............................................................................     6 259.20 7
  # R153 Major....................................................................................... 6 388.00 7
  # R154 Extensive major ......................................................................       6 568.95 6
       Note:
       1.Descriptive details of procedure (e.g. operative report) should be submitted with claims for
         codes R150 - R154 for professional assessment.
       2.Taking of skin by a surgeon for grafting by an Oral Surgeon - claim as R150.
       3.R150, R151, R152, R153, and R154 are not eligible for payment for the repair of any
         laceration(s). See repair of laceration services in the Integumentary System Surgical
         Procedures section of this Schedule.
       4.R150, R151, R152, R153, and R154 are not eligible for payment to physicians in the
         following specialties: General and Family Practice (00) and Emergency Medicine (12).
  # Z132 Insertion of tissue expander.................................................... 6 304.10  7
  # E527    - additional expander, same incision ............................ add            58.95
  # E528    - additional expander, different incision........................ add           258.50
        Note:
        1.Z132 is not eligible for payment for post-mastectomy reconstruction of the breast.
        2.Authorization may be required from the Ministry of Health (e.g. for scars of legs, etc.).
      Removal tissue expander injection port when sole procedure
  # Z094 - general anaesthetic ............................................................         6           75.45         6
  # Z095 - local anaesthetic.................................................................                   37.70
        Z137 Percutaneous inflation of first tissue expander .......................                            23.05
        E541   - each additional expander (to a maximum of 3)................                                   11.55
  # Z138 Replacement of tissue expander by permanent prosthesis....                                           195.85           7

Master, record 4405. Record Layout PDF, page 1.

R15020260401999999990000000000000000000000000009230000000095760000000957600

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.