R401

PDF page 603 / N23

Note:
         1.A shoulder procedure listed in the Shoulder section of the Schedule performed
           arthroscopically is eligible for payment in addition to R684 if that procedure is not described
           as a component of R684 or described by an E-add-on code to R684.
         2.Arthroscopic E-add-on codes listed below are not eligible for payment in addition to R684
           when the service described by the E-code is a generally accepted component of a procedure
           described in Note #1.
# E478 Pinning of osteochondral fragment, to R684 .................... add                                 251.55
      Note:
      F-prefix fracture procedures are not eligible for payment with E478 for the same fracture.
# E484 Superior labral anterior posterior (SLAP) repair,
           to R684......................................................................... add 336.65
# E485 Arthroscopic capsular release for frozen shoulder,
          to R684......................................................................... add             240.50
      Payment rules:
      E484 is not eligible for payment in addition to R401.

PDF page 607 / N27

MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
 SHOULDER, ARM AND CHEST
                                                                                                        Asst   Surg     Anae
    Dislocations
     Acromio-clavicular/sterno-clavicular
# D014 - no reduction........................................................................                   67.80
# D025 - closed with anaesthetic ......................................................                  6     134.55    6
# D023 - open reduction....................................................................              6     326.40    7
# R596 - late......................................................................................      6     350.50    6
     Glenohumeral joint
# D015 - closed reduction without anaesthetic .................................                                 49.20
# D016 - closed reduction with anaesthetic ......................................                              111.40    6
# D017        - open reduction, early..........................................................          6     323.85     6
# R472        - open reduction, late............................................................         6     580.90    10
# R401        - open reduction, recurrent ...................................................            6     524.55    10
# E062        - coracoid transfer (Latarjet) or bone block graft to glenoid, to
                R401............................................................................. add          350.00
# E058          - revision/repair following previous glenohumeral joint
                  surgery, to R401................................................. add 30%
         Payment rules:
         1.E551A, E552A, E553A are not eligible for payment with E062.
         2.R472 is not eligible for payment for open reduction and repair of recurrent glenohumeral
           instability.

Master, record 4629. Record Layout PDF, page 1.

R40120260401999999990000524550000000774600000000000000000159600000001596000

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.