S090

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 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

PDF page 690 / S8

DIGESTIVE SYSTEM SURGICAL PROCEDURES
OESOPHAGUS
                                                                                                        Asst         Surg         Anae
         Note:
         1.Z292 rendered in association with oesophagoscopy and oesophagoscopy-gastroscopy
           services is not eligible for payment unless the laryngoscopy service is rendered for suspicion
           of disease of the larynx. Claims for Z292 in these circumstances are assessed by a medical
           consultant on a manual review basis and require the submission of a written explanation.
         2.E836 is only eligible for payment when resection requires submucosal injection and
           piecemeal resection
         3.E836 includes any hemostatic techniques performed at the time of polypectomy
         4.E836 is limited to a maximum of 2 services per patient per day
         [Commentary:
         Manual review is not required for Z293, Z322 and Z323 rendered in association with
         oesophagoscopy and oesophagoscopy-gastroscopy services.]
    INCISION
    Oesophagostomy
      Cervical
# S084 - other than neonatal .............................................................                           212.35
# S085 - neonatal...............................................................................                     304.20
      Intrathoracic oesophageal stent
# S082 - via laparotomy .....................................................................                        410.55          7
# S083 - via oesophagoscope (includes Z515)..................................                                        304.20          6
# S081 Trans-oesophageal division of oesophageal varices...............                                              558.05
# S080 Oesophageal-gastric devascularization (including splenectomy
          and oesophageal division/anastomosis) .............................                                        898.15
    EXCISION
# S087 Intrathoracic diverticulum.........................................................                           507.00
# S086 Cricopharyngeal myotomy, open approach .............................                                          300.00
# Z505 Cricopharyngeal myotomy, when rendered by endoscopy, or in
          association with a surgical procedure during the same
          anaesthetic ..........................................................................          6           37.20          6
# S088 Cricopharyngeal diverticulum ..................................................                               390.05
# S089 Partial oesophageal resection and reconstruction (including
          intestinal transposition)........................................................                        1180.50          17
# S090 Total thoracic oesophageal resection ......................................                       10        1912.30          13
# E730    - with reconstruction ......................................................add                           740.95
# E847    - with reconstruction of diaphragm requiring repair with
            mesh or equivalent synthetic material, to S089 or S090
            ....................................................................................add                   75.00
# E644    - radical mediastinal node dissection following preoperative
            chemotherapy and/or radiotherapy, to S089 or S090 .add                                                   400.00
         Note:
         1.S086 is not eligible for payment with S088.
         2.Z505 is not eligible for payment with S086.
# S093 Enucleation of benign oesophageal tumour ............................                                         584.15

PDF page 691 / S9

DIGESTIVE SYSTEM SURGICAL PROCEDURES
 OESOPHAGUS
                                                                                                        Asst    Surg     Anae
# E683         - when performed thorascopically, by video-assisted
                 thoracic surgery (VATS), by robotic-assisted surgery, or by
                 uniportal approach, to S087, S089, S090, S093
                 ……................................................................... add 35%.
    REPAIR
# S161 Oesophageal myotomy, partial (below aortic arch)..................                                       584.15
# E758   - with oesophageal hiatus hernia repair ........................add                                    217.35
# S100 Total thoracic oesophageal myotomy (as sole procedure) ......                                            841.35
# E758    - with oesophageal hiatus hernia repair ........................add                                   217.35
# E683    - when performed thorascopically, by video-assisted
            thoracic surgery (VATS), by robotic-assisted surgery, or by
            uniportal approach, to S100, S161 .................. add 35%.
    REPAIR
    Oesophageal hiatus hernia
# S091 - abdominal or transthoracic approach with fundal plication..                                    10      750.00
# S092 - recurrent ..............................................................................       10     1100.00
# S079 - massive paraesophageal ....................................................                    10     1200.00
      Payment rules:
      S079 is only eligible for payment for surgical repair of
             a.a paraesophageal hernia with >50% intrathoracic herniation of the stomach with the
               fundus lying above the gastroesophageal junction, or
             b.a paraesophageal hernia with herniation of the stomach and any other abdominal
               organ(s) through the crus.
# E793         - laparoscopic, thoracoscopic, or laparoscopic/
                 thoracoscopic assisted, to S091, S092, or S079
                  ........................................................................... add 25%
# E744         - with gastroplasty, to either S091, S092, or S079 ........add                                   115.80
# E847         - with reconstruction of diaphragm requiring repair with
                 mesh or equivalent synthetic material, to S091, S092, or
                 S079 ...........................................................................add             75.00
# E742         - when S091, S092, or S079, with or without gastroplasty, is
                 done in conjunction with cholecystectomy, and/or
                 vagotomy with or without drainage procedures, add E742
                 to S091, S092, or S079 (with or without E744) for each
                 additional procedure performed. For any other
                 combination of surgical procedures with oesophageal
                 hiatus hernia repair (with the exception of S161 and S100),
                 see Surgical Preamble SP2 ........................................add                          217.35
# S095 Oesophageal stricture (Thal) - may include oesophageal hiatus
         hernia repair with or without gastroplasty............................                                 676.05
# S096 Ruptured oesophagus, suture and drainage ...........................                              10    1200.00
# S097 Oesophago-gastrostomy for bypass (as sole procedure)........                                             692.65

Master, record 5243. Record Layout PDF, page 1.

S09020260401999999990001912300000001291000000000000000000207480000002074800

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.