S312

PDF page 452 / J38

Note:
         1.E860 is not eligible for payment with R852 or R885, except in circumstances described in
           paragraph 23 of Surgical Preamble.
         2.Z552, Z553 and S312 are not eligible for payment in association with R852 or R885.

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 704 / S22

DIGESTIVE SYSTEM SURGICAL PROCEDURES
INTESTINES (EXCEPT RECTUM)
                                                                                                 Asst         Surg          Anae
# S185 Closure of colostomy or enterostomy - with or without
         resection and/or anastomosis ............................................                  6         574.70          7
# S187 Plication of small intestine for adhesions................................                   6         602.20          7
      Note:
      For division or removal of adhesions only, use S312.

PDF page 716 / S34

INCISION
# Z563 Needle biopsy of peritoneum ..................................................                                52.40
# Z564 Open lavage of peritoneal cavity for diagnosis without manual
         exploration of peritoneal cavity...........................................                                 73.60          7
# S312 Laparotomy, with or without biopsy or for Hirschsprung’s
         disease (except biopsies of stomach, liver, pancreas and
         multiple para-aortic lymph nodes) ......................................                        6         485.25           7
# S324 Temporary abdominal closure with or without peritoneal
         washout ..............................................................................          6         376.25           7
         Note:
         1.S312 - use for division or removal of adhesions, if no other abdominal surgery performed -
           may not be claimed with other intra-abdominal procedures (except for IOP).
         2.S324 is only eligible for payment when rendered as a standalone procedure
         3.S324 is not eligible for payment:
            a.When definitive fascial closure is achieved at the same operative episode
            b.For superficial wound management or application of negative pressure therapy only
# E745         - insertion of tubes and post-operative continuous peritoneal
                 lavage when combined with any other abdominal
                 procedure................................................................... add                    94.85
    Laparotomy
# S321 - for acute trauma .................................................................              6         671.65           6
# E733   - with repair of intestine - single ................................... add                               162.90
# E734   - multiple and/or with resection .................................... add                                 241.55
# E735   - with splenectomy (partial or complete) ...................... add                             4         325.80
# E736   - with repair of lacerated liver ....................................... add                    4         214.95
# E739   - with repair of diaphragm ............................................ add                     4         139.60
# E723   - with repair of lacerated spleen ................................... add                       4         325.85
# E693   - with repair of ruptured bladder ................................... add                       4           -
# E694   - with nephrectomy....................................................... add                   4           -

PDF page 740 / U8

INCISION
# Z712 Biopsy, needle ........................................................................                   91.60         6
# E821    - when performed by transperineal method, to Z712 .........                                            20.00
# Z713 Biopsy, needle with drainage abscess....................................                      6           98.70         6
    EXCISION
    Prostatectomy
# S650 - simple, by retropubic or suprapubic approach, with or
           without removal of bladder stones......................................                6  689.75                     6
# S651 - radical, with or without removal of bladder stones .............                         6 1174.70                    10
# E792     - when performed laparoscopically, to S650 or S651
              ........................................................................... add 25%
      Note:
      1. Prostatectomy (S650, S651) does not include investigative cystoscopy but includes
         vasectomy when rendered.
      2. S651 includes S519 - plastic repair of bladder neck when rendered and/or S636 -
         vesiculectomy when rendered.
# S652 Staging pelvic lymphadenectomy for prostatic cancer
           (laparoscopic or open) must include at a minimum bilateral
           obturator nodes .................................................................. 7 431.20 10
# E792     - when performed laparoscopically, to S652 .........add 25%
      [Commentary:
      A sampling of nodes does not constitute a complete staging lymphadenectomy. When only a
      sampling of nodes is performed, either S312 - laparotomy or Z553 - laparoscopic biopsy, may
      be eligible for payment depending on procedure performed.]

PDF page 785 / Z1

OTHER TERMS AND DEFINITIONS
                  1. The preamble to the Musculoskeletal System Surgical Procedures section also applies to this
                     section as applicable (e.g. fractures).
                  2. Fusion of one disc level (one motion segment) includes two levels of instrumentation.
                  3. Obtaining bone for grafting is included as a component of all fusion procedures and is not
                     eligible for payment when performed with any fusion procedure.
                  4. Thoracotomy performed in conjunction with spinal procedures by a surgeon not performing the
                     spinal surgery constitutes M137 (P14).
                  5. Laparotomy performed in conjunction with spinal procedures by a surgeon not performing the
                     spinal surgery constitutes S312 (S34).
                  6. Three-dimensional (3D) computer-assisted stereotactic navigation (E378) must include the pre-
                     operative or intra-operative generation of axial, sagittal and coronal reformatted images that are
                     processed and virtually represented in 3D by a surgical navigational system. In addition, the
                     surgical navigational system must be used to reflect the position of an image-guided (tracked)
                     surgical tool(s) relative to the patient's anatomy. This may be performed by either frame or
                     frameless technique and applies to any spinal level.
                  7. Two-dimensional (2D) computer-assisted stereotactic navigation (E379) must include the intra-
                     operative generation of antero-posterior, lateral or multiple oblique 2D views that are processed
                     and virtually represented in 2D by a surgical navigational system. In addition, the surgical
                     navigational system must be used to reflect the position of an image-guided (tracked) surgical
                     tool(s) relative to the patient's anatomy. This may be performed by either frame or frameless
                     technique and applies to any spinal level.
                     Note:
                     The use of an intra-operative imaging tool such as a portable x-ray, fluoroscope (2D or 3D), CT,
                     MRI or ultrasound for "live" localization without a surgical navigational system as defined
                     above does not constitute E378 or E379 and is not eligible for payment.
                  8. Acute spinal cord injury premium (E383) is only eligible for payment when rendered to patients
                     who are described under ASIA impairment scale ratings A to C and have acute conditions
                     which have been present for 6 weeks or less.

Master, record 5408. Record Layout PDF, page 1.

S31220260401999999990000485250000000774600000000000000000111720000001117200

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.