Z132

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

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 6955. Record Layout PDF, page 1.

Z13220260401999999990000304100000000774600000000000000000111720000001117200

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.