Z207

PDF page 587 / N7

MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
 GENERAL FEES
                                                                                                        Asst   Surg     Anae
       CASTS
        Corrective splints must be corrective to qualify for a benefit as such. The corrective splint
        listings are not applicable to simple immobilization such as with a Jones bandage or metal
        finger splint following soft tissue injury.
         Application of plaster casts or corrective splints are not to be claimed if applied at the time of
         surgery (except for the application of a cast brace) or applied during the first 2 weeks for a
         fracture or dislocation when a procedural fee is applicable. The subsequent application of
         plaster casts may be claimed according to the following Schedule.
       Direct supervision requires the physical presence of the physician in the office in which the cast
       is applied at the time the cast is applied unless all conditions listed on page GP62 to GP63 of
       the General Preamble (Delegated Procedures) are met.
   E584     - application of plaster cast outside hospital or ICHSC add                  11.15
   Z201 Finger......................................................................................            10.25
   Z202 Hand .......................................................................................            14.90    6
   Z203 Arm, forearm or wrist ..............................................................                    24.10    6
   Z199 Foot.........................................................................................           14.90    6
# Z213 Below knee, knee splints (Stove pipe, etc.) ............................                                 24.10    6
# Z211 Whole leg (mid thigh to toes) ..................................................                         28.80    6
  Z198 Toes ........................................................................................            10.25    6
# Z205 Head and torso .......................................................................            6      97.35    6
# Z208 Shoulder spica ........................................................................           6      97.35    7
# Z206 Body cast ................................................................................        6      57.50    6
      Hip spica
# Z207 - unilateral.............................................................................         6      97.35    6
# Z209 - bilateral...............................................................................        6     121.60    7
   Z216 Wedging of casts other than fracture treatment......................                                    10.25
   Z200 Application of Unna's paste ....................................................                        14.90
   Z873 Application of cast brace (must include hinge) .......................                                  67.75
   Z291 Application Pavlik Harness or DDH Splint ..............................                                 24.10
   Z204 Removal of plaster (not associated with fractures or
            dislocations within 2 weeks of initial treatment)..................        10.25
       Payment rules:
       Z201, Z198, and Z873 are not eligible for payment for application of a prefabricated cast, brace
       or splint.

PDF page 623 / N43

MUSCULOSKELETAL SYSTEM SURGICAL PROCEDURES
 FEMUR
                                                                                                     Asst    Surg     Anae
# F095 Closed reduction of femoral fracture including one of:
        - application of external fixation, or
        - skeletal traction, or
        - closed reduction with application of unilateral or bilateral hip
          spica cast in infant or child                                                               6      407.35    6
      Open reduction
# F096 Femur .....................................................................................    6      774.05    8
# F093 Diaphyseal or metaphyseal distal femur fracture with intra-
         articular extension – with or without intramedullary fixation                                6     1285.00    8
         Payment rules:
         1.F096 includes intramedullary nail with proximal and distal locking screws if performed.
         2.F093 is not eligible for payment for repair of an isolated distal femoral osteochondral fracture.
         3.F021 and F096 are not eligible for payment with F093 for treatment of fractures below the
           intertrochanteric region on the same femur.
         4.E555 is not eligible for payment with F094 or F095.
         5.Z207 and Z209 are not eligible for payment with F095.

Master, record 7018. Record Layout PDF, page 1.

Z20720260401999999990000097350000000774600000000000000000095760000000957600

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.