Z427

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 556 / M6

Face or neck
      Simple excision
  R048 - single lesion........................................................................       6         100.95          6
  R049 - two lesions..........................................................................       6         152.50          7
  R050 - three or more lesions..........................................................             6         255.25          7
  E542    - when performed outside hospital ............................... add                                 12.65
    Other areas
      Simple excision
  R094 - single lesion........................................................................       6          63.70          7
  R040 - two lesions..........................................................................       6         104.85          6
  R041 - three or more lesions..........................................................             6         209.70          7
  E542    - when performed outside hospital ............................... add                                 12.65
    Malignant melanoma
  R010 - wide excision in any area and must include > 1 cm margins
          and layered closure ............................................................           6         135.95          7
# E540   - if excision is performed in hospital for tumour free margin
           with frozen section, to excision or repair fees .... add 25%
        [Commentary:
        For sentinel node biopsy refer to Z427 p R2.]
        Note:
        1.When excision of benign, pre-malignant or malignant skin lesions are corrected by
            a.Advancement flap including undermining of more than 2.5 cm per side, or
            b.Rotation, transposition, Z-plasty, or
            c.Other flap or graft
        claim the appropriate benefit listed under Skin Flaps and Grafts Section instead of foregoing
        excision benefits.
        2.Excision by S-plasty technique is considered a form of simple excision rather than a
          reconstructive flap.
    Face or neck
     Curettage, electrodesiccation or cryosurgery
  R018 - single lesion........................................................................       6          75.10          6
  R019 - two lesions..........................................................................       6         123.70          7
  R020 - three or more lesions..........................................................             6         247.30          6

PDF page 567 / M17

# E540         - payable once per lesion for excision in hospital for tumour
                 free margin with frozen section, to first flap or graft
                 procedure........................................................... add 25%
         [Commentary:
         For sentinel node biopsy refer to Z427 p R2.]
         Note:
         When excision of benign, pre-malignant or malignant skin lesions are corrected by
         advancement flap including undermining of more than 2.5 cm per side, or by rotation,
         transposition, Z-plasty, flap or graft, claim appropriate benefit listed under Repair Section
         instead of foregoing excision benefits. Excision by S-plasty technique is considered a form of
         simple excision rather than a reconstructive flap.

PDF page 575 / M25

OPERATIONS OF THE BREAST
                                                                                                            Asst      Surg      Anae
                               INCISION
                Needle biopsy
              Z141 - one or more ........................................................................     nil      37.20
              E542   - when performed outside hospital ............................... add                             12.65
              Z143 - large core breast biopsy - (14 gauge or larger bore needle)                                      144.85
                Aspiration of cyst
              Z139 - one or more ........................................................................     nil       37.20
      Drainage of intramammary abscess or haematoma
  # Z140 Single or multiloculated - local anaesthetic.............................                                     33.00
  # Z740 Single or multiloculated - general anaesthetic ........................                                      133.80     6
      EXCISION
  # R107 Tumour or tissue for diagnostic biopsy and/or treatment, e.g.
           carcinoma, fibroadenoma or fibrocystic disease (single or
           multiple - same breast) ......................................................                     6       169.95     6
  # E525   - after localization with mammographic wire or radioactive
             seeds, to R107........................................................... add                              48.05
  # R111 Partial mastectomy or wedge resection for treatment of breast
            disease, with or without biopsy, e.g. carcinoma or extensive
            fibrocystic disease ..............................................................                6       306.75     7
  # E525    - after localization with mammographic wire or radioactive
              seeds to R111 ............................................................ add                            48.05
  # E546    - with axillary node dissection up to the level of the axillary
              vein, to R111 .............................................................. add                        388.75
  # E505    - with limited axillary node sampling, to R111............... add                                         178.05
        Payment rules:
        1.E505 is not eligible for payment in addition to Z427.
                                         2.Z427 is only eligible for payment in addition to E546 when a frozen section report
                                           demonstrates micrometastases.
                                         [Commentary:
                                         For sentinel node biopsy refer to Z427 p R2.]

PDF page 682 / R2

Neck lymph nodes
  # R910 - limited dissection, must include 2 levels (unilateral) or
            central compartment...........................................................                10         568.70          7
  # R915 - comprehensive dissection, must include 3 or more levels,
            unilateral.............................................................................       10        1120.80          8
  # R912 Ileoinguinal, radical resection .................................................                 6         733.95          8
      Axillary or inguinal lymph nodes
  # R913 - radical resection, unilateral.................................................                  6         551.90          7
  # R914 - limited resection, unilateral .................................................                 6         310.95          6
      BIOPSY
  # Z405 Anterior cervical lymph node(s), unilateral..............................                         6         186.90          6
  # Z411 Axillary or inguinal lymph node(s), unilateral ..........................                         6          68.70          6
  # Z406 Scalene, posterior cervical lymph node(s), unilateral ............                                6         247.75          6
  # Z578 Multiple para-aortic lymph nodes............................................                                 93.00
  # Z427 Sentinel node biopsy, per draining basin ................................                         6         330.45          8
      Percutaneous retroperitoneal
  # Z407 - one group ...........................................................................           6         117.90          6
  # Z409 - two or more groups ............................................................                 6         162.20          6
  # R916 Re-exploration of vascular graft and closure of lymph fistula in
           groin ...................................................................................       6         207.30          6

Master, record 7179. Record Layout PDF, page 1.

Z42720260401999999990000330450000000774600000000000000000127680000001276800

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.