Z459

PDF page 106 / GP92

GENERAL PREAMBLE
 ANAESTHESIOLOGISTS’ SERVICES
SPECIFIC ELEMENTS
In addition to the common elements, the general anaesthesia service includes the following specific
elements.
A. Supervising the preparation of the patient for anaesthesia.
B. Performing the anaesthetic procedure, and procedures associated with the anaesthetic procedure
   which are not separately payable including providing all supportive measures to the patient during
   and immediately after the period of anaesthesia; transfer of or assisting with the transfer of the
   patient to the recovery room; all indicated recovery room procedures, and ongoing monitoring and
   detention during the immediate post-operative and recovery period.
C. Making arrangements for any assessments, procedures, or therapy, including obtaining any
   specimens (except for arterial puncture Z459), and/or interpreting the results, on matters related to
   the service.
D. Making, or supervising the making of, arrangements for follow-up care and when medically
   indicated, post-procedure monitoring of the patient’s condition until the next insured service is
   provided.
E. Discussion with, and providing any advice and information, including prescribing therapy to the
   patient or the patient’s representative, whether by telephone or otherwise, on matters related to the
   service.
F. Providing premises, equipment, supplies, and personnel for any aspect(s) of specific elements A,
   C, D, and E that is (are) performed in a place other than the place in which the general anaesthetic
   service is performed.
While no occasion may arise for performing elements C, D or E, when performed in connection with
the other specific elements, they are included in the general anaesthetic service.
The general anaesthesia service includes:
      a. a pre-anaesthetic evaluation, with specific elements as for assessments (see GP15);
      b. the anaesthetic procedure; and
      c. post-anaesthetic follow-up.
       Note:
       1.With the exception of the listings in the “Consultations and Visits” section, all references to an
         anaesthesiologist in this Schedule are references to any physician providing anaesthetic
         services.
       2.As defined in the General Preamble (see GP3), general anaesthesia, for the purposes of this
         Schedule, includes all forms of anaesthesia except topical anaesthesia or local infiltration,
         unless otherwise specifically listed.
Calculation of Fee Payable – Basic and Time Units
The amount payable for the anaesthesia service is calculated by adding the number of basic and time
units and multiplying the total by the anaesthesiologist unit fee.
         Anaesthesiologist Unit fee ..................................................               $15.96
Basic Units: The number of basic units is the number of basic units listed opposite the service in the
column headed with “Anae” except,

PDF page 414 / H6

PULMONARY FUNCTION STUDIES
                                                                                                   H            P
  Oxygen saturation
J323 - by oximetry at rest, with or without O2................................                     4.20         -
J332 - by oximetry at rest and exercise, or during sleep with or
       without O2...........................................................................     17.60         11.35
J334 - J332 with at least two levels of supplemental O2 ...............                          30.55         16.85
J336 - with single blind assessment of exercise on room air and
       with supplemental oxygen ..................................................               30.55         16.85
      Note:
      1.J323 is not eligible for payment when rendered with J332, J315, J316, G315, G319, G111,
        G112, G570, G571, G582, G583, G574, G575 or any overnight sleep study.
      2.J332 is not eligible for payment when rendered with J315, J316, G315, G319, G111, G112,
        G570, G571, G582, G583, G574, G575 or any overnight sleep study.
      3.J336 is only eligible for payment for evaluation of a patient to determine eligibility for funding
        under the Ontario Home Oxygen Program.
      4.J336 is not payable in addition to J332 or J334.
      5.J301, J304, J324, or J327 are not eligible for payment when rendered to a patient who does
        not have symptoms, signs or an indication supported by current clinical practice guidelines
        relevant to the individual patient’s circumstances.
      Medical record requirements:
      J323, J332, J334 or J336 are not eligible for payment unless a permanent record of the study is
      maintained.
J322 Standard O2 consumption and CO2 production......................                              5.30          6.45
J333 Non-specific bronchial provocative test (histamine,
       methacholine, thermal challenge) ......................................                   48.25         41.55
J335 Antigen challenge test ............................................................         51.85         30.95
                                                                                                              Fee
Z459 Arterial puncture for blood gas analysis..................................                               10.20
    Note:
    For home/self-care ventilation listing - see Diagnostic and Therapeutic Procedures page J50.

PDF page 421 / J7

Vascular cannulation
  Z459 Arterial puncture ...................................................................... 10.20
# G268 Cannulation of artery for pressure measurements including cut
          down as necessary..............................................................       31.25
      Note:
      G268 is not eligible for payment with G249, G259, G261, G176, G177, G178, G288,
      Z443 or Z440.
# G269 Cannulation of central vein for pressure measurements or for
         feeding line - not to be billed with right heart catheterization
         (Z439) or with Swan-Ganz catheter insertion......................                           31.25
# G270 Intraosseous infusion...............................................................          23.90
# G309 Umbilical artery catheterization (including obtaining of blood
          sample)................................................................................    45.55
    Venipuncture
+ G480 - infant....................................................................................  9.90
+ G482 - child ..................................................................................... 7.35
+ G489 - adolescent or adult ..............................................................          3.54
     Note:
     G489 is not insured when rendered for the monitoring of adverse effects resulting from a calorie
     restricted weight loss program.
+ G483 Therapeutic venisection...........................................................             9.70
  G282 Umbilical vein catheterization (including obtaining of blood
          sample)................................................................................    43.60
# Z438 Insertion of Swan-Ganz catheter (not included in respiratory or
          critical care benefits) ...........................................................       162.50    6
          Note:
          1.Swan-Ganz catheter insertion is included in the anaesthesia basic units of any surgical
            services where anaesthesia basic units are listed
          2.Z438 includes dye dilution densitometry and/or thermal dilution studies, when rendered
            (except in the setting of a cardiac catheterization laboratory).
          [Commentary:
          See G285 for dye dilution densitometry and G286 for thermal dilution studies performed using a
          Swan-Ganz catheter in a cardiac catheterization laboratory.]
# Z456 Insertion of implantable central venous catheter .....................                       296.50    6
# Z457 Surgical removal or repair of tunneled central venous catheter                                60.00    6
# Z446 Insertion of subcutaneous venous access reservoir ...............                            168.00    6
# Z447 - revision same site................................................................         130.70    6
# E684           - when performed in infant or child, to Z456 or Z446 ....add                       233.65

Master, record 7211. Record Layout PDF, page 1.

Z45920250401999999990000010200000000000000000000000000000000000000000000000

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.