Z562

PDF page 320 / A192

Consultation
       A diagnostic radiology consultation is the service rendered when:
      a. radiographs or ultrasounds made at one institution or facility are referred to a radiologist at a
          different institution or facility for his/her written opinion. In this case, the specific elements are
          as for diagnostic radiology professional component (see page D1);
      b. a radiologist is required to make a special visit at evening or night (17:00h to 07:00h) or on a
         Saturday, Sunday or holiday to consult on the advisability of performing a diagnostic
         radiological procedure which eventually is not done. In this case, the specific elements are
         the same as for consultations; or
      c. when a radiologist is required to render an opinion prior to an interventional procedure and
         all of the following requirements are met. In this case, the specific elements are the same as
         for consultations:
           i.   the consultation is performed in an area remote from the radiologist’s normal procedural
                suite;
           ii. the requirements for a consultation are met;
           iii. the consultation is not solely for the purpose of clarifying or obtaining consent; and
           iv. the associated procedure is one of the following: J021, J025, J040, J041, J046, J048,
               J049, J050, J055, J056, J057, J058, J059, J063, J065, J066, N107, N118, N122, N125,
               S233, Z446, Z456, Z562, Z594.
 A335 Consultation............................................................................                 57.90
       Payment rules:
       1.A diagnostic radiology consultation is not eligible for payment when radiographs made in a
         different institution or facility are used for comparison purposes with radiographs or
         ultrasounds made in the consultant’s institution or facility.
       2.A335 is not eligible for payment for CT and MRI services.
       [Commentary:
       For a second opinion by a radiologist of CT and MRI studies, see A330 and A332 respectively.]

PDF page 388 / E4

CLINICAL PROCEDURES ASSOCIATED WITH DIAGNOSTIC
              RADIOLOGICAL EXAMINATIONS
MISCELLANEOUS PROCEDURES
                                                                                                                   Spec          Anae
# J001 Arthrogram, tenogram or bursogram ......................................       52.10        7
      Note:
      Biliary duct calculus manipulation etc. (see Z562 listed in Digestive System - Biliary Tract.)
    Bronchial brushing
# J024 - unilateral.............................................................................                    89.90          6
# J044 - bilateral...............................................................................                  135.00          6
    Bronchogram
# J002 - unilateral.............................................................................                     27.00         6
# J043 - bilateral...............................................................................                    40.65         6
    Bronchogram with intra-tracheal catheter
# J003 - unilateral.............................................................................                     68.00         6
# J042 - bilateral...............................................................................                    82.20         6
    Carotid or vertebral artery occlusion by detachable balloon
# J050 - percutaneous......................................................................                        297.30
# J053 Cavernosography ...................................................................                           45.35
# J005 Dacrocystogram......................................................................                          45.40         6
    Discogram
# J006 - one disc ..............................................................................                   105.30          7
# J030   - each additional disc ................................................... add                             54.05
    Embolization of spinal arteriovenous malformation
# J049 - percutaneous......................................................................                        670.10          6
# J036 Fistula or sinus injection .........................................................                          29.40
# J068 Hydrostatic/pneumatic reduction of intussusception...............                                             48.30         7
# J008 Hysterosalpingogram..............................................................                             56.70         6
# J004 Intramammary needling for localization under mammographic
          control.................................................................................                   76.75
# J009 Laryngogram...........................................................................                        33.50

PDF page 712 / S30

Endoscopic retrograde cholangiopancreatography (ERCP)
  # Z561 - with cannulation of common bile duct and/or pancreatic duct                                 213.15 6
  # Z558 - including sphincterotomy and may include removal of one or
             more bile duct stones .........................................................           300.25 6
  # Z760 - through gastrojejunostomy following previous Billroth II ....                               251.85 6
  # E702     - with multiple (3 or more) biopsies of a specific lesion add                              15.10
  # E666     - with biliary tract manometry ....................................... add                 52.30
  # E662     - with intraductal cytology brushing or intraductal biopsy
               ................................................................................... add  49.75
  # E668     - with cannulation of minor papilla................................ add                    93.80
  # E680     - with insertion of first endobiliary prosthesis and/or
               pancreatic stent (maximum 1).................................... add                     82.35
  # E681     - with insertion of each additional endobiliary prosthesis
               and/or pancreatic stent (maximum 3) ........................ add                         43.60
  # E669     - with oesophagoscopy-gastroscopy and may include
               duodenoscopy............................................................ add            102.75
  # E816     - with electrohydraulic lithotripsy for choledocholithiasis
               ................................................................................... add  50.00
        Note:
        1.E662, E666, E668, E702, E680, E681, E669, and E816 are payable with Z561, Z558 or
          Z760.
        2.E816 is only eligible for payment for confirmed choledocholithiasis that is refractory to
          standard extraction methods
  # Z593 Nasobiliary catheter insertion .................................................                                  55.25
      INCISION
  # S233 Percutaneous trans-hepatic catheter drainage of obstructed
            bile ducts including daily supervision and including
            percutaneous cholangiogram and catheterization to
            duodenum if achieved ........................................................                                 394.25
  # S234 Replacement of catheter in above ..........................................                                       64.85
      Biliary duct calculus manipulation and/or removal via T-tube tract
  # Z562 - as sole procedure...............................................................                               116.20          7
  # Z542 Intubation of bile duct for obstruction......................................                                     85.25

Master, record 7290. Record Layout PDF, page 1.

Z56220260401999999990000116200000000000000000000000000000111720000001117200

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.