Codeallocateconsult.xls

Discipline-
GENERAL SURGICAL - Abdominal Wall and Peritoneum GENERAL SURGICAL - Abdominal Wall and Peritoneum GENERAL SURGICAL - Abdominal Wall and Peritoneum GENERAL SURGICAL - Abdominal Wall and Peritoneum GENERAL SURGICAL - Abdominal Wall and Peritoneum GENERAL SURGICAL - Abdominal Wall and Peritoneum GENERAL SURGICAL - Abdominal Wall and Peritoneum Requires Pre
certification
Monitored
Anaesthesia
Side Room
CONSULTANT PAYMENT IDENTIFIER
Diagnostic
Independent
procedure
DESCRIPTION
Intraabdominal injury with rupture of viscus (I.P.) Intra abdominal injury, multiple complicated with rupture of Laparoscopy with or without biopsy (I.P.) Laparotomy, intra-abdominal sepsis (I.P.) Appendicectomy (with or without complications) (I.P.) Gastric restrictive procedure, with gastric bypass for morbid obesity with Roux-en-Y gastroenterostomy (I.P.) Gastric restrictive procedure, with partial gastrectomy, pylorus preserving duodenileostomy and ileoileostomy (50 to 100 cm common channel) to limit absorption/ biliopancreatic diversion Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en-Y gastroenterostomy (I.P.) Consultant anaesthetist benefit for gastroscopy (code 194) with any of the colonoscopy procedures (450, 455, 456 or 457) performed at the same session under anaesthesia Upper G.I. endoscopy with or without biopsies (includes jejunal biopsy), with or without polypectomy (see note below) Upper gastrointesinal endoscopy including oesophagus, stomach and either the duodenum and/or jenjunum as appropriate, with endoscopic ultrasound (IP) VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 Upper gastrointestinal endoscopy with endoscopic ultrasound exam including oesophagus, and either the duodenum and/or jenjunum as appropriate, with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s)) of lymph nodes in oesphageal gastric and lung cancer, biopsy of pancreatic lesion(s)) with or without coeliac plexus neurolysis for pain arising from pancreatic cancer Epigastric/Ventral hernia, repair of (I.P.) Femoral hernia, repair of, unilateral (I.P.) Hiatus hernia, transthoracic, repair of (I.P.) Inguinal hernia, repair of, bilateral (I.P.) Repair of inguinal hernia, neonate up to six weeks of age, Inguinal hernia, repair of, unilateral (I.P.) Strangulated inguinal hernia, unilateral (I.P.) Repair of inguinal hernia, neonate up to six weeks of age, Ileoscopy, through stoma, with or without biopsy Anal fissure, dilatation of anus (I.P.) Botulinum toxin injection of anal sphincter under general Destruction of lesion(s) by any method, genital/anal warts (e.g. condyloma, papilloma, molluscum contagiosum, herpetic Anus, excision of epithelioma of, without colostomy VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 Colonoscopy plus polypectomy, full colon Left colonoscopy and laser photocoagulation of rectum Colonoscopy, full colon and laser photocoagulation of rectum Fistula-in-ano, excision with endo-anal flap and advancement Fistula-in-ano, insertion/change of seton (I.P.) Haemorrhoidectomy, external, multiple (I.P.) Haemorrhoidectomy (internal) includes exploration of anal Haemorrhoids, injection and/or banding (I.P.) Ischiorectal abscess, incision and drainage (I.P.) Proctoscopy or sigmoidoscopy, with biopsy Diagnostic flexible sigmoidoscopy and biopsies VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 Proctoscopy or sigmoidoscopy with biopsy of muscle coats of Prolapse of rectum, perineal repair (I.P.) Closure of rectovesical fistula, with or without colostomy (I.P.) Rectal or sigmoid polypi (removal by diathermy etc.) Revision/refashioning of ileostomy and duodenostomy, complicated reconstruction in-depth (I.P.) Sigmoidoscopy including dilatation of intestinal strictures Stricture of rectum (dilation of) (I.P.) Meatoplasty (for meatotomy use procedure 665) Subcutaneous testosterone implantation for Injection of corpora cavernosa with pharmacologic agent(s) VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 Excision of epididymal cyst(s), unilateral (I.P.) Excision of epididymal cyst(s), bilateral (I.P.) Insertion of an endo urethral stent for urethral stricture Biopsy of prostate (perineal or transrectal) (I.P.) Orchidopexy, inguinal approach with or without hernia repair, Orchidopexy, inguinal approach with or without hernia repair, ERCP (endoscopic retrograde cholangiogram of pancreas) Haemodialysis, chronic, in the patient’s home or at a hospital out patient department, after completion of training sessions (minimum of three dialysis sessions per week inclusive of all Peritoneal dialysis, chronic, in the patient’s home or at a hospital out patient department, after completion of training sessions (minimum of three dialysis sessions per week inclusive of all consultant care), monthly benefit Bladder, instillation of anticarcinogenic agent (BCG) Bladder, DMSO instillation for interstitial cystitis Removal of permanent shunt inserted into vein or artery for access for haemodialysis (not for the removal of Hickman, Cystoscopy with or without overdistension with or without Cystoscopy with or without overdistension, with or without Cystoscopy with diathermy to bladder tumour(s) (I.P.) VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 GENERAL SURGICAL - Head & Neck - Mouth/Cheek GENERAL SURGICAL - Head & Neck - Mouth/Cheek GENERAL SURGICAL - Head & Neck - Mouth/Cheek GENERAL SURGICAL - Head & Neck - Lips GENERAL SURGICAL - Head & Neck - Lips GENERAL SURGICAL - Head & Neck - Lips GENERAL SURGICAL - Head & Neck - Palate Cystoscopy with ureteric catheterisation (I.P.) Cystoscopy with ureteroscopy and removal of ureteric calculus Percutaneous suprapubic cystostomy (I.P.) Percutaneous tract formation for renal stone removal by Ureteric reimplantation, unilateral for reflux, stricture or fistula Ureteric reimplantation, bilateral for reflux, stricture or fistula Complex uroflowmetry (using calibrated electronic equipment); for initail evaluation of bladder outlet obstruction Complex urodynamics using calibrated electronic equipment Whittaker test for evaluation of upper urinary tract Excision of lesion of mucosa and submucosa, vestibule of mouth, with simple repair (I.P.) (see note after procedure code Excision of lesion of mucosa and submucosa, vestibule of mouth, complex, with or without excision of underlying muscle (I.P.) (see note after procedure code 1048) Excision of malignant growth of mucosa and submucosa, vestibule of mouth, wide excision with excision of underlying muscle, complex layered closure, with or without skin graft Cyst or benign tumour on lip, excision of (I.P.) VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 Thyroid cyst(s) aspiration/fine needle biopsy (I.P.) Percutaneous core needle biopsy of thyroid gland (I.P.) (for fine needle biopsy use procedure code 1152) Breast cyst(s) aspiration/fine needle biopsy (diagnostic or Percutaneous core needle biopsy of breast with or without Stereotactic localisation core needle biopsy of breast (I.P.) Cysts or benign tumours, excision of, or segmental resection Excision of breast lesions identified by preoperative placement of radiological markers. Procedure includes specimen mammography, extension of margins and placement of orientation markers for later radiotherapy with removal of Mastectomy, simple, complete with removal of sentinel Mastectomy and axillary clearance, immediate breast reconstruction with latissimus dorsi pedicle flap, with or without prosthetic implant or expanding prosthesis (I.P.) Arterial biopsy (temporal artery, biopsy, bilateral under local Intraarterial injection (excluding arteriography) (I.P.) Transcatheter embolisation, extremity, arteriovenous Transcatheter therapy, infusion for thrombolysis other than coronary, including necessary local anaesthesia, all lesser order selective catheterisation used in the approach and any VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 Fine needle aspiration (FNA), not otherwise specified in this Schedule, with or without preparation of smears; superficial or deep tissue with or without radiological guidance Biopsy or excision of lymph node(s); by needle, superficial (e.g. Sentinel node biopsy with injection of dye and identification Axillary or inguinal lymph nodes, incision of abscess Biopsy or excision of lymph node(s); open, deep cervical Inguinal or pelvic lymph node block dissection, unilateral (I.P.) Inguinal or pelvic lymph node block dissection, bilateral (I.P.) Primary or secondary retroperitoneal, lymphadenectomy Endovenous radiofrequency ablation therapy of incompeten veins, extremity, inclusive of all imaging guidance and Endovenous radiofrequency ablation therapy of incompeten veins, extremity, inclusive of all imaging guidance and Endovenous laser ablation therapy of incompeten veins, extremity, inclusive of all imaging guidance and monitoring, Endovenous laser ablation therapy of incompeten veins, extremity, inclusive of all imaging guidance and monitoring, Sclerosing operation on varicose vein(s), one leg (I.P.) (see Sclerosing operation on varicose veins, both legs (I.P.) (see Cockett, Linton or Dodd procedure on perforating veins (I.P.) Venous pressure and blood volume studies Ligation of single varicose vein in thigh or calf (I.P.) VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 Ligation of multiple varicose veins one or both legs (I.P.) Abscess, cyst or tumour, aspiration of (I.P.) Angioma of skin and subcutaneous tissue or mucous surfaces, excision and repair of, under general anaesthetic Biopsy of skin, subcutaneous tissue and/or mucous membrane Destruction by cryotherapy of actinic keratosis or warts other than plantar warts with or without surgical curettement, one Destruction by cryosurgery of actinic keratoses or warts other than plantar warts with or without surgical curettement, Destruction by cryosurgery of actinic keratoses or warts other than plantar warts with or without surgical curettement, Destruction by any method, including laser, with or without surgical curettement, all benign or premalignant facial lesions, including local anaesthesia, patient examination, evaluation and assessment, one lesion (I.P.) (see note after procedure code Destruction by any method, including laser, with or without surgical curettement, all benign or premalignant facial lesions, including local anaesthesia, patient examination, evaluation and assessment, up to five lesions (I.P.) (see note after procedure Destruction by any method, including laser, with or without surgical curettement, all benign or premalignant facial lesions, including local anaesthesia, patient examination, evaluation and assessment, greater than five lesions (I.P.) (see note below) Stab avulsion of varicose vein(s), one leg (I.P.) Stab avulsion of varicose vein(s), both legs (I.P.) Phototherapy – Consultant Dermatologist consultations on an out-patient basis for a patient receiving a course of phototherapy in a Centura Healthcare approved hospital facility (list available on request from Centura Healthcare). (see note Skin abscess, (superficial) incision and drainage of (I.P.) Malignant melanoma, wide excisional biopsy VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 Excision of benign lesion or lesions (includes sebaceous cysts) Excision of benign lesion or lesions of face (includes sebaceous Excision of pre-malignant lesion or lesions (I.P.) Excision of pre-malignant lesion or lesions of face (I.P.) Basal cell carcinoma/squamous cell carcinoma, simple excision Basal cell carcinoma/squamous cell carcinoma, excision and Mohs micrographic surgery initial layer margin assessment Mohs micrographic surgery second and subsequent layers Laser treatment to port wine stains only, one or more sessions (benefit is not payable for initial patch test) Photodynamic therapy – for premalignant or malignant non- metstatic skin lesions, including application of photosensitising agent (5-aminolevulinic acid) one or more sessions (I.P.) Hydradenitis suppurativa, excision and suture Wounds up to 2.5cm in total length, suture of with one layer repair of the epidermis, dermis or subcutaneous tissues with Wounds from 2.6cm to 7.5cm in total length, suture of with one layer repair of the epidermis, dermis or subcutaneous Wounds greater than 7.5cm in total length, suture of with one layer repair of the epidermis, dermis or subcutaneous tissues Emergency assessment of a patient on a course of chemotherapy where a decision is made, due to a medical problem, not to proceed with planned chemotherapy that day and may require further tests before discharge Intravenous infusion of Fabrazyme doe patients with a Intravenous infusion for therapy of severe neurological disorders or auto immune disease, not elsewhere specified by Consultant Neurologists, Immunologists and Rheumatologists VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 Infusion of Mitozantrone (Novantrone) for patients with secondary progressive multiple sclerosis, progressive-relapsing multiple sclerosis and worsening relapsing-remitting multiple Initial consultation with a new patient commencing a cycle of intravenous cytotoxic chemotherapy, major consultation and reassessment of a patient commencing a new cycle of intravenous cytotoxic chemotherapy,consultation and assessment of a patient on day 8, 15 and 22 during a cycle of intravenous cytotoxic chemotherapy, consultation and assessment of a patient during the course of intravenous cytotoxic chemotherapy given on successive days in any week (days 2 to 7 inclusive), in these circumstances benefit can only be claimed for one additional assessment during the week’s Intravenous immunoglobulin for patients with myasthenia gravis, chronic inflammatory demyelinating polyneuropathy, multifocal motor neuropathy with conduction block and Intravenous infusion of zoledronic acid (zometa) for pain control for patients with metastatic carcinoma Removal of catheter from central venous system, when it is medically necessary to perform this procedure under general anaesthetic, on completion of therapy or because of complications with the catheter (I.P.) (see note below) Insertion of tunnelled central line for total parenteral nutrition only (I.P.) (see note after procedure code 1627) Intravenous infusion of pamidronate (aredia) for pain control Placement of central venous catheter (peripherally or centrally inserted) for chemotherapy, TPN or long-term antibiotic therapy (I.P.) (see note after procedure code 1627) Intravenous immunoglobulin for patients with a haematological Blood transfusion for patients with a haematological malignancy Intravenous antibiotics for patients on cytotoxic chemotherapy VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 Electrolyte replacement for patients on cytotoxic chemotherapy regimens for malignant disease Therapeutic phlebotomy for patients with polycythemia rubra Intravenous iron infusion for patients with resistant iron Insulin stress test (IST) to include initial consultation for a new patient or major reassessment of an established patient, in addition intravenous administration of insulin, sampling for basal level setting and all necessary sampling and monitoring of the Atresia of auricle, 2 or 3 stages, correction of (per stage) (I.P.) Aspirin desensitisation, to include all necessary sampling and monitoring of the patient during the procedure Infusion of MabThera with methotrexate for the treatment of adult patients with severe active rheumatoid arthritis who have had an inadequate response or intolerance to other disease- modifying anti-rheumatic drugs including one or more tumour necrosis factor (TNF) inhibitor therapies Infusion of Tysabri as a single disease modifying therapy in highly active relapsing remitting multiple sclerosis Excision/repair external ear; soft tissue lesion(s), polyp/polyi or repair of split ear lobe(s) or other trauma, one or both ears Debridement, ear canal and/or mastoidectomy cavity, complex and microinspection of tympanic membrane unilateral or bilateral, requiring the use of an operating microscope and a hospital operating theatre e.g. in chronic otitis media or keratosis obturans (not for routine syringing, cleaning or the Labyrinthotomy, with or without cryosurgery including other non excisional destructive procedures or perfusion of vestibuloactive drugs, single perfusion, transcanal Drainage external ear, abscess or haematoma External auditory canal, excision of tumour VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 External auditory canal, reconstruction of (meatoplasty) (e.g. for stenosis due to trauma, infection) (I.P.) Foreign body, removal from ear, under general anaesthetic Myringoplasty, surgery confined to drumhead and donor area (not for the removal of myringotomy tubes) (I.P.) Removal of drain tube(s) under general anaesthetic Myringotomy, bilateral, with insertion of grommets Tympanic membrane repair, with or without site preparation or perforation for closure, with or without patch (not for the Epistaxis, anterior packing and/or cautery (I.P.) Epistaxis – posterior – anterior packing and/or cautery (I.P.) Epistaxis, anterior ethmoid and/or internal maxillary ligation Foreign body, removal from nose, under general anaesthetic Antral puncture (antrotomy) and washout unilateral (I.P.) Antral puncture (antrotomy) and washout bilateral (I.P.) Nasal/sinus endoscopy, diagnostic, unilateral or bilateral (I.P.) Nasal/Sinus endoscopy, surgical; with biopsy, polypectomy or removal of diseased mucosa, lesions or debridement (I.P.) VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 transbronchial biopsy, (with or without Nasal septum, insertion of prosthetic button Oro antral fistula, closure of by means of surgical advancement Cauterisation and/or ablation, mucous of turbinates, unilateral or bilateral, any method, superficial (I.P.) Bronchoscopy; diagnostic, with or without cell washing or brushing, with or without bronchial biopsy (I.P.) Bronchoscopy; diagnostic, with or without cell washing or Bronchoscopy with bronchoalveolar lavage, with or without biopsy (I.P.) (This procedure is payable in the following Bronchoscopic biopsy of peripheral pulmonary nodule under Bronchoscopy with or without bronchial biopsy (less than 2 Bronchoscopy; diagnostic, (rigid), with or without biopsy (I.P.) Bronchoscopy with removal of foreign body (includes foreign Laryngoscopy, direct, operative with biopsy (I.P.) Microsurgery of larynx with complete removal of benign or malignant lesions (not for biopsy of lesions – see code 2031) Botulinum toxin injections for laryngeal dysphonia Oesphagoscopy with or without biopsy, with or without Oesophagoscopy with removal of foreign body (I.P.) Upper G.I. endoscopy with oesophageal dilatation and laser Operative peroral endoscopy (including biopsy of larynx, trachea, bronchus, pharynx or oesophagus) (I.P.) Balloon dilatation of the oesophagus (includes endoscopy) VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 response curve, with or without airway 2 Polysomnography, limited sleep study together with initiation of nasal CPAP titration for sleep apnoea performed during the Polysomnography, limited sleep study together with two nasal CPAP titration procedures for sleep apnoea performed during Polysomnography, full study with initiation of nasal CPAP titration for sleep apnoea together with a second nasal CPAP titration procedure performed for sleep apnoea during the Polysomnography, full study with Multiple Sleep Latency testing (MSLT) or maintenance of wakefulness, testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness during the same Initial nasal CPAP titration for sleep apnoea together with a second nasal CPAP titration procedure performed for sleep Full pulmonary function studies, to include as a minimum; spirometry and measurement of static lung volumes, with or without respiratory flow volume loop, with or without skin testing, with or without pre and post reversibility studies; for the diagnosis and assessment of obstructive lung diseases e.g. asthma, C.O.A.D.; by a consultant respiratory physician (I.P.) Full pulmonary function studies, to include as a minimum; spirometry and measurement of static lung volumes and diffusing capacity, with or without pre and post bronchodilator studies, with or without respiratory flow volume loop, with or resistance, with or without body plethysmography; for the assessment of restrictive lung defects e.g. interstitial lung disease, sarcoidosis (not claimable for diagnosis or assessment of asthma) and including up to one annual assessment for patients with emphysema; by a consultant respiratory physician VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 Full pulmonary function studies, to include as a minimum; spirometry and measurement of static lung volumes and diffusing capacity, with or without pre and post bronchodilator studies, with or without respiratory flow volume, and, in addition, must include at least one of the following tests: measurement of respiratory muscles strength (MIP, MEP), CO response curve; airway resistance or body plethysmography; for assessment before cardio-thoracic surgery; by a consultant respiratory physician (I.P.) (see note below) Prolonged post-exposure evaluation of bronchospasm after exercise, with multiple spirometric determinations as in 2127, 2128 and 2129 including measurement of thoracic gas volume Polysomnography, full study with initiation of nasal continuous airway pressure (CPAP) titration for sleep apnoea (I.P.) (see notes after procedure codes 2122 and 2139) Nasal CPAP titration for sleep apnoea (I.P.) Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate and oxygen saturation, unattended by Cervix, local excision of lesion (I.P.) Cervix, examination under anaesthesia (I.P.) Colposcopy with Lletz procedure for lesion removal and/or Colposcopy and diagnostic biopsy (I.P.) VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 Colposcopy and therapeutic loop electrode biopsy(s) of the Dilatation and curettage (diagnostic or therapeutic) (I.P.) Hysteroscopy with insertion of intrauterine device for menorrhagia (not for contraceptive purposes) Insertion of intrauterine device for menorrhagia, not for Hysteroscopy, surgical; with endometrial resection or ablation Hysteroscopy and dilatation and curettage (diagnostic or Oophorectomy, unilateral or bilateral (complete or partial) Ovarian cystectomy, unilateral or bilateral (I.P.) Salpingectomy complete or partial, unilateral or bilateral (I.P.) Salpingostomy or salpingolysis, unilateral or bilateral (I.P.) Microsurgical tuboplasty (salpingostomy or salpingolysis), Salpingooophorectomy, complete or partial, unilateral or Ventrosuspension/Gilliam’s operation (I.P.) Endoscopic periurethral bulking injection (polydimethylsiloxane elastomer) Benefit is paid for a maximum of two treatments Atresia vaginae, relief of (including dilatation of vulva and Bartholin’s or Skene’s gland, abscess of, incision and drainage Caruncle, vulvovaginal, removal of (I.P.) Cysts or simple tumours of the vulva or vagina, excision of Repair of enterocele, vaginal or abdominal approach (I.P.) VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 Closure of rectovaginal fistula; vaginal or transanal approach Closure of rectovaginal fistula; abdominal approach with or Sacrospinous ligament fixation for prolapse of vagina (I.P.) Colpopexy, abdominal approach (I.P.) (see note below) Laparoscopy, surgical, vaginal hysterectomy, with or without removal of tube(s) and/or ovary(s) (I.P.) Diagnostic laparoscopy with or without biopsy, with or without tubal irrigation/insufflation (I.P.) Laparoscopy with or without biopsy and one or more of the following procedures: excision of lesions of ovary; pelvic viscera or peritoneal surface; diathermy of endometriosis; division of adhesions; puncture of cysts. This procedure may or may not include tubal irrigation/insufflation (I.P.) Laparoscopy with or without biopsy. This procedure also includes dilatation and curettage (diagnostic or therapeutic), with or without tubal irrigation/insufflation (I.P.) Laparoscopy with or without biopsy and one or more of the following procedures: excision of lesions of ovary; pelvic viscera or peritoneal surface; diathermy of endometriosis; division of adhesions; puncture of cysts. This procedure also includes dilatation and curettage (diagnostic or therapeutic), with or without tubal irrigation/insufflation (I.P.) Conjunctival tumour with or without graft VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 Foreign body, removal of, from conjunctiva Pterygium removal and conjunctival graft Paracentesis of anterior chamber of eye with or without Intravitreal injection of a pharmacological agent with or Intravitreal injection of Macugen for the treatment of neovascular (wet) age-related macular degeneration (AMD) (Benefit is payable in a hospital setting only) (I.P.) Removal of sutures (late Stage) corneal/sclera Intravitreal injection of Avastin for the treatment of neovascular (wet) age-related macular degeneration (AMD) (Benefit is payable in a hospital setting only) (I.P.) Intravitreal injection of Lucentis for the treatment of neovascular (wet) age-related macular degeneration (AMD) (Benefit is payable in a hospital setting only) Ulcer/Recurrent erosion, surgical treatment/Cautery with or without pricking, with or without debridement, with or without cryotherapy, one or more treatments, per episode of Excimer laser therapy for corneal pathology, per course Botulinum injection for blepharospasm or to induce ptosis Repair of ectropion; suture or thermocauterization Repair of ectropion; excision of tarsal wedge/extensive (e.g. Repair of entropion; excision tarsal wedge/extensive (e.g. tarsal strip or capsulopalpebral fascia repairs operation) Repair of entropion; suture or thermocauterization Epilation, trichiasis, correction of, by other than forceps (e.g. electrosurgery, cryotherapy, laser surgery), unilateral or bilateral, maximum benefit for four months (I.P.) Cryo to lash/electrolysis/ removal lash follicle per course of VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 Excision of chalazion, papilloma, dermoid or other cyst or lesion, single, involving skin, lid margin, tarsus, and/or palpebral Excision of chalazions, papillomas, dermoids or other cysts or lesions, one or both eyelids, involving skin, lid margin, tarsus Argon or Diode laser or Xenon Arc, for treatment of retinal or choroidal disease, glaucoma, one or more treatments YAG laser, for capsulotomy, pupil formation, iridectomy, membranectomy, ciliary body treatment, glaucoma, one or YAG laser capsulotomy, post cataract surgery Prophylaxis of retinal detachment (eg retinal break, lattice degeneration), one or more sessions cryotherapy, diathermy, Laser trabeculoplasty, one or more treatments Lacrimal abscess, (dacrocystitis) incision Lacrimal sac, syringing and probing, unilateral or bilateral Probing of nasolacrimal duct, with or without irrigation; with Punctal closure with cautery or controller Correction of everted punctum : cautery only Intraocular lens insertion not associated with concurrent Cataract extraction plus insertion of artificial lens, (includes VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 Argon laser therapy for pan - retinal photocoagulation of diabetic retinopathy or central retinal vein occlusion (per Photodynamic therapy for exudative macular degeneration one eye - all inclusive of pre therapy assessment, counselling, infusion and post therapy aseesssement, outpatient consultaations within one week of treatment (pre-therapy Photodynamic therapy for exudative macular degeneration both eyes - all inclusive of pre therapy assessment, counselling, infusion and post therapy aseesssement, outpatient consultaations within one week of treatment (pre-therapy Post operative adjustment(s) of suture(s) (payable once only Botulinum toxin injection to extraocular muscles Retrobulbar, orbital floor, subconjunctival, subtenons and facial Examination of eye under general anaesthetic (I.P.) Buried tooth roots, (includes more than one root) of one Buried tooth roots, (multiple) of teeth, removal of Extraction of teeth (more than six permanent teeth) with or Removal of one upper impacted or unerupted tooth Removal of two upper impacted or unerupted teeth Removal of one lower impacted or unerupted tooth VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 Removal of two lower impacted or unerupted teeth Removal of one impacted or unerupted canine tooth Removal of two impacted or unerupted canine teeth Labial frenectomy with dissection of tissue Removal of four or more impacted or unerupted teeth Removal of three impacted or unerupted teeth which includes Removal of three impacted or unerupted teeth which includes Removal of one upper and one lower impacted or unerupted Periodontal mucoperiosteal flap surgery, one to four teeth Periodontal mucoperiosteal flap surgery, five to eleven teeth Periodontal mucoperiosteal flap surgery, twelve or more teeth Surgical exposure and repositioning of an impacted tooth Surgical exposure and repositioning of impacted teeth Root resection or apicectomy, single, with or without cyst Root resection or apicectomy, multiple, with or without cyst Temporomandibular joint, reconstruction osteotomy of ramus and joint with costochondral graft (I.P.) Temporomandibular joint, open surgical correction of Le Fort I osteotomy (includes segmental or cleft) with or Le Fort II osteotomy (includes via bicoronal flap) with or Reimplantation of tooth in socket with splinting Osseointegrated mandibular implant including second stage VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 Two osseointegrated mandibular implants including second Three osseointegrated mandibular implants including second Four osseointegrated mandibular implants including second Simple cysts or epulis, palate or floor of mouth, excision of Five osseointegrated mandibular implants including second Six or more osseointegrated mandibular implants including Le Fort III osteotomy via bicoronal flap with or without graft Small tumours of dental origin, removal of, includes biopsy Reconstruction midface, osteotomies (other than Le Fort I type) and bone grafts (includes obtaining autografts) includes Sagittal split osteotomy with or without graft (I.P.) Vertical ramus osteotomy, intraoral or extraoral with or Fracture of phalanges and/or metacarpals, closed reduction Manipulation for treatment of dislocation of Application of Plaster of Paris casts as a separate procedure not associated with concurrent surgery (I.P.) VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 Fracture (Colles’), manipulation and Plaster of Paris Arthroscopy, elbow, diagnostic, with or without synovial biopsy, removal of loose body or foreign body, synovectomy, Closed treatment of elbow dislocation (I.P.) Arthroscopy, shoulder, diagnostic with or without synovial Manipulation of shoulder joint under general anaesthetic (I.P.) Injection of sacroiliac joint region (I.P.) (see note below) Congenital dislocation of hip, E.U.A. and P.O.P.
Drainage of hip joint for acute infection (I.P.) Hip deformity, soft tissue operations for correction of (I.P.) Arthroscopy, knee, diagnostic, with or without synovial biopsy Arthroscopy and removal of cartilage, knee VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 Arthroscopy of the knee for removal of loose body or foreign Manipulation under general anaesthetic, knee/lower leg (I.P.) Arthroscopy, ankle, with or without removal of loose body or foreign body, with or without synovectomy, debridement Arthrodesis of first metatarsophalangeal joint (I.P.) Fracture of phalanges and/or metatarsals, closed reduction of Avulsion of nail plate, partial or complete, simple Excision of nail and nail matrix, partial or complete (e.g. Initial pledget insertion for infected ingrowing toe nail, under general anaesthetic, in children under 16 years of age (I.P.) Plantar warts, surgical excision, one or more (not local Plantar warts, one or more, local application, per complete Application of body cast (surgery benefit includes removal) VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 Peripheral blood stem cell harvesting (I.P.) Removal of plates, pins, screws; superficial (includes removal of Removal of plates, pins, screws; deep dissection through muscle into bone requiring layered repair of incision Injection, tendon sheath, ligament, trigger points or ganglion Arthrocentesis, aspiration and/or injection; small joint, bursa or ganglion cyst (e.g. fingers, toes) (I.P.) (see note below) Arthrocentesis, aspiration and/or injection; intermediate joint, bursa or ganglion cyst (e.g. temporomandibular acromioclavicular, wrist, elbow or ankle, olecranon bursa) (I.P.) Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g. shoulder, hip, knee joint, subacromial bursa) (I.P.) (see Scar excisions (per scar) flexion, fingers, elbows, groin, knees Breast reduction (This procedure requires pre-certification other than reconstruction following mastectomy, please see Ground Rule 14(b) in the Surgery & Procedures Ground Rules) Excision of benign or malignant lesion(s) including repair by adjacent tissue transfer or re-arrangement (Z-plasty, VY plasty, rotation flap, transposition flap, double pedicle flap) face, ears, VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 Excision of benign or malignant lesion(s) including repair by adjacent tissue transfer or rearrangement (e.g. Z-plasty, W- plasty, V-Y plasty, rotation flap, advancement flap, double pedicle flap) for other areas not described in procedure code Keloids and hypertrophic scars intralesional injection of triamcinolone, extensive, seven or more lesions or one lesion larger than 5 sq cm where general anaesthetic is medically necessary; by Consultant Plastic Surgeon registered with Keloids and hypertrophic scars intralesional injection of triamcinolone; up to and including the sixth lesions (I.P.) Epithelioma of ear, excision and reconstruction, lobule Protruding ears, correction with reconstruction of folds, bilateral (Benefit only payable for patients up to eighteen years Protruding ears, correction of with reconstruction of folds, unilateral (Benefit only payable for patients up to eighteen years Congenital hand deformities, moderate repairs on each hand Lengthening of the mandible by gradual distraction for Surgically assisted rapid maxillary expansion Temporo mandibular joint, reduction of dislocation under Arthroscopy, temporo mandibular joint for release of adhesions or arthroplasty, with or without biopsy Fracture of nose, digital closed reduction Fracture of nose, instrumental closed reduction Fracture of nose, instrumental closed reduction with plaster of Fracture of nose, instrumental closed reduction with reduction VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 Transthoracic echocardiography for congenital or acquired cardiac anomalies in children under 16; limited study for patients where the cardiac anatomy is known or in the evaluation or follow up of patients with predominantly non- cardiac problems, where the assessment of myocardial and valvular function of pericardial effusion is required Paediatric cardiac ultrasound (echocardiography) m-mode, 2D including ventricular function, chamber dimensions, wall motion, Doppler exam assessment of valve areas, pressure Refilling and maintenance of implantable pump or reservoir Removal of subcutaneous implantable pump or spinal cord stimulator (does not apply to removal of Hickman, Broviac, Subcutaneous implantation of a patient-activated cardiac event loop recorder with memory, activator and programmer, including elecronic analysis of implantable loop system (including retrieval of recorded and stored ECG data) Insertion or replacement of temporary transvenous single chamber cardiac electrode or pacemaker catheter (I.P.) Cardiac catheterisation (left, right or both sides) (I.P.) Transoesophageal echocardiography for congenital cardiac anomalies in children under 16 years of age; including probe placement, image aquisition, interpretation and report Cardiac catheterisation and coronary angiography with or Paediatric cardiac catheterisation (left, right or both sides) Paediatric cardiac catheterisation and cardiac angiography VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 Cardiac ultrasound, (echocardiography) m-mode, 2D including ventricular function, chamber dimensions, wall motion, doppler exam (pulse, continuous wave, colour flow) assessment of valve areas, pressure gradients, regurgitant fractions Echocardiography, transoesophageal, real-time with image documentation (2D) (with or without M-mode recording), including probe placement, image acquisition, interpretation Post bypass cardiac catheterisation and coronary angiography with or without ventriculography (including opacifaction of Mediastinoscopy, with or without biopsy (I.P.) Echocardiography, foetal, cardiovascular system, real-time with image documentation (2D) (with or without M-mode Percutaneous transthoracic biopsy under CAT guidance Paracentesis thoracis with intercostal drain (I.P.) Thoracotomy including lung or pleural biopsy (I.P.) Injection trigeminal branch (peripheral) Destruction by radiofrequency lesioning of trigeminal ganglion Injection, anaesthetic agent and/or steroid or other substance, facet joint, one or more levels under image guidance Pulsed radiofrequency lesioning to peripheral nerves (I.P.) denervation/radiofrequency/neurotomy/rhizotomy/rhizolysis, VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 Injection, anaesthetic agent, intercostal nerve, single (I.P.) Injection, anaesthetic agent, intercostal nerve, multiple, regional Burr hole(s) for brain biopsy/abscess tapping Burr hole for ventricular puncture or intense care monitoring High dose radiation brachytherapy gynaecological (no surgery case). Placement of treatment applicators,computerisd planning, dosimetry and brachytherapy treatment session (code is High dose radiation brachytherapy primary treatment post mastectomy, all inclusive benefit for computerisd planning, dosimetry , placement of treatment applicators and initial Subsequent brachytherapy treatment session post mastectomy Injection, single (not via indwelling catheter), not including neurolytic substances, with or without contrast (for either localisation or epidurography), of diagnostic or therapeutic substance(s) (including anaesthetic, antispasmodic, opioid, steroid, other solution), epidural or subarachnoid; lumbar, High dose radiation brachytherapy (HDR), bronchus, benefit for placement of treatment applicators, computerised planning, Subsequent brachytherapy (HDR) treatment session (bronchus) High dose radiation oesophagusl, all inclusive benefit for placement of treatment applicators , computerisd planning, dosimetry and initial treatment session.
Subsequent brachytherapy oesophagus treatment session VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 Injection procedure (e.g. methaline blue) for discography includes fluoroscopy or other guidance during the procedure Botulinum toxin injection for treatment of cervical dystonia Craniectomy or craniotomy, exploratory, supratentorial (I.P.) Craniectomy or craniotomy, exploratory, infratentorial (I.P.) Intrathecal cytotoxic chemotherapy infusion Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion (I.P.) Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal Transtemporal approach to posterior cranial fossa, jugular foramen or midline skull base, including mastoidectomy, decompression of sigmoid sinus and/or facial nerve (I.P.) Endoscopic extirpation of lesion of mediastinum Oesophageal motility (monometric) studies with or without 24 Ureteroscopy, diagnostic, with or without biopsy Creation of pericardial window or partial resection for Closure of median sternotomy separation with or without Electromyography study, rectal mucosal sensitivity testing Ligament reconstruction at the knee joint (I.P.) Ligament reconstruction of the knee joint using autogenous Extracorporeal shock wave lithotripsy (ESWL) Ureteroscopy & contact lithotripsy with placement/removal of J stent, one or more sessions per hospital stay (I.P.) VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008 Duplex ultrasound scan, unilateral or bilateral, only one claimable per anatomical site (eg for extracranial or intracranial arteries; unilateral or bilateral – one payment applies; for lower extremity arteries, one or both legs – one payment applies) Insertion of a spinal cord stimulator – trial stage Complete investigation of “at risk” patients with allergy/anaphylaxis requiring food and drug challenge studies Insertion of a spinal cord stimulator – implantation stage Uterine artery embolisation for fibroids including angiography Image-guided percutaneous core needle biopsy, including Consultant Radiologist interpretation and report (ultrasound Completed radiological examination and evaluation including imaging (mammography and/or ultrasound), and image-guided percutaneous core needle biopsy; where performed on same VIVAS Health Consultant Procedures Payment indicators - July 2007 to June 2008

Source: http://uat.vivashealth.ie:22222/docs/All%20Consultants/Indicators%20for%20Consultant%20Procedure%20Codes%200708.pdf