0001 For involuntarily scheduled after-hours emergency radiological services, the additional premium shall be 50% of the fee for the particular services (section 19.12 excluded). See general rule B.
For after-hours MR scans, a maximum levy of 100,00 radiological units (R781.10) is applicable.
0002 Item 38/0101: First consultation: Normal hours: At a doctor’s room or home: Radiologist, is applicable only where a radiologist is requested to give a written report on x-rays taken elsewhere and submitted to him. This item and item 0103 are not to be used for routine reporting of x-rays taken elsewhere.
0005 Multiple procedures/operations under the same anaesthetic.
(a) Unless otherwise identified in the tariff when multiple procedures/operations add significant time and/or complexity, and when each procedure/operation is clearly identified and defined, the following values shall prevail: 100% (full value) for the first or major procedure/operation, plus 50% (half of) the tariff fee in respect of each additional operation or procedure with a maximum of four additional operations or procedures.
(b) In the case of multiple fractures and/or dislocations the same values shall prevail.
(c) When purely endoscopic diagnostic procedures or diagnostic endoscopic procedures unrelated to any therapeutic procedures performed, are performed under the same general anaesthetic, modifier 0005 is not applicable to the fees for such diagnostic endoscopic procedures as the fees for endoscopic procedures do not provide for after-care. Specify unrelated endoscopic procedure and provide diagnosis to indicate diagnostic endoscopic procedure(s) unrelated to other (therapeutic) procedures performed under the same anaesthetic.
(d) Please note: When more than one small procedure is performed and the tariff makes provision for items for "subsequent" or "maximum for multiple additional procedures" (see section 2. Integumentary System) modifier 0005 is not applicable as the fee is already a reduced fee.
Note: In the case of multiple fractures and/or dislocations the same values shall prevail.
0006 A 25% reduction in the fee for a subsequent operation for the same condition within one month shall be applicable if the operations are performed by the same surgeon (an operation subsequent to a diagnostic procedure is excluded). After a period of one month the full fee is applicable.
0007
(a) Remuneration for the use of any type of own equipment in the rooms for procedures performed under intravenous sedation or for procedures performed in a hospital or day-clinic theatre when appropriate equipment is not provided by the hospital - 15,00 clinical procedure units (R114.00) irrespective of the number of items of equipment provided.
(b) Remuneration for the use of any type of own equipment for procedures performed in a hospital theatre or unattached theatre unit when appropriate equipment is not provided by the hospital - 15,00 clinical units (R114.00) irrespective of the number of items of equipment provided.
0008 Where a procedure requires a registered specialist surgeon assistant, the fee is 33,33% (1/3) of the fee for the specialist surgeon.
0009 The fee for an assistant is 20% of the fee for the specialist surgeon, with a minimum of 36,00 clinical procedure units (R273.50).
0010 A fee for a local anaesthetic administered by the operator may only be charged for an operation or a procedure having a value greater than 30,00 clinical procedure units (i.e. 31,00 or more units - R235.50 - allocated to a single item). The fee shall be calculated according to the basic anaesthetic fees for the specific operations. Anaesthetics time may not be charged for, but the minimum fee as per modifier 0036 shall be applicable in such a case. Not applicable to radiological procedures (such as angiography and myelography). No fee may be levied for topical application of local anaesthetic. Please note: modifier 0010 may not be added to the surgeon's account for procedures that were performed under general anaesthetic.
0011 Emergency surgery for theatre procedures: Any bona fide, justofiable emergency procedure (all hours) (for IOD patients only applicable during after-hour periods only - see general rule B) undertaken in a operating theatre will attract an additional 12,00 clinical procedure units (R91.20) per half-hour or part thereof of the operating time for all members of the surgical team. This does not apply in respect of patients on scheduled lists.
0013 Endoscopic examinations done at operations: Where a related endoscopic examination is done at an operation by the operating surgeon or the attending anaesthesiologist, only 50% of the fee for the endoscopic examination may be charged.
0014 Where an operation is performed which has been previously performed by another surgeon, e.g. a revision or repeat operation, the fee shall be calculated according to the tariff for the full operation plus an additional fee to be negotiated under General Rule J, except where already specified in the tariff.