Procedimiento N° 14 Elaboración de Guía de Horarios

C162 - first five weeks ...per visit 31.00 C167 - sixth to thirteenth week inclusive (maximum 3 per patient per week)....per visit 31.00 C169 - after thirteenth week (maximum 6 per patient per month) ...per visit 31.00

Subsequent visits by the Most Responsible Physician (MRP) See General Preamble GP29 to GP30 for terms and conditions.

C122 - day following the hospital admission assessment ... 58.80 C123 - second day following the hospital assessment... 58.80 C124 - day of discharge ... 58.80

Subsequent visits by the MRP following transfer from an Intensive Care Area See General Preamble GP31 for terms and conditions.

C142 - first subsequent visit by the MRP following transfer from an Intensive Care Area 58.80 C143 - second subsequent visit by the MRP following transfer from an Intensive Care

Area ... 58.80 C121 Additional visits due to intercurrent illness (see General Preamble GP28) per visit 31.00 C168 Concurrent care ...per visit 31.00 C982 Palliative care (see General Preamble GP34) ...per visit 31.00

NON-EMERGENCY LONG-TERM CARE IN-PATIENT SERVICES

Non-Emergency Long-Term Care In-Patient Services includes Chronic Care Hospitals, Convalescent Hospitals, Nursing Homes, Homes for the Aged, designated chronic or convalescent care beds in hospitals and nursing homes or homes for the aged, other than patients in designated palliative care beds. For emergency calls and other special visits to in-patients, use General Listings and Premiums when applicable - see General Preamble

GP44 to GP52.

W165 Consultation ... 157.00 W765 Consultation, patient 16 years of age and under... 167.00 W160 Comprehensive nephrology consultation - subject to the same conditions as A160 300.70 W865 Limited consultation... 105.25 W869 Periodic health visit ... 65.05 W164 General re-assessment of patient in nursing home (as per the Nursing Homes Act)* 20.60

Note:

*May only be claimed 6 months after Periodic health visit (as per the Nursing Homes Act).

Subsequent visits (see General Preamble GP33) Chronic care or convalescent hospital

W162 - first 4 subsequent visits per patient per month ...per visit 32.20 W161 - additional subsequent visits (maximum of 6 per patient per month)...per visit 21.20 W982 - palliative care (see General Preamble GP34) ...per visit 32.20

Nursing home or home for the aged

W163 - first 2 subsequent visits per patient per month ...per visit 32.20 W168 - subsequent visits per month (maximum of 3 per patient per month)...per visit 21.20 W972 - palliative care (see General Preamble GP34) ...per visit 32.20 W121 Additional visits due to intercurrent illness (see General Preamble GP33).per visit 31.00

NEUROLOGY (18)

GENERAL LISTINGS

A185 Consultation... 176.35 Special neurology consultation

Special neurology consultation is a consultation in which the physician provides all the elements of a consultation (A185) and spends a minimum of 75 minutes of direct contact with the patient exclusive of time spent rendering any other separately billable intervention to the patient.

A180 Special neurology consultation ... 300.70 Medical record requirements:

The service is eligible for payment only if start and stop times of the service are recorded in the patient's permanent medical record.

A385 Limited consultation ... 84.95 A186 Repeat consultation ... 84.95 A183 Medical specific assessment ... 78.80 A184 Medical specific re-assessment... 62.10 A181 Complex medical specific re-assessment... 71.90 A188 Partial assessment ... 37.65 E078 - chronic disease assessment premium (see General Preamble

GP16) ...add 50%

Complex neuromuscular assessment

A complex neuromuscular assessment is an assessment for the ongoing management of the following diseases of the neuromuscular system where the complexity of the condition requires the continuing management by a neurologist:

a. generalized peripheral neuropathies;

b. myopathies;

c. diseases of the neuromuscular junction; or d. diseases of the motor neurone.

A113 Complex neuromuscular assessment... 89.85 Payment rules:

1. A complex neuromuscular assessment must include the elements of a medical specific re-assessment, or the amount payable will be adjusted to lesser assessment fee.

2. This service is not eligible for payment to a physician for the initial evaluation of the patient by that physician.

3. Complex neuromuscular assessments are limited to 6 per patient, per physician, per 12 month period. Services in excess of this limit will be adjusted to a lesser assessment fee.

4. E078 is not eligible for payment with A113.

[Commentary:

1. A complex neuromuscular assessment is for the ongoing management of complex neuromuscular disorders, where the complexity of the condition requires the continuing management by a neurologist. It is not intended for the evaluation and/or management of uncomplicated neuromuscular disorders (e.g. carpal tunnel syndrome, Bell’s palsy, asymptomatic diabetic neuropathy).

2. A consultation or assessment service, as appropriate, may be claimed for the initial evaluation of a patient. A complex neuromuscular assessment is for the ongoing management of a patient with a complex neuromuscular disorder.]

NEUROLOGY (18)

EMERGENCY OR OUT-PATIENT DEPARTMENT (OPD)

Physician in hospital but not on duty in the Emergency Department when seeing patients in the Emergency or OPD - use General Listings.

NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES

See General Preamble GP26 to GP32. For emergency calls and other special visits to in-patients, use General Listings and Premiums when applicable - see General Preamble GP44 to GP52.

C185 Consultation... 176.35 C180 Special neurology consultation - subject to the same conditions as A180 ... 300.70 C385 Limited consultation ... 84.95 C186 Repeat consultation ... 84.95 C183 Medical specific assessment ... 78.80 C184 Medical specific re-assessment... 62.10 C181 Complex medical specific re-assessment... 71.90 C113 Complex neuromuscular assessment - subject to the same conditions as A113 .... 89.85

Subsequent visits

C182 - first five weeks ...per visit 31.00 C187 - sixth to thirteenth week inclusive (maximum 3 per patient per week)....per visit 31.00 C189 - after thirteenth week (maximum 6 per patient per month) ...per visit 31.00

Subsequent visits by the Most Responsible Physician (MRP) See General Preamble GP29 to GP30 for terms and conditions.

C122 - day following the hospital admission assessment ... 58.80 C123 - second day following the hospital assessment ... 58.80 C124 - day of discharge... 58.80

Subsequent visits by the MRP following transfer from an Intensive Care Area See General Preamble GP31 for terms and conditions.

C142 - first subsequent visit by the MRP following transfer from an Intensive Care Area 58.80 C143 - second subsequent visit by the MRP following transfer from an Intensive Care

Area ... 58.80 C121 Additional visits due to intercurrent illness (see General Preamble GP28) .per visit 31.00 C188 Concurrent care ...per visit 31.00 C982 Palliative care (see General Preamble GP34)...per visit 31.00

April 1, 2015

NEUROLOGY (18)

NON-EMERGENCY LONG-TERM CARE IN-PATIENT SERVICES

Non-Emergency Long-Term Care In-Patient Services includes Chronic Care Hospitals, Convalescent Hospitals, Nursing Homes, Homes for the Aged, designated chronic or convalescent care beds in hospitals and nursing homes or homes for the aged, other than patients in designated palliative care beds. For emergency calls and other special visits to in-patients, use General Listings and Premiums when applicable - see General Preamble GP44 to GP52.

W185 Consultation... 176.35 W180 Special neurology consultation - subject to the same conditions as A180 ... 300.70 W385 Limited consultation... 84.95 W186 Repeat consultation... 84.95 W113 Complex neuromuscular assessment - subject to the same conditions as A113.... 89.85 W184 General re-assessment of patient in nursing home (as per the Nursing Homes Act)* 20.60

Note:

*May only be claimed 6 months after Periodic health visit (as per the Nursing Homes Act).

Subsequent visits (see General Preamble GP33) Chronic care or convalescent hospital

W182 - first 4 subsequent visits per patient per month ...per visit 32.20 W181 - additional subsequent visits (maximum of 6 per patient per month)...per visit 21.20 W982 - palliative care (see General Preamble GP34) ...per visit 32.20

Nursing home or home for the aged

W183 - first 2 subsequent visits per patient per month ...per visit 32.20 W188 - subsequent visits per month (maximum of 3 per patient per month) ...per visit 21.20 W972 - palliative care (see General Preamble GP34) ...per visit 32.20 W121 Additional visits due to intercurrent illness (see General Preamble GP33) .per visit 31.00

April 1, 2015

NEUROSURGERY (04)