| A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | ASSESSMENT CODES | MENTAL HEALTH / COUNSELLING / ASSAULT | PROCEDURAL SEDATION | |||||||||||||||||||||||
2 | *Consultation (FRCP) | H055 | $125.65 | Form 1 | K623 | $133.60 | Anaesthesia Unit Fee | $15.96 per unit | ||||||||||||||||||
3 | *Consultation (CCFP) | H065 | $95.60 | Mental Health Care(per 1/2hr) | K005 | $80.00 | Add Basic Units + Time Units + Extra Units | |||||||||||||||||||
4 | Phone Consult - ER to Other Consultant | K734 | $37.05 | General Counselling | K013 | $80.00 | Time units are from time of attendance until departure | |||||||||||||||||||
5 | Day 8:00-17:00 | Needle stick/equiv counsel | K028 | $80.00 | Code | Units | ||||||||||||||||||||
6 | Minor | H101 | $22.65 | STD counselling (1/2 hr) | K028 | $80.00 | Basic Units | 6 | ||||||||||||||||||
7 | Comprehensive | H102 | $56.70 | Bereavement counselling | K015 | $80.00 | Time Units (one unit for every | |||||||||||||||||||
8 | Multiple | H103 | $46.65 | Transplant counselling | K014 | $80.00 | 15 minutes or part thereof) | |||||||||||||||||||
9 | *Reassessment | H104 | $22.75 | Interview with CAS | K003 | $80.00 | Extra Units | |||||||||||||||||||
10 | Evening 17:00-24:00 (Mon to Thur) | Public Health | K034 | $36.00 | BMI > 40 (wt(kg)/height(m2)) | E010C | 2 | |||||||||||||||||||
11 | Minor | H131 | $30.05 | Referring Consult | K734 | $37.05 | Prone position | E011C | 4 | |||||||||||||||||
12 | Comprehensive | H132 | $75.40 | Accepting Consult | K735 | $47.75 | 60 degrees | E024C | 4 | |||||||||||||||||
13 | Multiple | H133 | $61.65 | Criticall | K736 | $37.05 | ASA III | E022C | 4 | |||||||||||||||||
14 | *Reassessment | H134 | $30.05 | Taking blood for police | K061 | $34.80 | ASA IV | E017C | 10 | |||||||||||||||||
15 | Weekend/Holiday (includes Fri after 1700) | FORMS | ASA V | E016C | 20 | |||||||||||||||||||||
16 | Minor | H151 | $34.15 | Death Certificate only | A771 | $24.20 | ASA E (emergency) | E020C | 4 | |||||||||||||||||
17 | Comprehensive | H152 | $85.70 | Pronounce +/- death cert | A777 | $44.55 | Weekend/Evening (1700-2400) | E400C | +50% | |||||||||||||||||
18 | Multiple | H153 | $69.60 | Special Diet Form | K055 | $23.20 | Night (2400-0800) | E401C | +75% | |||||||||||||||||
19 | *Reassessment | H154 | $34.15 | Home Care Referral Form/Revision | K070 | $34.75 | Age - Child 1-8 | E019C | 2 | |||||||||||||||||
20 | Night 24:00-8:00 | Min. of Transportation Report | K035 | $36.25 | - Adult 70 - 79 | E007C | 1 | |||||||||||||||||||
21 | Minor | H121 | $39.85 | SPECIAL VISIT/TRAVEL PREMIUMS | - Adult 80+ | E018C | 3 | |||||||||||||||||||
22 | Comprehensive | H122 | $99.60 | Day 0700-1700 | ASA III | |||||||||||||||||||||
23 | Multiple | H123 | $80.95 | Travel Premium (max 2) | H960 | $37.40 | patient with severe systemic disease limiting activity but | |||||||||||||||||||
24 | *Reassessment | H124 | $39.80 | 1st patient | H980 | $20.55 | not incapacitating (can walk > 2 blocks/1 flight stairs) | |||||||||||||||||||
25 | Reassess: max 3/pt/day and max of 2/MD/pt/day | Additional patients (max 4) | H981 | $20.55 | eg. angina/MI, COPD, CVA, CHF, IDDM, alcohol dependance) | |||||||||||||||||||||
26 | * need additional documentation | Evening 1700-2400 | ASA IV | |||||||||||||||||||||||
27 | HOLDING ORDERS | H105 | $29.05 | Travel Premium (max 2) | H962 | $37.40 | patient with incapacitating systemic disease that is | |||||||||||||||||||
28 | CRITICAL CARE | 1st patient | H984 | $61.70 | a constant threat to life eg (shock, sepsis, DIC, Defibrillator, | |||||||||||||||||||||
29 | Life threatening 1st 15min | G521 | $125.10 | Additional patients (max 4) | H985 | $61.70 | eg. unstable angina, recent MI/CVA, severe CHF/COPD | |||||||||||||||||||
30 | 2nd 15min | G523 | $64.50 | Weekend/Holiday | ASA V | |||||||||||||||||||||
31 | each 15 min after 1/2 hr | G522 | $42.50 | Travel Premium (max 4) | H963 | $37.40 | moribund patient not expected to live 24 hours with | |||||||||||||||||||
32 | Other resusitation | G395 | $64.70 | 1st patient | H988 | $77.10 | or without operation (eg ICH w mass effect) | |||||||||||||||||||
33 | each 15 min thereafter | G391 | $34.35 | Additional patients (max 9) | H989 | $77.10 | NERVE BLOCKS | |||||||||||||||||||
34 | Trauma Premium | E420 | add 50% | Night 2400-0700 | Blocks allowed in addition to procedure | |||||||||||||||||||||
35 | if ISS>15 (age≥16) or ISS>12 (age<16) | Travel Premium (unlimited) | H964 | $37.40 | Median, radial, ulnar, | G224 | $15.55 | |||||||||||||||||||
36 | PREMIUM CODES (for G/K codes; not H codes) | 1st patient | H986 | $102.80 | intercostal, femoral, pudendal, sciatic, | |||||||||||||||||||||
37 | A) For G/K codes (not H) | Additional patients (unlimited) | H987 | $102.80 | ilioinguinal, brachial, trigeminal, infra/supraorbital | |||||||||||||||||||||
38 | Nights 24:00-8:00 | H112 | $50.95 | Assessment Codes | Comined 3-in-1 femoral | G260 | $80.00 | |||||||||||||||||||
39 | Fri after 1700/Sat/Sun/Holiday 8-24:00 | H113 | $32.20 | Minor | A001 | $26.80 | Blocks NOT allowed in addition to procedure | |||||||||||||||||||
40 | Evenings (1700 to midnight) | H114 | $23.65 | Intermediate | A007 | $44.55 | Infraorbital | G219 | $34.20 | |||||||||||||||||
41 | B) For Procedures | General | A003 | $95.60 | Intercostal | G220 | $34.20 | |||||||||||||||||||
42 | Nights (24:00-07:00) | E413 | +40% | * Must bill A codes with special visit/travel premiums | each additional | G221 | $16.95 | |||||||||||||||||||
43 | Evenings and Weekends | E412 | +20% | Proc. Premium-#, dislocation 17-24,W/E | E409 | +50% | Mental | G225 | $34.20 | |||||||||||||||||
44 | FRACTURES - No Reduction (only 75%) | Proc. Premium-#, dislocation 24-07 | E410 | +75% | Supraorbital | G235 | $34.10 | |||||||||||||||||||
45 | Phalanx Toe (+ rigid immob) | F056 | $49.20 | LACERATIONS (glue 50%) | Maxillary/Mandibular | G250 | $75.10 | |||||||||||||||||||
46 | each additional | E560 | $12.05 | Simple up to 5cm | Z176 | $21.90 | Femoral | G243 | $54.65 | |||||||||||||||||
47 | Metatarsals (no cast) | F061 | $49.20 | Simple 5.1-10cm | Z175 | $39.35 | bilateral | G244 | $81.95 | |||||||||||||||||
48 | Metatarsals (with cast) | F062 | $67.75 | Simple 10.1-15cm | Z179 | $55.20 | Intrapleural | G258 | $44.25 | |||||||||||||||||
49 | Calcaneous | F070 | $97.35 | Simple >15cm | Z191 | $84.70 | Other peripheral nerve | G231 | $34.10 | |||||||||||||||||
50 | Ankle | F074 | $67.75 | Comp/Face up to 5cm | Z154 | $39.35 | each additional | G223 | $17.10 | |||||||||||||||||
51 | Tibia +/- Fibula | F078 | $115.95 | Comp/Face 5.1-10cm | Z177 | $78.15 | Trigger Piont | G384 | 8.85 | |||||||||||||||||
52 | Fibula (with cast) | F082 | $67.75 | Comp/Face 10.1-15cm | Z190 | $111.20 | each additional (to two) | G385 | 4.55 | |||||||||||||||||
53 | Femur with cast | F097 | $258.90 | Comp/Face >15cm | Z192 | $169.75 | transcapular | G238 | ||||||||||||||||||
54 | Patella | F085 | $67.75 | Complex >20 min - Face | Z187 | $101.15 | accessory | G227 | ||||||||||||||||||
55 | Scapula | F119 | $67.80 | Complex > 20 min - Other | Z188 | $101.15 | Peripheral Block Minor | G061 | ||||||||||||||||||
56 | Clavicle | Visit Fee | Complex > 20 min - Digit Zone 1 | Z189 | $101.15 | Femoral - Acute (i.e. #hip) | G060 | 55.00 | ||||||||||||||||||
57 | Nasal bones | Visit Fee | OTHER WOUNDS | OTHER PROCEDURES | ||||||||||||||||||||||
58 | Humerus (shaft) | F042 | $67.80 | Secondary closure | Z783 | $97.35 | Procedures NOT Billable with Crit Care Codes | |||||||||||||||||||
59 | Epicondyle | F029 | $67.75 | Muscle repair (incl. skin) | R525 | $97.95 | ECG interpretation | G313 | 9.75 | |||||||||||||||||
60 | Olecranon | F034 | $126.25 | Extensor tendon repair | R578 | $276.10 | Intubation | G211 | $38.35 | |||||||||||||||||
61 | Radius and Ulna (shaft) | F024 | $67.75 | Flexor tendon repair | R585 | $307.60 | Cardioversion (can bill with G3's) | Z437 | $92.45 | |||||||||||||||||
62 | Radius or Ulna | F031 | $67.75 | Foreign body deep to dermis | R517 | $107.70 | Central line | G269 | $31.25 | |||||||||||||||||
63 | Colles'/Smith's | F027 | $67.75 | Earlobe laceration | R024 | $100.65 | Arterial line | G268 | $31.25 | |||||||||||||||||
64 | Carpal | F102 | $49.20 | Vaginal laceration | P036 | $54.40 | Therapeutic gastric lavage | G356 | $33.80 | |||||||||||||||||
65 | Scaphoid | F018 | $49.20 | Amputate phalanx | R606 | $161.45 | Transthoracic Pacing | G115 | $46.30 | |||||||||||||||||
66 | Metacarpals | F008 | $49.20 | *Revision Amputation Finger | R629 | $241.55 | Intravenous Adult/Child | G379 | $6.15 | |||||||||||||||||
67 | Bennett's | F012 | $49.20 | Needs Operative Report submitted with claim | Intravenous Infant/neonate | G376 | $10.20 | |||||||||||||||||||
68 | Phalanx Finger(+rigid immob) | F004 | $49.20 | Debridement of Wound | Z080 (1) | $21.90 | Intraosseous | G270 | $23.90 | |||||||||||||||||
69 | each additional | E558 | $22.25 | Z081 (2) | $32.90 | ABG | Z459 | $9.55 | ||||||||||||||||||
70 | tarsal | F066 | $98.10 | Z082 (3) | $49.30 | Procedures Billable with Critical Care Codes | ||||||||||||||||||||
71 | FRACTURES - Closed Reduction (only 75%) | Z083 (4) | $65.75 | Pericardiocentesis | Z401 | $131.70 | ||||||||||||||||||||
72 | Phalanx Toe | F058 | $72.35 | intertendon | Z084 | $65.75 | Chest tube insertion | Z341 | $76.80 | |||||||||||||||||
73 | each additional | E561 | $14.90 | bone/ligament | Z085 | $98.65 | Chest tube removal | Z363 | $20.00 | |||||||||||||||||
74 | Metatarsals | F063 | $98.35 | Burn Debride- Hand digit EACH | R660 | $31.60 | Lumbar puncture | Z804 | $150.00 | |||||||||||||||||
75 | Calcaneous | F071 | $161.45 | Burn Debride- Dosum, palm EACH | R661 | $52.55 | Paracentesis diagnostic | Z590 | $31.30 | |||||||||||||||||
76 | Ankle | F075 | $144.80 | Burn Debride nose, cheek, lip, ear.. EACH | R662 | $31.65 | Paracentesis therapeutic | Z591 | $57.65 | |||||||||||||||||
77 | Ankle with Tibial Plafond Burst | F104 | $242.25 | Burn Debride NOT hand, head,neck per %BSA | R637 | $32.50 | Peritoneal lavage | Z763 | $38.70 | |||||||||||||||||
78 | Tibia +/- Fibula | F079 | $180.05 | MINOR SURGERY | Thoracentesis-therapeutic or diagnostic | Z332 | $104.40 | |||||||||||||||||||
79 | Fibula | F083 | $101.25 | Abscess/hematoma I&D | Local | IM / SC injection | G372 | $3.89 | ||||||||||||||||||
80 | Femur - shaft (with traction) | F095 | $407.35 | one | Z101 | $28.20 | Inject/aspirate joint/bursa | G370 | $20.25 | |||||||||||||||||
81 | Femur - Neck/Troch/Subtroch (w traction) | F098 | $426.90 | two | Z173 | $33.25 | -each additional one | G371 | $19.90 | |||||||||||||||||
82 | Sternum | F123 | $115.95 | three or more | Z174 | $44.70 | Inject/aspirate joint/bursa: complex not knee | G328 | $39.80 | |||||||||||||||||
83 | Clavicle | F110 | $62.20 | pilonidal/ischiorectal | Z106 | $48.60 | Spirometry | J301 | $7.85 | |||||||||||||||||
84 | Nasal bones | F136 | $102.35 | perianal | Z104 | $33.25 | after bronchodilator | J324 | $4.20 | |||||||||||||||||
85 | Humerus (shaft) | F043 | $147.60 | hemmorhoid | Z545 | $25.25 | Obstetrics vaginal delivery | P006 | $498.70 | |||||||||||||||||
86 | Epicondyle | F037 | $126.25 | palmar/plantar | Z103 | $44.35 | - sole delivery on that day | E411 | +100% | |||||||||||||||||
87 | Olecranon | F035 | $129.00 | breast | Z140 | $33.00 | Perimortum C-section | P018 | $579.80 | |||||||||||||||||
88 | Radius and Ulna (shaft) | F025 | $148.50 | oral | Z506 | $50.90 | Epley Manoeuvre | G403 | $21.15 | |||||||||||||||||
89 | Radius or Ulna | F032 | $117.85 | oropharynx | Z510 | $91.10 | Induction of Hypothermia | G210 | $190.75 | |||||||||||||||||
90 | Colles'/Smith's | F028 | $109.45 | nose | Z301 | $55.60 | Transvenous pacer | Z443 | $154.10 | |||||||||||||||||
91 | Colles'/Smith's w/ General Anaesthetic | F046 | $149.35 | Bartholin's (don't use this code, use Z101) | Z714 | $17.30 | - Reposition pacing wire | Z431 | $64.25 | |||||||||||||||||
92 | Metacarpals | F009 | $99.25 | Pinna | E318 | $92.40 | CASTS/SPLINTS (not billed if fracture code used) | |||||||||||||||||||
93 | Bennett's | F013 | $119.80 | Eye lid | Z854 | $60.00 | Cast Removal (after 2/52) | Z204 | $10.25 | |||||||||||||||||
94 | Phalanx Finger | F005 | $99.25 | Nail removal (single) | Z128 | $36.30 | Hand | Z202 | $14.90 | |||||||||||||||||
95 | each additional | E558 | $22.25 | Nail removal (multiple) | Z129 | $39.20 | Finger | Z201 | $10.25 | |||||||||||||||||
96 | Phalanx Finger (open reduction) | F007 | $191.30 | Nail wedge resection | Z130 | $68.75 | Foot | Z199 | $14.90 | |||||||||||||||||
97 | tarsal | F067 | $165.20 | Nail trephination | Z101 | $28.20 | Arm/forearm/wrist | Z203 | $24.10 | |||||||||||||||||
98 | Pelvis (binding pelvis?) | F134 | $750.00 | Skin lesion excise/suture | Below Knee | Z213 | $24.10 | |||||||||||||||||||
99 | DISLOCATIONS | one | Z162 | $20.00 | Full Leg | Z211 | $28.80 | |||||||||||||||||||
100 | AC or SC Joint - reduction | D014 | $67.80 | two | Z163 | $26.50 | Toes | Z198 | $10.25 |