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PP4U:ERRATA TO THE 2019 MEDICAL DOCTORS' CODING MANUAL

 

 

ERRATA TO THE 2019 MEDICAL DOCTORS’ CODING MANUAL

Interpretation of item 0146
The wording of the third bullet of the interpretation of item 0146: For an EMERGENCY consultation/visit AT the medical doctor's home or rooms: ADD only to the consultation/visit items 0190-0193, items 0161-0164 or items 0151-0153, as appropriate. Note: Only one of items 0145, 0146, 0126 or 0147 may be coded and not combinations thereof, has to be amended. This change was also made to the eMDCM Browser.

This change was also made to the eMDCM Browser.

0146

• Only one of items 0145, 0146, 0126 or 0147 may be added to a consultation/visit item, (as appropriate) and not combinations thereof
• Refer to item 0126 for UNSCHEDULED consultation/visit at doctor's rooms or home
• To be added to items 0190-0193 (as appropriate) for emergency or unscheduled consultations in rooms
• To be added to items 0190-0193 (as appropriate) for consultations by doctors normally using 24-hour emergency facilities
• The patient is responsible for the payment if his/her medical scheme does not grant benefits for this service (not applicable to Compensation Fund cases)
• Rule P is only applicable to emergency travel to a place where the doctor does not normally perform voluntary services, such as hospital visits.

Interpretation of item 0733 and item 0735 The wording of the interpretation of item 0733: Motor nerve conduction studies (single nerve) and item 0735: Examinations of sensory nerve conduction by sweep averages (single nerve) - Anaesthetic: If required has to be amended as proposed by the Neurology Association of SA (NASA) to read as follows. This change was also made to the eMDCM Browser.

0733

• For carpal tunnel use item 0733 a maximum of 2 times per patient per side (right arm and left arm)
• For peripheral neuropathy, radiculopathy, plexopathy use item 0733 a maximum of 8 times per patient

0733

• For carpal tunnel use item 0735 a maximum of 2 times per patient per side (right arm and left arm) • For peripheral neuropathy, radiculopathy, plexopathy use item 0735 a maximum of 6 times per patient

Interpretation of item 1232
The wording of the interpretation of item 1232: Electrocardiogram: Without effort (interpretation included) was incorrect and was amended to read as follows: This change was also made to the eMDCM Browser:

1232

• A specialist physician/paediatrician is entitled to a code for the interpretation of an ECG tracing referred to him/her by another doctor (refer to item 1230 or item 1231)
• Item 1232 may not be used in conjunction with items 1230, 1231, 1233, 1234, 1235, 1236 and 1240
Item 1232 is not to be coded by the doctor performing the ECG
Item 1232 includes the interpretation of the ECG

Interpretation of item 1252
This new interpretation was added to item 1252: Left heart catheterisation with coronary angiography (with or without biopsy). This change was also made to the eMDCM Browser:

1252

• Item 1252 is a diagnostic procedure followed by item 1276 or item 1277 (therapeutic procedure)

Interpretation of item 1276 and item 1277
The wording of the interpretation of item 1276: Percutaneous transluminal angioplasty: First cardiologist: Single lesion and item 1277: Percutaneous transluminal angioplasty: Second cardiologist: Single lesion were incorrect and was amended to read as follows: This change was also made to the eMDCM Browser:

1276

  • Item 1276 includes cardiac catheterisation and angioplasty
  • Item 1276 is a therapeutic procedure added to item 1252 (diagnostic procedure)
  • Aftercare not included (PPC May 2000)

1276

  • Item 1276 includes cardiac catheterisation and angioplasty
  • Item 1276 is a therapeutic procedure added to item 1252 (diagnostic procedure)
  • Aftercare not included (PPC May 2000)

Interpretation of item 1949, item 2545: and item 2548
Add a new interpretation to item 1949: Cystoscopy: Hospital equipment. Please replace the interpretation at item 2545: Surgery for stress incontinence: Vesicourethropexy/urethropexy; abdominal approach with the amended interpretation and add a new interpretation to item 2458: Surgery for stress incontinence: Use of tape/fascia. These changes were also be made to the eMDCM Browser:

1949

  • • Item 1949 may not be coded in addition to item 2548 or item 2549

2545

  •  Item 1949 may not be coded in addition to item 2548
  •  Item 1949 may not be coded in addition to item 2545

2548

  •  Item 1949 may not be coded in addition to item 2548

Interpretation of item 3090
Please add the new interpretation to item 3090: Intra-vitreal injection drug. This interpretation was added to the eMDCM Browser

3090

  • Modifier 0004 may be added once to item 3090 per session when the intra-vitreal injection drug is being administered in the doctor’s rooms.

Interpretation of item 3183
The wording of the interpretation of item 3183: Entropion or ectropion by free skin, mucosal grafting or flap was incorrect and was amended. This change was also be made to the eMDCM Browser.

3183

  •  Item 3183 may not to be used in conjunction with item 3179 or item 3183 3181

2019 eMDCM
Description of item 2497 in the eMDCM
The description of item 2497: Laparoscopy and sterilisation (occlusion of oviducts by device e.g. band, clip, or Falope ring) - stand-alone procedure in the eMDCM has been replaced to read as follows.

2497

  • Laparoscopy and sterilisation (occlusion of oviducts by device e.g. band, clip, or Falope ring) - stand-alone procedure

The description of item 2497 is correct in the 2019 MDCM

The Scale of Fees for Compensation for Occupational Injuries and Diseases Act (COID) Changes in the Rules, Codes, Descriptions and Units applicable from 1 April 2019
These are the changes that have been noted and identified between the 2018/2019 and 2019/2020 COID Gazettes:

Codes

Changes Made

Units

Fixed Amount

ò 0136

Applicable to Compensation Fund cases only: Item 0136: Special medical examination requested by the Compensation Fund. Amount applicable from 2019/04/01 until further notice (VAT inclusive) - please note this is a fixed amount

127.14

R3724,00

òD ● 2058

Applicable to Compensation Fund cases only: DISCONTINUED 2019: Item 2058 [Urologist: Non-surgical supervision of head/brain injuries, spinal injuries (including paraplegics) or burns. All urodynamic studies excluded and charged for separately under items 1979, 1981, 1991 and 1992 of the Tariff. Note: This code is applicable to non-operational supervision of head/brain injuries, spinal injuries or burns for urologists if patient is in a hospital or step-down facility. This code must be claimed where the occurrence of code 0109 exceeds 20 within a period of 4 calendar months. (General Rule G and N(c) refers)] has been discontinued 2019-04-01

• The Office of the Compensation Fund confirmed that for the rehabilitation codes item 2918 and item 2058, that has been discontinued in the latest Government Gazette, medical doctors may now use item 0109 for non-operative supervision of head/brain injuries, spinal injuries (including paraplegics) or burns, even if it exceeds 20 visits within a period of 4 calendar months if the patient is in a hospital or step-down facility.

 

 

òD ● 2918

Applicable to Compensation Fund cases only: DISCONTINUED 2019: Item 2918 [Non-operative supervision of head/brain injuries, spinal injuries (including paraplegics) or burns for all disciplines, except urologists. Note: This code is applicable to non-operational supervision of head/brain injuries, spinal injuries or burns for all disciplines if patient is in a hospital or step-down facility. This code must be claimed where the occurrence of code 0109 exceeds 20 within a period of 4 calendar months. (General Rule G and N(c) refers)] has been discontinued from 2019-04-01

• The Office of the Compensation Fund confirmed that for the rehabilitation codes item 2918 and item 2058, that has been discontinued in the latest Government Gazette, medical doctors may now use item 0109 for non-operative supervision of head/brain injuries, spinal injuries (including paraplegics) or burns, even if it exceeds 20 visits within a period of 4 calendar months if the patient is in a hospital or step-down facility.

 

 

The Medical Doctors’ Coding Manual (MDCM) browser information on the SAMA webpage www.samedical.org was amended and the latest version of these items is available on the web.

Kind regards
Medical Coding Division of the
SAMA Private Practice Department
E-mail: coding@samedical.org
Tel: 012 4012073 

The South African Medical Association - Postal Address-The South African Medical Association P O Box 74789,Lynnwood Ridge Pretoria 0040, South Africa Physical address The South African Medical Association, Block F Castle Walk Corporate Park Nossob Street Erasmuskloof Ext3 Pretoria 0181,
South Africa www.samedical.org

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