Health Service Code 03.56B
Non-invasive cardiac study, interpretation
NOTE:
Includes apexcardiogram, carotid pulse tracing, phonocardiogram plus or minus systolic time intervals.
Category: | T Test |
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Base rate: | $34.07 |
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Fee modifiers:
No modifiers.
Governing Rules:
2.5.2
Unless otherwise specified in this Schedule, HSCs designated with a T category code may be claimed with visits and consultations on the same day.
4.4.8 CLAIMS REQUIRING REFERRING PRACTITIONER NUMBER
When a claim is submitted for the following HSCs, the referring practitioner field must be completed with a valid referring practitioner number.
HSCs in the following list marked with an asterisk(*) cannot be self-referred. Self-referred means the physician is providing the diagnostic service and treating the patient.
HSCs in Section E (Lab and Pathology) and X (Diagnostic Radiology) require a valid referring practitioner number with the following exceptions: HSC X27D does not require a referral and HSC X27F may be self-referred. HSC 03.03D requires a valid referring physician, chiropractor, midwife, podiatrist, dentist, optometrist, physical therapist or nurse practitioner number when it is a visit to a referred patient.
6.5 NON-INVASIVE DIAGNOSTIC PROCEDURES IN HOSPITAL, AACC OR UCC
Benefits for non-invasive diagnostic procedures including HSCs in Section E (Laboratory and Pathology) and X (Diagnostic Radiology) performed for a hospital inpatient, registered outpatient or AACC or UCC patient are not payable under the Schedule. Payment for these services is the responsibility of the hospital/Regional Health Authority. This applies to both the technical and professional components. Such procedures include but are not limited to the following list.
11.2 ELECTROCARDIOGRAPHY/TAPE ECG/CARDIOVASCULAR STRESS TESTING
A claim for HSCs 03.41A, 03.41B, 03.41C, 03.44A, 03.52B, 03.52D, 03.55B and 03.56B may be submitted by physicians who have been approved by the CPSA to provide these services. For purposes of claims for HSC 03.52D, CPSA approval for ECGs will be used as a proxy.