Health Service Code 09.41B
Interpretation
NOTE:
Only one 09.41B fee, per patient, should be claimed, regardless of the number of tests performed per day.
| Category: | T Test |
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| Base rate: | $16.89 |
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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.
