Fee Navigator®

    Health Service Code 17.39D

    Brachial plexus exploration, full 60 minutes or major portion thereof for the first call when only one call is claimed

    NOTE:
    1. May not be claimed with other procedures.
    2. Each subsequent 15 minutes, or major portion thereof, is payable at the rate specified on the Price List after the first full 60 minutes has elapsed.
    Category:14 Major Procedure (pre-operative period: 30 days, post-operative period: 14 days)
    Base rate:$647.81

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANEYesIncrease By25%
    BMIBMIANTYesIncrease By25%
    BMIBMIPROYesIncrease By25%
    ROLEANEYesReplace Base$202.64
    ROLEANESTYesReplace Base$18.39
    ROLEMSRGPYesReplace Base$518.25
    ROLESAYesReplace Base$148.05
    ROLESAQSYesReplace Base$50.97
    ROLESSSTYesReplace Base$280.58
    ANUANU1For Each Call Pay Base At100%
    ANUANU2 - 288For Each Call Increase By$18.39
    SAUSAU1For Each Call Pay Base At100%
    SAUSAU2 - 93For Each Call Increase By$37.04
    2MPU2MPU1 - 24For Each Call Pay Base At100%
    SAQUSAQU1 - 96For Each Call Pay Base At100%
    CALLH1M151For Each Call Pay Base At100%
    CALLH1M152 - 92For Each Call Increase By$161.93
    SURCEVYesIncrease By$48.70
    SURCNTAMYesIncrease By$116.83
    SURCNTPMYesIncrease By$116.83
    SURCWKYesIncrease By$48.70

    Governing Rules:

    • 6.8.1

      HSCs with a designated category code of 1 and 15 include related post-operative services and those with a designated category code of 3, 4, 6 and 14 include both related pre-operative and post-operative services.

      1. a consultation benefit may be claimed up to and including the day of surgery.
      2. pre-operative hospital care may be claimed by the physician who performs the surgery if information is submitted to show that conservative treatment was attempted before surgery was performed.
      3. benefits may be claimed as applicable for complications occurring during or following post-operative time periods.
      4. Deleted
      5. HSC 03.04R may be claimed in the pre-operative time frame when all conditions in the notes have been met.

      The following chart gives the pre-operative and post-operative periods.

      CategoryPre-operativePost-operative
      10 - Days14 - Days
      37 - Days7 - Days
      47 - Days14 - Days
      614 - Days14 - Days
      1430 - Days14 - Days
      150 - Days7 - Days