| Category: | M Minor Procedure |
|---|---|
| Base rate: | $31.51 |
| Type | Code | # of calls | Explicit | Action | Amount |
|---|---|---|---|---|---|
| CALL | NBRSER | 1 | For Each Call Pay Base At | 100% | |
| CALL | NBRSER | 2 - 2 | For Each Call Pay Base At | 75% | |
| TRAY | MINT | Increase By | $13.14 | ||
| NBTR | NBTR | Yes | |||
| LVP | LVP75 | Yes | Reduce Base To | 75% |
If a physician performs a minor procedure and provides a service warranting a claim for an office visit or a home visit on the same day, benefits for both may be claimed only if the services and diagnoses are unrelated.
If a service is provided in a hospital emergency department, AACC or UCC, only the minor procedure or the visit benefit, whichever is the greater, may be claimed, unless the problems are emergencies and the diagnoses are unrelated.
If a minor procedure (M or M+) is provided with a hospital visit on the same day, only the greater benefit HSC may be claimed.
Three technical services and three interpretive services from the following examinations may be claimed in addition to HSCs 03.04A, 03.04AZ, 03.08A, 03.08AZ, 03.08H and 09.04:
Three technical services and three interpretive services from the following examinations may be claimed in addition to HSCs 03.02A, 03.03A, 03.03AZ, 03.07A, 03.07AZ, and 03.07B:
When done independently on a separate day or as a repeat, not more than three interpretations and three technical services from the list in GR 9.1.3 may be claimed.
Unless otherwise specified, the HSCs listed under GR 9.1.2 and 9.1.3 include both the technical and interpretive components.
A minor tray service benefit may be claimed for the following procedures only when they are performed in a location other than a nursing home, general or auxiliary hospital, AACC, UCC or a facility which has a contract with a regional health authority to provide any of these insured services.
| 07.53C | 07.56A | 07.57B | 10.16A | 11.23A | 12.01 |
| 12.21 | 13.53B | 13.59E | 13.59F | 13.59H | 13.59J |
| 13.59K | 13.59L | 13.59N | 13.99BB 16.89B | 16.89C | |
| 16.89D | 17.71A | 17.71B | 18.29E | 18.29EA 19.81 |
| 21.31A | 21.41 | 21.32D | 21.69C | 23.99D | 24.91 |
| 30.19A | 32.96A | 32.96B | 33.01A | 33.03A | 33.21A |
| 33.22A | 33.61A | 35.0 A | 37.81 | 37.91A | 38.0 A |
| 39.91B |
| 43.0 B | 50.98A | 51.92A | 53.81B |
| 61.01A | 67.93 | 70.5 B | 71.95 | 73.91 | 78.7 A |
| 79.22 |
| 80.83B | 81.8 | 93.91A | 93.91B | 94.01B | 94.04 |
| 95.03 | 95.93 | 95.94A | 95.94B | 95.96A | 97.81 |
| 97.89A | 98.01A | 98.03A | 98.03B | 98.03C | 98.03E |
| 98.04B | 98.04C | 98.12K | 98.12S |
If multiple procedures listed under GRs 14.1 and 14.2 are performed during the same encounter in a location other than a nursing home, general or auxiliary hospital, AACC, UCC or a facility which has a contract with a regional health authority to provide any of these insured services, the following applies:
For the same anatomical area (example - 3 moles removed from the face), only one tray may be claimed except when the condition relates to suspected cancer or infection, in which case, if required, additional tray(s) may be claimed at 50%.
For different anatomical areas, the tray for the initial procedure may be claimed at 100% and if required, the tray for each additional procedure may be claimed at 50%.
Benefits for additional trays may not exceed the benefit listed for one major tray.
