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    Health Service Code 66.19D

    Laparotomy for trauma patients, first 60 minutes

    NOTE:
    1. Benefit includes exploration of hematoma(s), Kockerization of duodenum, lesser sac and control of minor bleeding as well as other explorations for injury in trauma patients.
    2. Each subsequent 15 minutes or major portion thereof may be claimed at the rate specified on the Price List.
    3. Other procedures may be claimed in addition but the time spent in performing them may not be included in the time claimed for this procedure.
    4. A maximum of three hours may be claimed.
    5. HSC 66.67A may be claimed in addition.
    Category:14 Major Procedure (pre-operative period: 30 days, post-operative period: 14 days)
    Base rate:$433.14

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANEYesIncrease By25%
    BMIBMIPROYesIncrease By25%
    BMIBMI2ANYesIncrease By25%
    ROLEANEYesReplace Base$321.18
    ROLESAYesReplace Base$148.05
    ROLESAQSYesReplace Base$50.97
    ROLESSSTYesReplace Base$280.58
    ROLE2ANESYesReplace Base$22.07
    VANEL30ANIncrease By$108.34
    VANEL30AT2Increase By$108.34
    ANEUANEU1For Each Call Pay Base At100%
    ANEUANEU2 - 25For Each Call Increase By$26.79
    2ANU2ANU1For Each Call Pay Base At100%
    2ANU2ANU2 - 288For Each Call Increase By$22.07
    SAUSAU1For Each Call Pay Base At100%
    SAUSAU2 - 33For Each Call Increase By$37.04
    SAQUSAQU1 - 36For Each Call Pay Base At100%
    CALLH1M151For Each Call Pay Base At100%
    CALLH1M152 - 9For Each Call Increase By$108.29
    SURCEVYesIncrease By$48.70
    SURCNTAMYesIncrease By$116.83
    SURCNTPMYesIncrease By$116.83
    SURCWKYesIncrease By$48.70
    LMTSL44ANEYesIncrease Base By$108.34

    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