I
CERTAIN DIAGNOSTIC AND THERAPEUTIC PROCEDURES
II
OPERATIONS ON THE NERVOUS SYSTEM
III
OPERATIONS ON THE ENDOCRINE SYSTEM
IV
OPERATIONS ON THE EYES
V
OPERATIONS ON THE EARS
VI
OPERATIONS ON THE NOSE, MOUTH,AND PHARYNX
VII
OPERATIONS ON THE RESPIRATORY SYSTEM
VIII
OPERATIONS ON THE CARDIOVASCULAR SYSTEM
IX
OPERATIONS ON THE HEMIC AND LYMPHATIC SYSTEMS
X
OPERATIONS ON THE DIGESTIVE SYSTEM AND ABDOMINAL REGION
XI
OPERATIONS ON THE URINARY TRACT
XII
OPERATIONS ON THE MALE GENITAL ORGANS
XIII
OPERATIONS ON THE FEMALE GENITAL ORGANS
XIV
OBSTETRIC PROCEDURES
XV
OPERATIONS ON THE MUSCULOSKELETAL SYSTEM
- 88
  OPERATIONS ON FACIAL BONES AND JOINTS
- 89
  INCISION, EXCISION, AND DIVISION OF OTHER BONES
  - 89.0
    Sequestrectomy
  - 89.1
    Other incision of bone without division
  - 89.2
    Wedge osteotomy
    NOTE: Benefits for HSCs 89.20A to 89.26A include fixation 89.20 Wedge osteotomy, scapula, clavicle, and thorax (ribs and sternum)
  - 89.4
    Excision of bunion (bunionectomy)
  - 89.5
    Local excision of lesion or tissue of bone
  - 89.6
    Excision of bone for graft
    Allograft harvesting from cadaver for bone bank
    - 89.6 A
      Major, may include hemipelvis, long bone and joint articulation
    - 89.6 C
      Harvesting of autologous bone
      That for grafting by a second surgeon for immediate insertion
  - 89.7
    Other partial ostectomy
  - 89.8
    Total ostectomy
  - 89.9
    Biopsy of bone
- 90
  OTHER OPERATIONS ON BONES EXCEPT FACIAL BONES
- 91
  REDUCTION OF FRACTURE AND DISLOCATION
- 92
  INCISION AND EXCISION OF JOINT STRUCTURES
- 93
  REPAIR AND PLASTIC OPERATIONS ON JOINT STRUCTURES
- 94
  OPERATIONS ON MUSCLE, TENDON, FASCIA AND BURSA OF HAND
- 95
  OPERATIONS ON MUSCLES, TENDONS, FASCIA AND BURSA, EXCEPT HAND
- 96
  OTHER OPERATIONS ON THE MUSCULOSKELETAL SYSTEM
XVI
OPERATIONS ON THE BREAST
XVII
OPERATIONS ON SKIN AND SUBCUTANEOUS TISSUE
XVIII
PROCEDURES NOT ELSEWHERE CLASSIFIED
LABORATORY AND PATHOLOGY
DIAGNOSTIC RADIOLOGY
NOTE: As stated in G.R. 11.1.1, claims for services in the Diagnostic Radiology section will not be payable unless the physician has been approved by the CPSA to provide those services.
THERAPEUTIC RADIOLOGY

Health Service Code 89.6 C

Harvesting of autologous bone

That for grafting by a second surgeon for immediate insertion

Category:	M Minor Procedure
Base rate:	$211.99

Fee modifiers:

Type	Code	# of calls	Explicit	Action	Amount
BMI	BMIANT		Yes	Increase By	25%
ROLE	ANEST		Yes	Replace Base	$18.70
ANU	ANU	1		For Each Call Pay Base At	100%
ANU	ANU	2 - 150		For Each Call Increase By	$18.70
SURC	EV		Yes	Increase By	$48.82
SURC	NTAM		Yes	Increase By	$117.12
SURC	NTPM		Yes	Increase By	$117.12
SURC	WK		Yes	Increase By	$48.82

Governing Rules:

6.1
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.
6.2
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.
6.7.1
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.

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Health Service Codes

Health Service Code 89.6 C

Harvesting of autologous bone

That for grafting by a second surgeon for immediate insertion

Fee modifiers:

Governing Rules:

Fee Navigator®

Health Service Codes

Health Service Code 89.6 C

Harvesting of autologous bone

That for grafting by a second surgeon for immediate insertion

Fee modifiers:

Governing Rules:

Fee Navigator^®