Compensation for Occupational Injuries and Diseases Act, 1993 (Act No. 130 of 1993)

1.

CONSULTATION TARIFF CODES

Code

Description

UNITS

RAND

66101

First consultation (5-15 min). Charged once.

60

754.42

66108

Follow-up consultation (15-30 min). May be charged twice only per week.

15

188.60

66109

Follow-up consultation (30-60 min). May be charged up to four times per week.

30

377.21

2.

EVALUATION PROCEDURES

CODE

DESCRIPTION

UNITS

RAND

66201

Observation and screening. May be charged at every treatment session as clinically appropriate.

10

125.74

66203

Specific evaluation for a single aspect of dysfunction (Specify which aspect). May be charged once per week as clinically appropriate.

7.5

94.30

66205

Specific evaluation of dysfunction involving one part of the body for a specific functional problem (Specify part and aspects evaluated). May be charged once per week as clinically appropriate.

22.5

282.91

66207

Specific evaluation for dysfunction involving the whole body (Specify condition and which aspects evaluated). May be charged once per three months as clinically appropriate.

45

565.81

66209

Specific in depth evaluation of certain functions affecting the total person (Specify the aspect assessed). May be charged once per three months as clinically appropriate.

75

943.02

66211

Comprehensive in depth evaluation of the total person (Specify aspects assessed).

Item 66211 cannot be charged together with tariff code 66136.

105

1320.23

66136

In depth evaluation of the total person to enable the vocational rehabilitation specialist to complete a comprehensive assessment of certain functions affecting the total person. (This code can only be requested by the Compensation Fund for Section 42 Case reviews). Tariff code 66136 cannot be charged together with tariff code 66211.

218.15

2742.93

3.

MEASUREMENT FOR DESIGNING

CODE

DESCRIPTION

UNITS

RAND

66213

Measurement for designing a static orthosis.

10

125.74

66215

Measurement for designing a dynamic orthosis

10

125.74

66217

Measurement for designing a pressure garment for one limb orthosis

10

125.74

66219

Measurement for designing a pressure garment for one hand orthosis

10

125.74

66221

Measurement for designing a pressure garment for the trunk orthosis

10

125.74

66223

Measurement for designing a pressure garment for the face (chin strap only)

10

125.74

66225

Measurement for designing a pressure garment for the face (full face mask) orthosis

10

125.74

4.

PROCEDURES FOR THERAPY

CODE

DESCRIPTION

UNITS

RAND

66301

Group treatment in a task-cantered activity, per patient (treatment time 60 minutes or more).

10

125.73

66303

Placement of a patient in an appropriate treatment situation requiring structuring the environment, adapting equipment and positioning the patient. This does not require individual attention for the whole treatment session.

20

251.47

66305

Groups directed to achieve common goals per person.

20

251.47

66307

Simultaneous treatment of two to four patients, each with specific problems utilising individual activities, per patient (treatment time 60 minutes or more).

48

603.53

66308

Simultaneous treatment with two to four neuro-behavioural and stress related conditions or severe head injury patients, each with specific problems, utilising individual activities, per patient (treatment time 90 minutes or more).

30

377.21

5.

INDIVIDUAL AND UNDIVIDED ATTENTION DURING TREATMENT SESSIONS UTILISING SPECIFIC ACTIVITY OR TECHNIQUES IN AN INTEGRATED TREATMENT SESSION (TIME OF TREATMENT MUST BE SPECIFIED)

CODE

DESCRIPTION

UNITS

RAND

66309

On level one (15 min)

12

150.88

66311

On level two (30 min)

24

301.77

66313

On level three (45 min)

36

452.65

66315

One level four (60 min)

48

603.53

66317

On level five (90 min)

72

905.30

66319

On level six (120 min)

96

1207.07

6.

PROCEDURES FOR WORK REHABILITATION

CODE

DESCRIPTION

UNITS

RAND

66321

Work evaluation - This includes an assessment of the inherent demands of the job and the patient's ability to perform these. A detailed report is not included in this code (charged for under 325), but must be submitted with the referral from the medical practitioner.)

Item 66321 cannot be charged together with item 66211 or 66136

80

1005.89

66323

Work Visit Evaluation of the job tasks by observing while the patient or a colleague in the same role performs the job tasks. May include discussing possible adaptations to the process or the work station and making the necessary recommendations to enable a patient to return to work.

Rule: A maximum of two work visits are allowed per patient.

However, in extenuating circumstances, further motivation may be made to the Compensation Fund.

Item 66323 cannot be charged together with item 66211 or 66136.

40

502.94

66325

Reports - To be used only when reporting on work assessments.

Use once per day and per claim only

22.14

278.38

66327

Work hardening. Must include a graded return to work plan. Refer to Rule 020.

80

1005.89

7.

PROCEDURES REQUIRED TO PROMOTE TREATMENT

CODE

DESCRIPTION

UNITS

RAND

66401

Work Workplace assessment (Recommendation as regards to assistive device and environmental adaptations.)

Item  66401 cannot be charged together with item 66211, 66321, 66323 and 66327.

15

188.60

8.

DESIGNING AND CONSTRUCTING A CUSTOM MADE ADAPTATION OR ASSISTIVE DEVICE, SPLINT OR SIMPLE PRESSURE GARMENT FOR TREATMENT IN TASK-CENTERED ACTIVITY (SPECIFY THE ADAPTATION, DEVICE, SPLINT OR PRESSURE GARMENT)

CODE

DESCRIPTION

UNITS

RAND

66403

On level one

12

150.88

66405

On level two

24

301.77

66407

On level three

36

452.65

66409

On level four

48

603.53

66411

On level five

60

754.42

66413

On level six

72

905.30

66415

Designing and constructing a static orthosis

60

754.42

66417

Designing and constructing a dynamic orthosis

120

1508.83

9.

DESIGNING AND MAKING PRESSURE GARMENT

CODE

DESCRIPTION

UNITS

RAND

66419

Per limb

60

754.31

66421

Face (chin strap only)

45

565.81

66423

Face (full face mask)

60

754.42

66425

Trunk

90

1131.62

66427

Per hand

90

1131.62

The whole body or part thereof will be the subtotal of the parts for the first garment and 75% of the fee for any additional garments on the same pattern

66431

Planning and preparing in depth home programme on a monthly basis.

90

1131.62