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

Note

Only one of the following codes can be claimed per session/consultation: 72925, 72926, 72327, 72921, 72923, 72928, 72927, 72501 and 72503

1

REHABILITATION

RAND

72501

Rehabilitation where the pathology requires the undivided attention of the physiotherapist.

Duration: 30min.

This code can only be claimed once per treatment session

530.77

72503

Rehabilitation for Central Nervous System disorders - condition to be clearly stated and fully documented (No other treatment modality may be charged in conjunction with this). Duration: 60min.

This code can only be claimed once per treatment session

1061.74

72509

Rehabilitation. Each additional full 15 mins needs to be medically motivated with a clear indication where pathology requires the undivided attention of the physiotherapist. This code can only be claimed once per treatment session.

Item 72509 can be added to 72501 and 72503.

169.81

2

EVALUATION

Rand

72701

Applies to simple evaluation once at first visit only. It should not be used for each condition. A treatment plan / rehabilitation progress report must be fully documented and submitted at the initiation of treatment.

305.73

72702

Complex evaluation once at first visit only. Applies to complex injuries only. It should not be used for each condition. A treatment plan / rehabilitation progress report describing what makes the evaluation complex, must be fully documented and submitted at the initiation of treatment.

Item 72702 cannot be used with 72701

458.17

72703

One complete re-assessment or one physical performance test during the course of treatment. To be used only once per episode of care. This should be fully documented and a rehabilitation progress report provided to the Compensation Fund. This code will apply to patients that have been discharged and are now re-admitted, if there has been a gap in treatment or during the course of his treatment to ensure treatment goals and outcomes are aligned.

152.46

3

VISITING CODES

Rand

72901

Consultation: Treatment at a nursing home: Relevant fee plus (to be charged only once per day and not with every hospital visit).

111.72

72903

Consultation: Domiciliary treatments: Apply only when medically motivated and pre-authorised: relevant fee plus.

203.28

4

OTHER

72939

Cost of material:Items to be charged (exclusive of VAT) at net acquisition price plus -

26% of the net acquisition price where the net acquisition price of that material is less than one hundred rands;

a maximum of twenty six rands where the net acquisition price of that material is greater

than or equal to one hundred rands.

Cost of materials does not cover consumables

See the attached Annexure A for consumables and Annexure B for equipment and or appliances that are considered reasonable to be used with code 72939.

72925

Level 1 chest pathology, which includes either or / and:

> Vibration

> Percussion

> Nebulisation

> Suction: Level 1 (including sputum specimen taken by suction)

Applies to non-ventilated patients only

500.52

72926

Level 2 chest pathology which includes either or / and:

> Vibration

> Percussion

> Postural drainage

> Upper respiratory nebulisation and/or lavage

> Suction: Level 2 (Suction with involvement of lavage as a treatment in a special unit situation or in the respiratory compromised patient) e.g. Tracheostomy

> Pre- and post-operative exercises and/or breathing

Applies to High Care and non-ventilated patients

827.00

72327

Level 3 chest pathology which includes either or / and:

> Vibration

> Percussion

> Postural drainage

> Upper respiratory nebulisation and/or lavage

> Intermittent positive pressure ventilation

> Suction: Level 2 (Suction with involvement of lavage as a treatment in a special unit situation or in the respiratory compromised patient

> Bagging (used on the intubated unconscious patient or in the severely respiratory distressed patient)

> Pre- and post-operative exercises and/or breathing exercises applies for ventilated patients only

1049.85

72921

Simple spinal treatment which includes either or / and:

MANIPULATION/MOBILISATION OF JOINTS OR IMMOBILISATION which includes

either or / and:

> Spinal (Manual spinal mobilisation)

> Pre meditated manipulation

> Immobilisation (excluding materials)

> Pre- and post-operative exercises and/or breathing exercises

735.05

72923

Complex spinal treatment which includes either or / and:

MANIPULATION/MOBILISATION OF JOINTS OR IMMOBILISATION which includes

either or / and:

> Spinal (Manual spinal mobilisation)

> Pre meditated manipulation

> Immobilisation (excluding materials)

> Rehabilitation for Central Nervous System disorders - condition to be clearly stated and fully documented (No other treatment modality may be charged in conjunction with this

> Traction

> Pre- and post-operative exercises and/or breathing exercises

1061.74

72928

Simple soft tissue / peripheral joint injuries or other general treatment which includes either or / and:

> Massage

> Neural tissue mobilisation

> Pre- and post-operative exercises and/or breathing exercises

735.05

72927

Complex soft tissue / peripheral joint injuries or other general treatment

> Massage

> Myofacial release/soft tissue mobilisation, one or more body parts

> Neural tissue mobilisation

> Pre- and cost-operative exercises and/or breathing exercises

960.10