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

Specialist

General Practitioner

Anaesthetic

U/E

R

U/E

R

U/E

R          T/M

3.1.1

Fractures

0383

Fracture (reduction under general anaesthetic): Scapula

s

s

3

357.06 + T+M

0384

Fracture: Scapula: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

284.20

7 238.57

227.38

5 790.86

3

357.06 +T+M

0386

Fracture: Clavicle: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

209.4

5 333.42

167.52

4 266.73

3

357.06 +T+M

0387

Fracture (reduction under general anaesthetic): Clavicle

77

1 961.19

77

1 961.19

3

357.06 +T+M

0388

Percutaneous pinning supracondylar fracture elbow - stand alone procedure

175.70

4 475.08

140.56

3 580.06

3

357.06 +T+M

0389

Fracture (reduction under general anaesthetic): Humerus

111.60

2 842.45

111.60

2 842.45

3

357.06 +T+M

0390

Fracture: Humerus: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

255.3

6 502.49

204.24

5 201.99

3

357.06 +T+M

0391

Fracture (reduction under general anaesthetic): Radius and/or Ulna

77

1 961.19

77

1 961.19

3

357.06 +T+M

0392

Open reduction of both radius and ulna (Modifier 0051 not applicable)

210

5 348.70

168

4 278.96

3

357.06 +T+M

0401

Fracture: Carpal bone: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

206.7

5 315.59

166.96

4 252.47

3

357.06 +T+M

0402

Fracture (reduction under general anaesthetic): Carpal bone

64

1 630.08

64

1 630.08

3

357.06 +T+M

0403

Bennett's fracture-dislocation

51

1 298.97

51

1 298.97

3

357.06 +T+M

0405

Fracture reduction under general anaesthetic: Open treatment of Metacarpal: Simple

118.3

3 013.10

118.3

3 013.10

3

357.06 +T+M

0409

Fracture (reduction under general anaesthetic): Finger phalanx: Distal: Simple

β

β

3

357.06 +T+M

0411

Fracture (reduction under general anaesthetic): Finger phalanx: Distal: Compound (open)

52

1 324.44

52

1 324.44

3

357.06 +T+M

0413

Fracture (reduction under general anaesthetic): Finger phalanx: Proximal or middle: simple

48

1 222.56

48

1 222.56

3

357.06 +T

0415

Fracture (reduction under general anaesthetic): Finger phalanx: Proximal or middle: Compound (open)

102

2 597.94

102

2 597.94

3

357.06 +T+M

0417

Fracture (reduction under general anaesthetic): Pelvis fracture: Closed (modifier 0051 is applicable_

β

β

357.06 +T

0419

Fracture (reduction under general anaesthetic): Pelvis: Operative reduction and fixation

320

8 150.40

256

6 520.32

3

357.06 +T+M

0420

Fracture: Acetabulum: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

560

14 263.20

448

11 410.56

3

357.06 +T+M

0421

Fracture (reduction under general anaesthetic): Femur: Neck or shaft

237

6 036.39

189.6

4 829.11

3

357.06 +T+M

0422

Fracture: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

392.3

9 991.88

313.84

7 993.50

3

357.06 +T+M

0425

Fracture (reduction under general anaesthetic Patella

51

1 298.97

51

1 298.97

3

357.06 +T+M

0426

Fracture: Patella: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

219.5

5 590.67

175.6

4 472.53

3

357.06 +T+M

0429

Fracture (reduction under general anaesthetic) Tibia with or without Fibula

128

3 260.16

120

3 056.40

3

357.06 +T+M

0430

Fracture: Tibia, with or without fibula: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

293.2

7 467.80

234.56

5 974.24

3

357.06 +T+M

0433

Fracture (reduction under general anaesthetic) Fibula shaft

β

β

3

357.06 +T+M

0434

Fracture: Fibula shaft: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

207

5 272.29

165.6

4 217.83

3

357.06 +T+M

0435

Fracture (reduction under general anaesthetic): Malleolus of ankle

58

1 477.26

58

1 477.26

3

357.06 +T+M

0436

Fracture: Ankle malleolus: Open reduction and internal fixation (modifiers 0051, 0052 not applicable)

207.10

5 274.84

165.68

4 219.87

3

357.06 +T+M

0437

Fracture-dislocation of ankle

128

3 260.16

120

3 056.40

3

357.06 +T+M

0438

Open reduction Talus fracture (Modifier 0051 not applicable)

198.7

5 060.89

158.96

4 048.71

3

357.06 +T+M

0439

Fracture (reduction under general anaesthetic): Tarsal bones (excluding talus and calcaneus)

64

1 630.08

64

1 630.08

3

357.06 +T+M

0440

Open reduction: Calcaneus fracture (Modifier 0051 not applicable)

403.50

10 277.15

322.5

8 214.08

3

357.06 +T+M

0441

Fracture (reduction under general anaesthetic): Metatarsal

41.8

1 064.65

41.8

1 064.65

3

357.06 +T+M

0442

Fracture: Metatarsal bones: Open reduction with internal fixation (modifiers 0051, 0052 not applicable)

154.7

3 940.21

123.76

3 152.17

3

357.06 +T+M

0443

Fracture (reduction under general anaesthetic): Toe phalanx: Distal: Simple

β

β

3

357.06 +T

0444

Fracture: Toe phalanx, distal: Open reduction with internal fixation (modifiers 0051, 0052 not applicable)

144.5

3 680.42

120

3 056.40

3

357.06 +T

0445

Fracture (reduction under general anaesthetic): Toe phalanx: Compound

32

815.04

32

815.04

3

357.06 +T+M

0446

Fracture: Tarsal bones (excluding talus and calcaneus): Open reduction with internal fixation (modifiers 0051, 0052 not applicable)

178.2

4 538.75

142.56

3 631.00

3

357.06 +T+M

0447

Fracture (reduction under general anaesthetic): Other: Simple

26

662.22

26

662.22

3

357.06 +T

0448

Fracture: Calcaneus (reduction under general anaesthetic)

103.3

2 631.05

103.3

2 631.05

3

357.06 +T+M

0449

Fracture (reduction under general anaesthetic): Other: Compound

52

1 324.44

52

1 324.44

3

357.06 +T+M

0451

Fracture (reduction under general anaesthetic): Sternum and/or ribs: Closed

β

β

3

357.06 +T

0452

Fracture (reduction under general anaesthetic): Sternum and/or ribs: Open reduction and fixation of multiple fractured ribs for flail chest

230

5 858.10

184

4 686.48

3

357.06 +T+M

0455

Fracture (reduction under general anaesthetic): Spine: With or without paralysis: Cervical

β

β

3

357.06 +T+M

0456

Fracture (reduction under general anaesthetic): Spine: With or without paralysis: Rest

β

β

357.06 +T+M

0459

DELETED 2009: Open reduction and  internal fixation for fracture and/or dislocation of spine

0461

Fracture (reduction under general anaesthetic): Compression fracture: Cervical

s

s

3

357.06 +T+M

0462

Fracture (reduction under general anaesthetic): Compression fracture: Rest

s

s

3

357.06 +T+M

0463

Fracture (reduction under general anaesthetic): Spinous or transversa processes: Cervical

s

s

3

357.06 +T+M

0464

Fracture (reduction under general anaesthetic): Spinous or transverse processes: Rest

s

s

3

357.06 +T+M

3.1.1.1

Operations for fractures

0465

Fractures involving large joints (includes the item for the relative bone). This item may not be used as a modifier

288

7 335.36

230.4

5 868.29

3

357.06 +T+M

0473

Percutaneous insertion plus subsequent removal of Kirschner wires or Steinmann pin (Not subject to rite G) (Modifier 0005 not applicable)

43

1 095.21

43

1 095.21

3

357.06 +T    

0475

Bonegrafting or internal fixation for malunion or non-union: Femur, Tibia, Humerus, Radius and Ulna

282

7 182.54

225.6

5 746.03

3

357.06 +T+M

0479

Bonegrafting or internal fixation for malunion or non-union: Other bones (not applicable to fingers and toes)

154

3 922.38

123.2

3 137.90

3

357.06 +T+M

3.1.2

Bony operations

3.1.2.1

Bone grafting

0497

Resection of bone with or without grafting (benign)

282

7 182.54

225.6

5 746.03

3

357.06 +T+M

0498

Resection of bone or tumour (malignant) with or without grafting (does not include digits)

340

8 659.80

272

6 927.84

3

357.06 +T+M

0499

Grafts to cysts: Large bones

192

4 890.24

153.6

3 912.19

3

357.06 +T+M

0501

Grafts to cysts: Small bones

128

3 260.16

120

3 056.40

3

357.06 +T+M

0503

Grafts to cysts: Cartilage graft

206

5 246.82

164.8

4 197.46

3

357.06 +T+M

0505

Grafts to cysts: Inter-metacarpal bone graft

147

3 744.09

120

3 056.40

3

357.06 +T+M

0506

Harvesting of graft: Cartilage graft, costochondral

91.1

2 320.32

91.1

2 320.32

6

714.12 +T    

0507

Removal of autogenous bone for grafting (not subject to modifier 0005)

50

1 273.50

50

1 273.50

3

357.06 +T+M

3.1.2.2

Acute/chronic osteomyelitis

0509

Conservative treatment

s

s

0511

Operation: Tariff which would be applicable for compound (open) fracture of the bone involved, including six weeks post-operative care

0512

Sternum sequestrectomy and drainage: Including six weeks after care

128

3 260.16

120

3 056.40

3

357.06 +T+M

3.1.2.3

Osteotomy

0514

Osteotomy: Sternum: Repair of pectus-excavatum

330

8 405.10

264

6 724.08

3

357.06 +T+M

0515

Osteotomy: sternum: Repair of pectus carinatum

330

8 405.10

264

6 724.08

3

357.06 +T+M

0516

Osteotomy: Pelvic

320

8 150.40

256

6 520.32

3

357.06 +T+M

0521

Osteotomy: Femoral: Proximal (Modifier 0051 is applicable)

320

8 150.40

256

6 520.32

3

357.06 +T+M

0527

Osteotomy: Knee region (Modifier 0051 is applicable)

320

8 150.40

256

6 520.32

3

357.06 +T+M

0528

Osteotomy: Os Calcis (Dwyer operation) (Modifier 0051 is applicable)

115

2 929.05

115

2 929.05

3

357.06 +T+M

0530

Osteotomy: Metacarpal and phalanx: Corrective for mal-union or rotation (Modifier 0051 is applicable)

120

3 056.40

120

3 056.40

3

357.06 +T+M

0531

Rotational osteotomy tibia and fibula - stand alone procedure

278.90

7 103.58

223.12

5 682.87

3

357.06 +T+M

0532

Rotation osteotomy of the Radius. Ulna or Humerus (modifier 0051 is applicable)

160

4 075.20

128

3 260.16

3

357.06 +T+M

0533

Osteotomy single metatarsal (modifier 0051 Is applicable)

60

1 528.20

60

1 528.20

3

357.06 +T+M

0534

Multiple metatarsal osteotomies (modifier 0051 is applicable

150

3 820.50

120

3 056.40

3

357.06 +T+M

3.1.2.4

Exostosis

0535

Exostosis: Excision: Readily accessible sites

60

1 528.20

60

1 528.20

3

357.06 +T+M

0537

Exostosis: Excision: Less accessible sites

96

2 445.12

96

2 445.12

3

357.06 +T+M

3.1.2.5

Biopsy

0539

Needle Biopsy: Spine (no after-care). Modifier 0005 not applicable

50

1 273.50

50

1 273.50

4

476.08 +T

0541

Needle Biopsy: Other sites (no after-care). Modifier 0005 not applicable

32

815.04

32

815.04

4

476.08 +T

0543

Biopsy: Open (modifier 0005 is not applicable): Readily accessible site

64

1 630.08

64

1 630.08

As per bone

0545

Biopsy: Open (modifier 0005 is not applicable): Less accessible site

96

2 445.12

96

2 445.12

As per bone