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

Specialist

General

Practitioner

Anaesthetic

U

R

U

R

U

R

T

3.

Musculo-Skeletal System

3.1

Bones

3.1.1

Fractures

0383

Fracture (reduction under general anaesthetic): Scapula

®

®

3

335.58

+T+M

0384

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

284.2

6803.75

227.36

5443.00

3

335.58

+T+M

0386

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

209.4

5013.04

167.52

4010.43

3

335.58

+T+M

0387

Fracture (reduction under general anaesthetic): Clavicle

77

1843.38

77

1843.38

3

335.58

+T+M

0388

Percutaneous pinning supracondylar fracture elbow - stand alone procedure

175.70

4206.26

140.

3365.01

3

335.58

+T+M

0381

Fracture (reduction general anaesthetic): Humerus

111.60

2671.70

111.60

2671.70

3

335.58

+T+M

0390

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

255.30

6111.88

204.24

4889.51

3

335.58

+T+M

0391

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

77

1843.38

77

1843.38

3

335.58

+T+M

0392

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

210

5027.40

168

4021.92

3

335.58

+T+M

0401

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

208.70

4996.28

166.96

3997.02

3

335.58

+T+M

0402

Fracture (reduction under general anaesthetic): Carpal bone

64

1532.16

64

1532.16

3

335.58

+T+M

0403

Bennett;s fracture-dislocation

51

1220.94

51

1220.94

3

335.58

+T+M

0405

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

118.3

2832.10

118.3

2832.10

3

335.58

+T+M

0409

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

ß

ß

33

335.58

+T+M

0411

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

52

1 244.88

52

1244.88

3

335.58

+T+M

4013

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

48

1149.12

48

1149.12

3

335.58

+T

0415

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

102

2441.88

102

2441.88

3

335.58

+T+M

0417

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

ß

ß

3

335.58

+T+M

0419

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

320

7660.80

256

6128.64

3

335.58

+T+M

0420

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

560

13406.40

448

10725.12

3

335.58

+T+M

0421

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

237

5673.78

189.6

4539.02

3

335.58

+T+M

0422

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

392.3

9391.66

313.84

7513.33

3

335.58

0425

Fracture (reduction under general anaesthetic): Patella

51

1220.94

51

1220.94

3

335.58

0426

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

219.5

5254.83

175.6

4203.86

3

335.58

0429

Fracture (reduction under general anaesthetic Tibia with or without Fibula

128

3064.32

120

2872,80

3

335.58

0430

Fracture: Tibia, with or without fibula: Open reduction and internal fixation (modifiers 005, 0052 not applicable)

293.2

7019.21

234.56

5616.37

3

335.58

0433

Fracture (reduction under general anaesthetic)

ß

ß

3

335.58

+T+M

0434

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

207

4955.58

165.6

3964.48

3

335.58

+T+M

0435

Fracture (reduction under general anaesthetic: Malleolus

58

1388.52

58

1388.52

3

335.58

+T+M

0436

Fracture: ankle malleolus: Open reduction and internal fixation (modifier 0051, 0052 not applicable)

207.1

4957.97

165.88

1388.52

3

335.58

+T+M

0437

Fracture-dislocation of ankle

128

3064.32

120

2872.80

3

335.58

+T+M

0438

Open reduction Talus fracture (Modifier 0051 not applicble)

198.70

4756.88

158.96

3805.50

3

335.58

+T+M

0439

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

64

1532.18

64

1532.18

3

335.58

+T+M

0440

Open reduction Calcaneus fracture (Modifier 0051 not applicable)

403.50

9659.79

322.5

7720.65

3

335.58

+T+M

0441

Fracture (reduction under general anaesthetic: Metatarsal

41.8

1000.69

41.8

1000.88

3

335.58

+T+M

0442

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

154.70

3703.52

123.7

2962.81

3

335.58

+T+M

0443

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

ß

ß

3

335.58

+T

0444

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

144.5

3459.33

120

2872.80

3

335.58

+T

0445

Fracture (reduction under general anaesthetic): Toe phalanx

32

766.08

32

766.08

3

335.58

+T+M

0446

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

178.2

4266.11

142.56

3412.89

3

335.58

+T+M

0447

Fracture (reduction under general anaesthetic): Other: Simple

26

622.44

26

622.44

3

335.58

+T

0448

Fracture: Calcaneus (reduction under general anaesthetic)

103.3

2473.00

103.3

2473.00

3

335.58

+T+M

0449

Fracture (reduction under general anaesthetic): Other: Compound

52

1244.88

52

1244.88

3

335.58

+T+M

0451

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

ß

ß

3

335.58

+T

0452

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

230

5506.20

184

4404.96

3

335.58

+T+M

0455

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

ß

ß

3

335.58

+T+M

0456

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

ß

ß

3

335.58

+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

®

®

3

335.58

+T+M

0462

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

®

®

3

335.58

+T+M

0463

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

®

®

3

335.58

+T+M

0464

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

®

®

3

335.58

+T+M

3.1.1.1

Operations for fractures

0465

Fractures involving large joints (includes the item for the relative bone). this item may ot be used as a modifier

268

6894.72

230.4

5515.76

3

335.58

+T+M

0473

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

43

1029.42

43

1029.42

3

335.58

+T

0475

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

282

6751.08

225.6

5400.86

3

335.58

+T+M

0479

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

154

3686.76

123.2

2949.41

3

335.58

+T+M