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

16.1

Procedures performed in rooms

16.1.1

Eye investigations

Note: Not more that three (3) items in this section may be charged during one visit

Eye investigations and photography refer to one or both eyes except where otherwise indicated

Material used is excluded.The tariff for photography is not related to the number of photographs taken

3002

Gonioscopy

7

115.08

7

115.08

3003

Fundus contact lens or 90D lens examination (not to be charged with item 3004 and/ or item 3012)

7

115.08

7

115.08

3004

Peripheral fundus examination with indirect ophthalmoscope (not to be charged with item 3003 and/or item 3012)

7

115.08

7

115.08

3009

Basic capital equipment used in own rooms by Opthalmologists. Only to be charged at first and follow-up consultations. Not to be charged for post-operative follow-up consultations

+         11.68

192.02

-

#VALUE!

3013

Ocular motility assessment: Comprehensive examination

12

197.28

12

197.28

3014

Tonometry per test with maximum of 2 tests for provocative ionometry (one or both eyes)

7

115.08

7

115.08

3021

Retina function assessment including refraction after occular surgery (within four months) maximum two examinations

9

147.96

9

147.96

16.1.2

Special eye investigations

3015

Charting of visual field with manual perimeter

28

460.32

28

460.32

3016

Retinal threshold test without storage facilities

30

493.20

30

493.20

3017

Retinal threshold test inclusive of computer disc storage for Delta or Statpak programs

74

1,216.56

74

1,216.56

3018

Retinal threshold trend evaluation (additional to 3017)

16

263.04

16

263.04

3020

Pachymetry: Only when own instrument is used, per eye. Only in addition to corneal surgery

46

758.24

46

758.24

3025

Electronic tonography

19

312.36

19

312.36

3027

Fundus photography

21

345.24

21

345.24

3029

Anterior segment microphotography

21

345.24

21

345.24

3031

Fluorescein angiography: One or both eyes

45

739.80

45

739.80

4

307.24

+T

3032

Eyelid and orbit photography

9

147.96

9

147.96

3033

Interpretation of item 3031 referred by other clinician

15

246.60

15

246.60

3034

Determination of lens implant power per eye

15

246.60

15

246.60

3035

Where a minor procedure usually done in the consulting rooms requires a general anaesthetic or use of an operating theatre, an additional fee may be charged

22

361.68

22

361.68

As per procedure

3036

Corneal topography: For pathological corneas only on special motivation. For refractive surgery - may be charged once pre-operative and once post-operative per sitting (for one or both eyes)

36

591.84

36

591.84

16.2

Retina

3037

Surgical treatment of retinal detachment including vitreous replacement but excluding vitrectomy

306.9

5,045.44

245.52

4,036.35

6

460.86

+T

3039

Prophylaxis and treatment of retina and choroid by cryotherapy and/or diathermy and/or photocoagulation and/or laser per eye

105

1,726.20

105

1,726.20

6

460.86

+T

3041

Pan retinal photocoagulation (per eye), done in one sitting (Subsequent sittings: Modifier 0005)

150

2,466.00

120

1,972.80

6

460.86

+T

3044

Removal of encircling band and/or buckling material

105

1,726.20

105

1,726.20

6

460.86

+T

16.3

Cataract

3045

Intra-capsular extraction

210

3,452.40

168

2,761.92

7

537.67

+T

3047

Extra-capsular (including capsulotomy)

210

3,452.40

168

2,761.92

7

537.67

+T

3049

Insertion of lenticulus in addition to 3045 or 3047 (cost of lens excluded) Modifier 0005 not applicable

57

937.08

57

937.08

7

537.67

+T

3050

Repositioning of intra ocular lens

171.10

2,812.88

136.88

2,250.31

7

537.67

+T

3051

Needling of capsulotomy

130

2,137.20

120

1,972.80

4

307.24

+T

3052

Laser capsulotomy

105

1,726.20

105

1,726.20

4

307.24

+T

3057

Removal of lenticulus

210

3,452.40

168

2,761.92

7

537.67

+T

3058

Exchange of intra ocular lens

236

3,879.84

188.8

3,103.87

7

537.67

+T

3059

lnsertion of lenticulus when 3045 or 3047 was not executed (cost of lens excluded)

210

3,452.40

168

2,761.92

7

537.67

+T

3060

Use of own surgical microscope for surgery or examination (not for slit lamp microscope) (for use by opthalmologists only)

4

65.76

16.4

Glaucoma

3061

Drainage operation

247.6

4,070.54

198.08

3,256.44

6

460.86

+T

3062

Implanataion of aqueous shunt device/seton in glaucoma (additional to item 3061)

60

986.40

60

986.40

6

460.86

+T

3063

Cycloryotherapy or cyclodiathermy

105

1,726.20

105

1,726.20

6

460.86

+T

3064

Laser trabeculoplasty

105

1,726.20

105

1,726.20

6

460.86

+T

3065

Removal of blood anterior chamber

105

1,726.20

105

1,726.20

4

307.24

+T

3067

Goniotomy

210

3,452.40

168

2,761.92

7

537.67

+T

16.5

Intra-ocular foreign body

3071

Intra-ocular foreign body: Anterior to iris

127

2,087.88

120

1,972.80

4

307.24

+T

3073

Intra-ocular foreign body: Posterior to iris (including prophylactic thermal treatment to retina)

210

3,452.40

168

2,761.92

6

460.86

+T

16.6

Strabismus

3075

Strabismus (whether operation performed on one eye or both): Operation on one or two muscles

175.60

2,886.86

140.48

2,309.49

5

384.05

+T

3076

Strabismus (whether operation performed on one eye or both). Operation on three or four muscles

200

3,288.00

160

2,630.40

5

384.05

+T

3077

Strabismus (whether operation performed on one eye or both): Subsequent operation, one or two muscles

120

1,972.80

120

1,972.80

5

384.05

+T

3078

Strabismus (whether operation performed on one eye or both): Subsequent operation on three or four muscles Subsequent operation on three of four muscles

150

2,466.00

120

1,972.80

5

384.05

+T

16.7

Globe

3080

Examination of eyes under general anaesthetic where no surgery is done

80

1,315.20

80

1,315.20

4

307.24

+T

3081

Treatment of minor perforating injury

161.6

2,656.70

129.28

2,125.36

6

460.86

+T

3083

Treatment of major perforating injury

267.5

4,397.70

214

3,518.16

6

460.86

+T

3085

Enucleation or Evisceration

105

1,726.20

105

1,726.20

5

384.05

+T

3087

Enucleation or Evisceration with mobile implant:· Excluding cost of implant and prosthesis

160

2,830.40

128

2,104.32

5

384.05

+T

3088

Hydroxyapatite insertion (Additional to item 3087)

+          40

657.60

40

657.60

5

384.05

+T

3089

Subconjunctival injection if not done at the time of operation

10

184.40

10

164.40

5

384.05

+T

3091

Retrobulbar injection (if not done at time of operation)

16

263.04

16

283.04

4

307.24

+T

3092

External laser treatment for superficial lesions

53

871.32

53

871.32

3096

Adding of air or gas in vitreous as a post-operative procedure or pneumoretinopexy

130

2,137.20

120

1,972.80

7

537.67

+T

3097

Anterior vitrectomy

280

4,603.20

224

3,682.56

6

460.86

+T

3098

Removal of silicon from globe

280

4,603.20

224

3,682.56

6

460.86

+T

3099

Posterior vitrectromy including anterior vitrectomy, encircling of globe and vitreous replacement

419

6,888.36

335.2

5,510.69

6

460.86

+T

3100

Lensectomy done at time of posterior vitrectomy

30

493.20

30

493.20

7

537.67

+T

16.8

Orbit

3101

Drainage of orbital abscess

105

1,726.20

105

1,726.20

5

384.05

+T

3104

Removal orbital prosthesis

212.7

3,496.79

170.16

2,797.43

5

384.05

+T

3105

Exenteration

275

4,521.00

220

3,616.80

5

384.05

+T

3107

Orbitomy requiring bone flap

393

6,460.92

314.40

5,168.74

5

384.05

+T

3108

Eye socket reconstruction

206

3,386.64

164.8

2,709.31

5

384.05

+T

3109

Hydroxyapetite implantation in eye cavity when evisceration or enucleation was done previously

300

4,932.00

240

3,945.60

5

384.05

+T

3110

Second stage hydroxyapatite implantation

110

1,808.40

110

1,808.40

5

384.05

+T

16.9

Cornea

3111

Contact lenses: Assessment involving preliminary fittings and tolerance

•

#VALUE!

•

•

3113

Fitting of contact lenses and instructions to patient: Includes eye examination, first fittings of the contact lenses and further post-fitting visits for one year

200

3,288.00

160

2,630.40

3115

Fitting of only one contact lens and instructions to patient: Eye examination , first fitting of the contact lens and further post-fitting visits for one year included

166

2,729.04

132.8

2,183.23

3116

Astigmatic correction with T cuts or wedge resection in pathological corneal astigmatism following trauma, intra ocular surgery or penetrating keratoplasty

135.2

2,222.69

120

1,972.80

6

460.86

+T

3117

Removal of foreign body: One the basis of fee per consultation

•

4

307.24

+T

3118

Curettage of cornea after removal of foreign body (aftercare excluded)

10

164.40

10

164.40

3119

Tattooing

26

427.44

26

427.44

4

307.24

+T

3121

Corneal graft (Lamellar or full thickness)

289

4,751.16

231.2

3,800.93

6

460.86

+T

3123

Insertion of intra-corneal or intrascleral prosthesis for refractive surgery

254

4,175.76

203.2

3,340.61

6

460.86

+T

3125

Keratectomy

127

2,087.88

120

1,972.80

6

460.86

+T

3127

Cauterisation of cornea (by chemical, thermal or cryotherapy methods)

10

164.40

10

164.40

4

307.24+T

3130

Pterygium or conjunctival cyst. No conjunctival flap or graft used

96.9

1,593.04

96.9

1,593.04

4

307.24

+T

3131

Paracentesis

53

871.32

53

871.32

4

307.24

+T

3136

Conjunctival flap or graft: Not for use with pterygium surgery

95.7

1,573.31

95.7

1,573.31

6

460.86

+T

16.10

Ducts

3133

Probing and/or syringing, per duct

10

164.40

10

164.40

4

307.24

+T

3135

Insert polythene tubes/stent: Unilateral: Additional

51.8

851.59

51.8

851.59

4

307.24

+T

3137

Excision of lacrimal sac: Unilateral

132

2,170.08

120

1,972.80

4

307.24

+T

3139

Dacryocystorinostomy (single) with or without polythene tube

210

3,452.40

168

2,761.92

5

384.05

+T

3141

Sealing Punctum surgical/cautery: Per eye

24.9

409.36

24.9

409.36

4

307.24

+T

3142

Sealing Punctum with plugs: Per eye

20

328.80

20

328.80

4

307.24

+T

3143

Three-snip operation

10

164.40

10

164.40

4

307.24

+T

3145

Repair of caniculus: Primary procedure

132

2,170.08

120

1,972.80

4

307.24

+T

3147

Repair of caniculus: Secondary procedure

175

2,877.00

140

2,301.60

4

307.24

+T

16.11

lris

3149

lndectomy or iridotomy by open operationas isolated procedure

132

2,170.08

120

1,972.80

4

307.24

+T

3153

lndectomy or iridotomy by laser or photocoagulation as isolated procedure (maximum one procedure)

105

1,726.20

105

1,726.20

4

307.24

+T

3157

Division ofanterior synechiae as isolated procedure

132

2,170.08

120

1,972.80

4

307.24

+T

3158

Repair iris as in dialysis: Anterior chamber reconstruction

142.4

2,341.06

120

1,972.80

4

307.24

+T

16.12

Lids

3161

Tarsorrhaphy

47

772.68

47

772.68

4

307.24

+T

3165

Repair of skin laceration of the lid. Simple

27.3

448.81

27.3

448.81

4

307.24

+T

3176

Lid operation for facial nerve paralysis including tarsorrhapy but excluding cost of material

187

3,074.28

149.6

2,459.42

4

307.24

+T

16.12.1

Entropion or ectropion by

3177

Entropion or ectropion by cautery

10

164.40

10

164.40

4

307.24

+T

3179

Entropion or ectropion by suture

49.4

812.14

49.4

812.14

4

307.24

+T

3181

Entropion or ectropion by open operation

111.5

1,833.08

111.5

1,833.08

4

307.24

+T

3183

Entropion or ectropion by free skin, mucosal grafting or flap

122.6

2,015.54

120

1,972.80

4

307.24

+T

16.12.2

Reconstruction of eyelid

3185

Staged procedure for partial or total loss of eyelid: First stage

259

4,257.96

207.2

3,406.37

4

307.24

+T

3187

Staged procedure for partial or total loss of eyelid: Subsequent

206

3,386.64

164.8

2,709.31

4

307.24

+T

3189

Full thickness eyelid Iaceration for injury:· Direct repair

136.5

2,244.08

120

1,972.80

4

307.24

+T

3172

Blepharoplasty lower eyelid plus fat pad

125.80

2,068.15

120

1,972.80

4

307.24

+T

3191

Blepharoplasty: Upper lid for improvement in function (unilateral)

150.2

2,469.29

120.16

1,975.43

4

307.24

+T

16.12.3

Ptosis

3193

Repair by superior rectus, levator or frontalis muscle operation

190

3,123.60

152

2,498.88

4

307.24

+T

3195

Ptosis: By lesser procedure. e.g. sling operation: Unilateral

137.6

2,262.14

120

1,972.80

4

307.24

+T

3197

Ptosis: By lesser procedure, e.g. sling operation: Bilateral

186

2,729.04

132.8

2,183.23

4

307.24

+T

16.13

Conjunctiva

3199

Repair of conjunctiva by grafting

132

2,170.08

120

1,972.80

4

307.24

+T

3200

Repair of lacerated conjunctiva

47

772.68

47

772.68

4

307.24

+T

16.14

General

3196

Diamond knife: Use of own diamond knife during intraocular surgery

12

197.28

3198

Eximer laser: Hire fee

284.13

4,671.10

3201

Laser apparatus (ophthalmic): hire fee for one or both eyes treated in one sitting (not to be used with IOL master)

109

1,791.96

3202

PHAKO emulsification apparatus (hire fee)

109

1,791.96

3203

Vitrectomy apparatus (hire fee)

120

1,972.80