SURGICAL PROCEDURES OPERATIONS ON ORGANS OF SPECIAL SENSES OPERATIONS ON THE EYE

Transcription

1 98800 Examination and unlisted minor procedures under general anaesthetic, when sole procedure (IOP) EYEBALL Enucleation, donor eye, post-mortem (1 or both) Removal of intraocular foreign body non-magnetic-posterior segment Penetrating wound with prolapse of intraocular tissue without prolapse of intraocular tissue CORNEA Paracentesis (IOP) Removal embedded foreign body (IOP) Note: Not to be claimed for the routine removal of sutures within 42 days of procedure local anaesthetic - 1 foreign body or more foreign bodies... IC general anaesthetic Chelation of band keratopathy with EDTA (IOP) local anaesthetic general anaesthetic Pterygium - simple (unilateral) with partial keratectomy with lamellar graft with autogenous conjunctival transplant...add with mucous membrane graft...add Keratectomy of dermoid with partial keratectomy with lamellar graft Cauterization of ulcer (IOP) local anaesthetic general anaesthetic Replacement Corneal transplant penetrating with artificial prosthesis...add lamellar Division of iris to cornea W-1

2 SCLERA Sclerotomy, posterior Anterior chamber - open evacuation of clot IRIS AND CILIARY BODY Laser iridotomy Laser angle surgery Iridectomy - surgical - when sole procedure Glaucoma filtering procedures with intraocular implant of seton... add Extraocular glaucoma procedures Ciliary body reattachment CRYSTALLINE LENS Needling (discission) - primary or subsequent Capsulotomy (any method) Cataract all types of, by any procedure dislocated lens extraction insertion of intraocular lens... add Fixation of intraocular lens (McCannell suture procedure) of secondary membrane with corneal section following cataract extraction Removal of intraocular lens Repositioning, surgical of dislocated intraocular lens Insertion of secondary intraocular lens VITREOUS Vitrectomy by infusion suction cutter technique with transscleral retinal suturing... add Vitreous aspiration, posterior with needle for culture and/or injection of medication, with or without cryopexy Anterior vitrectomy (planned) when done in conjunction with another intraocular procedure... add Preretinal membrane peeling or segmentation to include posterior vitrectomy and coagulation Vitreous exchange (air, gas or artificial vitreous substance) - add to vitrectomy W-2

3 RETINA Reattachment of retina and choroid by diathermy, photocoagulation or cryopexy as initial procedure Scleral resection or buckling procedure... - with or without diathermy, photocoagulation or cryopexy, primary or subsequent procedure Secondary operation following unsuccessful operation or fresh detachment in the same eye by a different surgeon with or without diathermy, photocoagulation or cryopexy Removal of scleral implant Photocoagulation - 1 eye Cryopexy - extraocular or subconjunctival - 1 eye EXTRAOCULAR MUSCLES Strabismus procedures muscle, 1 or both eyes muscles, 1 or both eyes or more muscles, 1 or both eyes for adjustable suture...add Repeat strabismus procedure (more than 2 previous repairs by different surgeon)...add ORBIT Drainage of abscess Enucleation, with or without primary implant Evisceration, with or without primary implant Exenteration with major plastic repair...add Secondary orbital implant Tumour or foreign body - anterior route posterior exposure Biopsy - anterior posterior exposure Lateral orbitotomy (Kronlein) Decompression - 2 walls walls W-3

4 ORBIT (Cont d) Reconstruction Dermis fat graft - immediately following enucleation delayed Fornix reconstruction with mucous membrane graft with autogenous conjunctival transplant... add Free mucous membrane graft full thickness split thickness Alloplastic volume replacement EYELIDS Drainage of abscess (IOP) local anaesthetic general anaesthetic Verrucae, papilloma, keratosis, etc. (IOP) - see Skin and Subcutaneous Tissue-Integumentary System also Lid Tumours or Unlisted Plastic Procedures Chalazion - single or multiple (IOP) local anaesthetic general anaesthetic Epilation by hyfrecator, electrolysis (IOP) by cryopexy Suture Tarsorrhaphy Double adhesion Ptosis repeat or second repair Distichiasis - unilateral Trichiasis, repair by tarsal transplantation Entropion, other than Zeigler puncture repeat by second surgeon... add with mucous membrane graft... add Ectropion, other than Zeigler puncture repeat by second surgeon... add with skin graft, see Plastic Surgery Procedures - Integumentary System W-4

5 EYELIDS (Cont d) (Cont d) Zeigler punctures (for entropion/ectropion) (IOP) Laceration - full thickness including lid margin Laceration of eyelid including levator palpebrae superioris with ptosis Blepharoplasty excision of skin, with/without partial excision of the orbicularis oculi muscle - 1 lid plus removal of orbital fat and/or lid fold reconstruction - 1 lid Lid lengthening procedure with scleral graft...add Primary closure of full thickness lid defect with cantholysis...add with releasing rotation flap including cantholysis..add Transconjunctival flap and skin graft (Hughes) second stage Lower or upper eyelid bridge flap second stage Temporal rotation flap with free posterior lamellar graft...add Free tarsal, scleral or cartilage graft with local skin mobilization Free composite eyelid graft Medial canthoplasty (skin and muscle) Medial canthal tendon tendon repair only fixating to bone when done in conjunction with another procedure Lateral canthal surgery Canthotomy - not to be claimed with 98930, Cantholysis - when primary procedure Lateral canthopexy when done in conjunction with another procedure...add CONJUNCTIVA Removal of foreign body VF VF Peritomy (Gunderson conjunctival flap) Biopsy (IOP) W-5

6 CONJUNCTIVA (Cont d) of conjunctival lesion with mucous membrane graft... add with autogenous conjunctival transplant... add LACRIMAL TRACT Dacryocystotomy - general anaesthetic (IOP) Three Snip punctum procedure (IOP) Dacryocystectomy Lacerated canaliculus - immediate repair delayed repair Dacryocystorhinostomy repeat procedure by second surgeon... add with lacrimal by-pass procedure (e.g., Lester Jones) or canalicular reconstruction... add Lacrimal by-pass procedure (e.g., Lester Jones) - when sole procedure Manipulation Irrigation of nasolacrimal system - uni or bilateral Probing and dilation of duct - initial or repeat local anaesthetic - unilateral general anaesthetic - uni or bilateral with insertion of inlying tube or filament Reinsertion of Lester Jones tube W-6

7 OPERATIONS ON THE EAR EXTERNAL EAR Endoscopy Removal of foreign body - simple... VF VF complicated - general anaesthetic, when sole procedure (IOP) post auricular approach from middle ear space Removal of drainage tubes under general anaesthesia (IOP) Debridement of ear(s) under microscopy (IOP) under general anaesthesia (IOP) NOTE: Debridement of ears may only be claimed for removal of impacted cerumen by means other than syringing, or suction, or for the therapeutic removal of debris resulting from infection Biopsy, ear canal (IOP) Limited incision for perichondritis, removal of cartilage and drainage Radical surgery for perichondritis Local excision polyp - office (IOP) hospital (IOP) Amputation - partial complete Exostosis, simple endomeatal surgery and removal and drilling out of exostosis with multiple removal, with necessary grafting posterior auricular approach Pre-auricular sinus (IOP) requiring general anaesthetic Microtia minor repair major repair or first stage of a major repair subsequent stages of a major repair (maximum of 2 subsequent stages) Congenital atresia of canal, includes necessary mastoid surgery Otoplasty for correction of outstanding ears - unilateral Note: Otoplasty for correction of outstanding ears is insured for patients 0-17 years of age. It is not an insured service for patients 18 years of age and older Meatoplasty or canalplasty for congenital malformation with grafting of canal...add with tympanoplasty and/or ossiculoplasty and/or mastoidectomy...add W-7

8 OPERATIONS ON THE EAR MIDDLE EAR Introduction (IOP) Eustachian Catheterization unilateral - local anaesthetic uni or bilateral - general anaesthetic Insufflation of eustachian tube... VF VF Intratympanic injections (IOP) Myringotomy, to include aspiration when indicated local anaesthetic with insertion of ventilation tube using operating microscope general anaesthetic - with/without operating microscope, unilateral with insertion of drainage tube using operating microscope, unilateral Aspiration of serous otitis Mastoidectomy - simple child adult or adolescent radical or modified radical revision mastoidectomy with revision of middle ear and regrafting with meatoplasty and/or canalplasty... add with ossiculoplasty... add Myringoplasty Tympanoplasty including necessary mastoid or middle ear surgery Ossiculoplasty Facial nerve decompression Facial nerve graft Closure of mastoid fistula Exploratory tympanotomy Section tympanic plexus Tympanotomy with round or oval window fistula repair (IOP) W-8

9 OPERATIONS ON THE EAR INNER EAR Labyrinthotomy or labyrinthectomy Surgical including Tack or Fick procedures or ultrasound Fenestration of semicircular canals Stapes mobilization - unilateral Stapedectomy with prosthesis Endolymphatic shunt or sac decompression Temporal bone resection Permanent Cochlear Prosthesis Insertion Extra-cochlear (round window, middle ear) Intra-cochlear Bone conduction hearing aid insertion implantable, including necessary mastoidectomy ACOUSTIC NERVE Translabyrinthine resection of acoustic neuroma (includes surgical approach and closure, any method) W-9