TABLE OF SURGICAL PROCEDURES - MOH
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Ministry of Health
TABLE OF SURGICAL
PROCEDURES
(Updated as of 1 Feb 2021)
1TABLE OF CONTENTS
Guiding Principles………………………………………………………...2
Guidance on Specific Procedures………………………………………3
SA - Integumentary ........................................................................... 4
SB - Musculoskeletal ....................................................................... 12
SC - Respiratory .............................................................................. 33
SD - Cardiovascular ........................................................................ 36
SE - Hemic & Lymphatic ................................................................. 44
SF - Digestive .................................................................................. 46
SG - Urinary .................................................................................... 59
SH - Male Genital ............................................................................ 63
SI - Female Genital ......................................................................... 66
SJ - Endocrine ................................................................................. 74
SK - Nervous ................................................................................... 75
SL - Eye........................................................................................... 83
SM - ENT......................................................................................... 90
Annex…………………………………………………………………….95
GUIDING PRINCIPLES
The Table of Surgical Procedures (TOSP) is an exhaustive list of procedures with table ranking 1A to
7C, for which MediSave / MediShield Life can be claimed. TOSP codes focus on the intent and
outcome of the surgical procedure, regardless of the surgical access route and/or technology used.
Any procedures not listed or without a table ranking 1A to 7C are not claimable.
Specifically, Minor Surgical Procedures (procedures with table ranking “MSP”) are procedures which
the TOSP review committee decided to be non-claimable. The list of MSPs is non-exhaustive, i.e.
procedures not in the TOSP and not a MSP are still not claimable.
For a single episode of surgery/procedure, if a single TOSP code adequately describes the
surgery/procedure performed, only one TOSP code should be utilised1. This is regardless of the
number of primary surgeons involved in the surgery/procedure. For example, a revision total knee
replacement should only be coded for by SB717K. Additional codes for the removal of screws or
prostheses should not be included. The example stated is by no means exhaustive and serves as an
illustration of the general principle which will be applied to all procedures. If the complexity of a
procedure is not stipulated in the TOSP code description, the code should be interpreted as
encompassing a range of complexities and not just the basic standard procedure.
For guidelines on MediSave claims for surgical procedures, please refer to Annex. Appeals will be
assessed based on the prevailing guidelines at time of appeal.
1A single surgical/procedural episode refers to the entire suite of services provided during the time the patient
arrives to the operating theatre complex until the patient leaves. If the patient requires anesthesia, the
continuous period under General Anesthesia/Sedation is also defined under the same surgical episode.
2GUIDANCE ON SPECIFIC PROCEDURES
Pain procedures
A therapeutic pain procedure performed in the same setting as a surgical procedure should not be
charged separately from the surgical code. This would apply for all forms of anaesthesia: general,
regional or local. Diagnostic anaesthetic blocks, unlike therapeutic anaesthetic blocks, can be coded
as a standalone procedure.
A maximum of 1 pain procedure code, excluding those which are already done in the operating theatre
complex (e.g. pre-emptive anaesthesia administered outside of the operating theatre complex),
should be claimed throughout the entire admission for the same indication.
For multiple pain procedures performed at the same spinal level on the same side, only one code (of
the highest table) should be claimed.
Spine – revision surgery
Revision surgery codes apply to revision performed at the same level as primary operation. If
procedure is performed for adjacent segment disease, the applicable code for non-revision surgery
should be used (not to be combined with other codes). If procedure is performed to address a
complication of the initial surgery, the revision surgery code can be used.
Cosmetic procedures
MediSave use is not allowed for cosmetic surgeries, except those defined as cosmetic surgery to
reconstruct a body part, particularly face and neck, where that part (physical appearance or function)
has been affected by trauma, cancer, congential anomalies, nerve palsies and other disfiguring
diseases (to be ascertained by pre-surgical photographs). Medical practitioners are expected to
exercise good clinical judgement in determining if a procedure is cosmetic in nature. If audited,
medical practitioners must be prepared to justify their decision. For consistency, the use of MediSave
for complications arising from cosmetic surgery will follow the above principles i.e. MediSave claims
will be disallowed for treatment of complications where the treatment itself is cosmetic in nature.
Frequency-Limited TOSP codes
For TOSP codes with restrictions on the frequency at which these procedures can be claimed (i.e.
only one claim allowed within a specified timeframe), medical practitioners and institutions should
ensure that the frequency of claims adhere to the period specified in the respective code descriptions.
MOH will be monitoring the use of the following three frequency-limited TOSP codes from 1 Feb 2021:
TOSP code Description
SA902S / 1B (New) Skin, pre-malignant lesions, Excision/Vaporisation by laser and
other ablative modalities, therapeutic, up to 4 sessions in 12 months
(To provide histopathology report if audited)
SM839E / 2A (New) Ear, Tympanic Membrane, Unilateral, transtympanic perfusion of
drugs, with injections/myringotomy including repeat procedures
during a 90-day period in the same ear
SM700N / 1A Nose, Nasoendoscopy/Nasopharyngolaryngoscopy (single or
(Revised) repeat examinations, during a 90 day global period)
3SA - INTEGUMENTARY
S/N Code Description Table Classification
BOTULINUM TOXIN THERAPY FOR MOVEMENT
1 SA700B MSP Existing
DISORDERS
BREAST, DUCTAL LESIONS, MICRODOCHECTOMY
2 SA701B 3A Existing
(BILATERAL)
BREAST, DUCTAL LESIONS, MICRODOCHECTOMY
3 SA702B 2C Existing
(UNILATERAL)
BREAST, LUMPS, IMAGING GUIDED VACUUM ASSISTED
4 SA704B 2B Existing
BIOPSY, SINGLE LESION
BREAST, LUMP (REMOVAL) WITH PARENCHYMAL FLAP Descriptor
5 SA705B 4A
CLOSURE (UNILATERAL/BILATERAL) change
BREAST, LUMPS, IMAGING GUIDED VACUUM ASSISTED
6 SA706B 2C Existing
BIOPSY, > 1 LESIONS
BREAST, TUMOR (MALIGNANT), WIDE EXCISION/
LUMPECTOMY/SEGMENTAL MASTECTOMY/ PARTIAL
7 SA707B 4A Uptable
MASTECTOMY, WITH SENTINEL NODE BIOPSY/ AXILIARY
NODE SAMPLING
BREAST, VARIOUS LESIONS, PERCUTANEOUS
8 SA708B MSP Existing
ASPIRATION UNDER ULTRASOUND
BREAST, VARIOUS LESIONS, TRUCUT BIOPSY,
9 SA709B 1C Existing
ULTRASOUND GUIDED OR STEREOTACTIC (MULTIPLE)
BREAST, VARIOUS LESIONS, TRUCUT BIOPSY,
10 SA710B 1B Existing
ULTRASOUND GUIDED OR STEREOTACTIC (SINGLE)
BREAST, VARIOUS LESIONS, WIRE LOCALISATION,
11 SA711B 3B Existing
EXCISION (MULTIPLE)
BREAST, VARIOUS LESIONS, WIRE LOCALISATION,
12 SA712B 3A Existing
EXCISION (SINGLE)
BREAST, POST MASTECTOMY, RECONSTRUCTION USING
13 SA713B PEDICLED TRANSVERSE RECTUS ABDOMINIS 6A Existing
MUSCULOCUTANEOUS FLAP (UNILATERAL)
BREAST (NIPPLE), VARIOUS LESIONS, GRAFT AND/OR
14 SA800B 4B Existing
FLAP RECONSTRUCTION (BILATERAL)
BREAST (NIPPLE), VARIOUS LESIONS, GRAFT AND/OR
15 SA801B 4A Existing
FLAP RECONSTRUCTION (UNILATERAL)
BREAST, DIFFUSE HYPERTROPHY, REDUCTION
16 SA802B 6A Existing
MAMMOPLASTY >500G (BILATERAL)
BREAST, DIFFUSE HYPERTROPHY, REDUCTION >250G
17 SA803B 4B Existing
(UNILATERAL)
BREAST, DROOPING, MASTOPEXY/REDUCTION
18 SA804B 5B Existing
(BILATERAL)
BREAST, DROOPING, MASTOPEXY/REDUCTION
19 SA805B 4A Existing
(UNILATERAL)
20 SA806B BREAST, GYNECOMASTIA, REDUCTION (BILATERAL) 4A Existing
21 SA807B BREAST, GYNECOMASTIA, REDUCTION (UNILATERAL) 3A Existing
BREAST, HYPOPLASIA, AUGMENTATION MAMMOPLASTY
22 SA808B 4A Existing
(PROSTHETIC AND BILATERAL)
BREAST, HYPOPLASIA, AUGMENTATION MAMMOPLASTY
23 SA809B 3A Existing
(PROSTHETIC AND UNILATERAL)
BREAST, INVERTED NIPPLES, SURGICAL EVERSION
24 SA810B 3A Existing
(BILATERAL)
BREAST, INVERTED NIPPLE, SURGICAL EVERSION
25 SA811B 2C Existing
(UNILATERAL)
26 SA812B BREAST, LUMP (SINGLE), EXCISION BIOPSY 2C Existing
BREAST, LUMPS (MULTIPLE/BILATERAL), EXCISION
27 SA813B 3A Existing
BIOPSY
4SA - INTEGUMENTARY
BREAST, POST MASTECTOMY, IMPLANT/EXPANDER
28 SA814B 5A Existing
RECONSTRUCTION (BILATERAL)
BREAST, POST MASTECTOMY, IMPLANT/EXPANDER
29 SA815B 4A Existing
RECONSTRUCTION (UNILATERAL)
BREAST, POST MASTECTOMY, LATISSMUS DORSI
30 SA816B PEDICLED FLAP WITH OR WITHOUT IMPLANT 6C Existing
RECONSTRUCTION (BILATERAL)
BREAST, POST MASTECTOMY, LATISSMUS DORSI
31 SA817B PEDICLED FLAP WITH OR WITHOUT IMPLANT 5C Existing
RECONSTRUCTION (UNILATERAL)
BREAST, POST MASTECTOMY, RECONSTRUCTION USING
32 SA818B PEDICLED TRANSVERSE RECTUS ABDOMINIS 7A Existing
MUSCULOCUTANEOUS FLAP (BILATERAL)
BREAST, POST MASTECTOMY, RECONSTRUCTION USING
33 SA819B 7C Existing
FREE FLAP (UNILATERAL)
BREAST, POST PROSTHETIC CONTRACTION,
34 SA820B 3A Existing
CAPSULOTOMY (BILATERAL)
BREAST, POST PROSTHETIC CONTRACTION,
35 SA821B 2C Existing
CAPSULOTOMY (UNILATERAL)
BREAST, TUMOR (MALIGNANT), WIDE EXCISION/
36 SA822B LUMPECTOMY/SEGMENTAL MASTECTOMY/ PARTIAL 3C Uptable
MASTECTOMY
BREAST, TUMOR (MALIGNANT), WIDE EXCISION/
LUMPECTOMY/SEGMENTAL MASTECTOMY/ PARTIAL
37 SA823B 4C Uptable
MASTECTOMY, WITH AXILIARY CLEARANCE,
WITH/WITHOUT SENTINEL NODE BIOPSY
BREAST, TUMOR (MALIGNANT), SIMPLE MASTECTOMY
38 SA824B WITH AXILIARY CLEARANCE, WITH/WITHOUT SENTINEL 5A Existing
NODE BIOPSY
BREAST, TUMOR (MALIGNANT), RADICAL MASTECTOMY
39 SA825B 5C Existing
WITH/WITHOUT AXILIARY CLEARANCE
40 SA826B BREAST, TUMOR (MALIGNANT), SIMPLE MASTECTOMY 4A Existing
BREAST, TUMOR (MALIGNANT), SIMPLE MASTECTOMY
41 SA827B 4C Existing
WITH SENTINEL NODE BIOPSY/ AXILIARY NODE SAMPLING
BREAST, VARIOUS LESIONS, SUBCUTANEOUS
42 SA828B 4A Existing
MASTECTOMY BILATERAL, EXCLUDING GYNAECOMASTIA
43 SA829B BREAST, VARIOUS LESIONS, TRUCUT BIOPSY 1A Existing
BREAST, VARIOUS LESIONS, SUBCUTANEOUS
44 SA830B MASTECTOMY UNILATERAL, EXCLUDING 3C Existing
GYNAECOMASTIA
CONTRALATERAL MASTOPEXY/REDUCTION FOLLOWING
BREAST, TUMOUR (MALIGNANT) WIDE
45 SA831B EXCISION/LUMPECTOMY/SEGMENTAL OR PARTIAL 4A New
MASTECTOMY, WITH OR WITHOUT SENTINEL NODE
BIOPSY AND/OR AXILLARY CLEARANCE
IPSILATERAL MASTOPEXY/REDUCTION FOLLOWING
BREAST, TUMOUR (MALIGNANT) WIDE
46 SA832B EXCISION/LUMPECTOMY/SEGMENTAL OR PARTIAL 4A New
MASTECTOMY, WITH OR WITHOUT SENTINEL NODE
BIOPSY AND/OR AXILLARY CLEARANCE
BREAST, TUMOR (MALIGNANT), NIPPLE/SKIN SPARING
47 SA833B 4C New
MASTECTOMY
BREAST, TUMOR (MALIGNANT), NIPPLE/SKIN SPARING
48 SA834B MASTECTOMY WITH SENTINEL NODE BIOPSY/AXILIARY 5A New
NODE SAMPLING
5SA - INTEGUMENTARY
BREAST, TUMOR (MALIGNANT), NIPPLE/SKIN SPARING
49 SA835B MASTECTOMY WITH AXILIARY CLEARANCE, 5C New
WITH/WITHOUT SENTINEL NODE BIOPSY
FASCIA (DEEP), RUPTURE WITH HERNIATED MUSCLE,
50 SA800F 1B Existing
REPAIR
FAT TRANSFER, CORRECTION OF
CONTOURS/CONGENITAL DEFORMITIES,
51 SA812F 2A Existing
RECONSTRUCTION POST ABLATIVE SURGERY/TRAUMA,
= 100CC
54 SA800H HAND, BURNS (MAJOR), EXCISION AND SPLIT SKIN GRAFT 4A Existing
MUCOUS MEMBRANE (EAR/NOSE/EYELID)
55 SA800M AVULSION/COMPLEX LACERATION, FULL THICKNESS 3A Existing
REPAIR
MUCOUS MEMBRANE, DEEP LACERATION/MULTIPLE
56 SA801M 3A Existing
LACERATIONS, REPAIR
MUCOUS MEMBRANE, SUPERFICIAL LACERATION
57 SA802M 1B Existing
EQUAL/LESS THAN 7CM, REPAIR
MUCOUS MEMBRANE, SUPERFICIAL LACERATION(S)
58 SA803M 2B Existing
MORE THAN 7 CM, REPAIR
MUCOUS MEMBRANE, TUMOR/CYST/ULCER/SCAR,
59 SA804M 2B Existing
EXCISION
60 SA805M MUSCLE AND DEEP TISSUE, FOREIGN BODY, REMOVAL 2C Existing
RADIOTHERAPY, ENDOLUMINAL BRACHYTHERAPY:
61 SA700R OESOPHAGUS, NASOPHARYNGEAL CARCINOMA (NPC), 2B Existing
HEPATOBILIARY, CARDIAC, LUNG, OTHERS
RADIOTHERAPY, INTERSTITIAL BRACHYTHERAPY
62 SA701R 4B Existing
(WITH/WITHOUT OPEN SURGERY)
RADIOTHERAPY, INTERSTITIAL BRACHYTHERAPY
63 SA702R 5A Existing
(WITHOUT OPEN SURGERY): PROSTATE
RADIOTHERAPY, INTRACAVITARY BRACHYTHERAPY
64 SA703R 2C Existing
(MULTI-CHANNEL): CERVIX, OTHERS
RADIOTHERAPY, INTRACAVITARY BRACHYTHERAPY
65 SA704R 2A Existing
(SINGLE CHANNEL): ENDOMETRIUM, OTHERS
RADIOTHERAPY, INTRA-OPERATIVE RADIOTHERAPY
66 SA705R (ELECTRONS OR KILOVOLTAGE): BREAST, SARCOMA, 3A Existing
UPPER GI, LOWER GI, OTHER SITES
SKIN (UPPER LIMB), OPEN WOUND, MAJOR
67 SA700S 2A Existing
DESLOUGHING
SKIN AND SUBCUTANEOUS TISSUE,
TUMOR/CYST/ULCER/SCAR, EXCISION BIOPSY, REMOVAL
68 SA701S 2A Existing
OF 2 OR MORE OR RECURRENT OR COMPLICATED
(ADHERENT), EXCISION
SKIN AND SUBCUTANEOUS TISSUE,
69 SA702S TUMOR/CYST/ULCER/SCAR, EXCISION BIOPSY, LESION 1B Existing
SIZE MORE THAN 15MM IN DIAMETER
SKIN CANCER, MOHS MICROGRAPHIC SURGERY
70 SA704S 2B Existing
WITHOUT RECONSTRUCTION
71 SA705S SKIN, DEFECT, DISTANT SKIN FLAPS 4B Existing
72 SA706S SKIN, DEFECT, NEUROVASCULAR ISLAND FLAP 5A Existing
6SA - INTEGUMENTARY
SKIN, NEUROMAS/HEMANGIOMAS,
Descriptor
73 SA707S EXCISION/VAPORISATION BY LASER AND OTHER 1C
change
ABLATIVE MODALITIES, THERAPEUTIC
SKIN, SURGICAL TREATMENT FOR VITILIGO (INVOLVING
74 SA708S 3C Existing
NON-CULTURED CELLULAR GRAFTING) (40 SQ CM)
SKIN, SURGICAL TREATMENT FOR VITILIGO (INVOLVING
76 SA710S 4A Existing
NON-CULTURED CELLULAR GRAFTING) (20-40 SQ CM)
SOFT TISSUE (LOWER LIMB), CONTRACTURE, MAJOR
77 SA711S 4A Existing
RELEASE
SOFT TISSUE (LOWER LIMB), CONTRACTURE, MINOR
78 SA712S 2C Existing
RELEASE
SOFT TISSUE (LOWER LIMB), OPEN WOUND/INFECTION,
79 SA713S 2A Existing
MAJOR DESLOUGHING
SOFT TISSUE (LOWER LIMB), SMALL TUMORS (BENIGN),
80 SA714S 1B Existing
EXCISION BIOPSY UNDER GENERAL ANESTHESIA
SOFT TISSUE (LOWER LIMB), TUMOR/TUMOR-LIKE
81 SA715S 2C Existing
LESIONS, MARGINAL EXCISION
SOFT TISSUE (LOWER LIMB), TUMORS (BENIGN), WIDE
82 SA716S 4A Existing
EXCISION BIOPSY
SOFT TISSUE (LOWER LIMB), TUMORS (MALIGNANT),
83 SA717S 5C Existing
RADICAL EXCISION BIOPSY
SOFT TISSUE (LOWER LIMB), VARIOUS LESIONS, MAJOR
84 SA718S 4B Existing
RELEASE
SOFT TISSUE (LOWER LIMB), VARIOUS LESIONS, MINOR
85 SA719S 3A Existing
RELEASE
86 SA720S SOFT TISSUE (PALMAR SPACE), ABSCESS, DRAINAGE 2B Existing
SOFT TISSUE (UPPER LIMB), TUMORS (BENIGN), MAJOR
87 SA721S 4A Existing
EXCISION BIOPSY
SOFT TISSUE (UPPER LIMB), TUMORS (MALIGNANT),
88 SA722S 6B Existing
RADICAL EXCISION BIOPSY
SOFT TISSUE (UPPER LIMB), TUMORS (MALIGNANT), WIDE
89 SA723S 5A Existing
EXCISION BIOPSY
SOFT TISSUE, TUMOR (MALIGNANT), MAJOR RESECTION
90 SA724S 7C Existing
AND RECONSTRUCTION (MICROSURGICAL)
SWEAT GLAND, AXILLARY HYPERHIDROSIS, WEDGE
91 SA725S 3A Existing
EXCISION (BILATERAL)
SKIN CANCER, MOHS MICROGRAPHIC SURGERY WITH
92 SA726S 2C Existing
RECONSTRUCTION/GRAFT/FLAP ( 5 TISSUE BLOCKS)
SKIN AND MUCOUS MEMBRANE, VARIOUS LESIONS,
94 SA800S 1A Existing
EXCISION BIOPSY
SKIN AND SUBCUTANEOUS TISSUE, TUMOUR
95 SA801S (MALIGNANT), WIDE EXCISION AND RECONSTRUCTION 3A Existing
AND LOCAL FLAP/SKIN GRAFT
SKIN AND SUBCUTANEOUS TISSUE, TUMOUR
96 SA802S (MALIGNANT), WIDE EXCISION WITH IMMEDIATE BLOCK 5A Existing
DISSECTION
SKIN AND SUBCUTANEOUS TISSUE
97 SA803S (EAR/NOSE/EYELID/FACE), COMPLEX LACERATIONS, 3B Existing
REPAIR
SKIN & SUBCUTANEOUS, SCAR REVISION, FACE & NECK
98 SA804S 1C Existing
(< 3CM)
SKIN AND SUBCUTANEOUS TISSUE (FACE AND NECK),
99 SA805S 2B Existing
SCAR OF MORE THAN 3CM, REVISION
7SA - INTEGUMENTARY
SKIN AND SUBCUTANEOUS TISSUE, BURNS,
100 SA806S 2A Existing
ESCHAROTOMY (EXTENSIVE)
SKIN AND SUBCUTANEOUS TISSUE, BURNS,
101 SA807S 1A Existing
ESCHAROTOMY (LIMITED)
SKIN AND SUBCUTANEOUS TISSUE, BURNS, EXCISION
102 SA808S 5A Existing
AND MAJOR FLAP REPAIR
SKIN AND SUBCUTANEOUS TISSUE, BURNS, EXCISION
103 SA809S 4A Existing
AND MAJOR FULL THICKNESS GRAFT
SKIN AND SUBCUTANEOUS TISSUE, BURNS, EXCISION
104 SA810S 3A Existing
AND SMALL FULL THICKNESS GRAFT
SKIN AND SUBCUTANEOUS TISSUE,
105 SA811S DEEP>3CM/EXTENSIVE CONTAMINATED WOUND, 2C Existing
DEBRIDEMENT
SKIN AND SUBCUTANEOUS TISSUE, DEFECT (DEEP),
106 SA812S DERMOFAT/FASCIA GRAFT (INCLUDING 3A Existing
TRANSPLANT/MUSCLE FLAP)
SKIN AND SUBCUTANEOUS TISSUE, DEFECT (DEEP),
107 SA813S DIRECT FLAP (CROSS ARM/RADIAL FORE 5A Existing
ARM/ABDOMINAL/SIMILAR)
SKIN AND SUBCUTANEOUS TISSUE, DEFECT (DEEP),
108 SA814S 5C Existing
DIRECT FLAP REPAIR (CROSS LEG)
SKIN AND SUBCUTANEOUS TISSUE, DEFECT (DEEP),
109 SA815S 7C Existing
FREE FLAPS
SKIN AND SUBCUTANEOUS TISSUE, DEFECT (DEEP),
110 SA816S FREE GRAFT (SPLIT SKIN GRAFT - EXTENSIVE/INLAY 3B Existing
GRAFT USING A MOULD)
SKIN AND SUBCUTANEOUS TISSUE, DEFECT (DEEP),
111 SA817S 2A Existing
STAGED DISTANT FLAP (DIVISION)
SKIN AND SUBCUTANEOUS TISSUE, DEFECT (MULTIPLE
112 SA818S 3B Existing
DIGITS), FREE FULL THICKNESS GRAFT
SKIN AND SUBCUTANEOUS TISSUE, DEFECT (MULTIPLE
113 SA819S 2A Existing
DIGITS), STAGED LOCAL FLAP (DIVISION)
SKIN AND SUBCUTANEOUS TISSUE, DEFECT (SINGLE
114 SA820S 2C Existing
DIGIT), FREE FULL THICKNESS GRAFT
SKIN AND SUBCUTANEOUS TISSUE, DEFECT, DIRECT
115 SA821S 4A Existing
FLAP (CROSS FINGER/SIMILAR FLAPS)
SKIN AND SUBCUTANEOUS TISSUE, DEFECT, FREE
116 SA822S 1B Existing
GRAFT (SPLIT SKIN GRAFT/PINCH GRAFTS UNDER 1/2%)
SKIN AND SUBCUTANEOUS TISSUE, DEFECT, FREE
117 SA823S 2B Existing
GRAFTS (SPLIT SKIN GRAFT 1/2 TO LESS THAN 2%)
SKIN AND SUBCUTANEOUS TISSUE, DEFECT, FREE
118 SA824S 3A Existing
GRAFTS (SPLIT SKIN GRAFT 2 TO LESS THAN 5%)
SKIN AND SUBCUTANEOUS TISSUE, DEFECT, FREE
119 SA825S 4A Existing
GRAFTS (SPLIT SKIN GRAFT 5 TO 10%)
SKIN AND SUBCUTANEOUS TISSUE, DEFECT, FREE
120 SA826S 5B Existing
GRAFTS (SPLIT SKIN GRAFT MORE THAN 10%)
SKIN AND SUBCUTANEOUS TISSUE, DEFECT, LOCAL FLAP
121 SA827S TO MULTIPLE DIGITS (CROSS 5A Existing
FINGER/THENAR/FLAG/ROTATION FLAP)
SKIN AND SUBCUTANEOUS TISSUE, DEFECT, SINGLE
122 SA828S 5B Existing
STAGE LOCAL FLAP (COMPLICATED/LARGE)
SKIN AND SUBCUTANEOUS TISSUE, DEFECT, SINGLE
123 SA829S 3A Existing
STAGE LOCAL FLAP (SIMPLE/SMALL)
SKIN AND SUBCUTANEOUS TISSUE, DEFECT, STAGED
124 SA830S 1B Existing
LOCAL FLAP(DIVISION)
SKIN AND SUBCUTANEOUS TISSUE, FOREIGN BODY
125 SA831S 1C Existing
(SUBCUTANEOUS), REMOVAL
8SA - INTEGUMENTARY
SKIN AND SUBCUTANEOUS TISSUE, FOREIGN BODY
126 SA832S MSP Existing
(SUPERFICIAL), REMOVAL
SKIN AND SUBCUTANEOUS TISSUE, HEMATOMA
127 SA833S (SMALL)/FURUNCLE/ABSCESS/SIMILAR LESION, INCISION MSP Existing
WITH DRAINAGE
SKIN AND SUBCUTANEOUS TISSUE, HEMATOMA,
128 SA834S MSP Existing
ASPIRATION
SKIN AND SUBCUTANEOUS TISSUE, ARTERIOVENOUS
Descriptor
129 SA835S MALFORMATION/HEMANGIOMA/LYMPHANGIOMA 7B
change
(EXTENSIVE AND COMPLEX), EXCISION
SKIN AND SUBCUTANEOUS TISSUE, ARTEIOVENOUS
Descriptor
130 SA836S MALFORMATION/HEMANGIOMA/LYMPHANGIOMA (LARGE 5C
change
AND DEEP-SEATED), EXCISION
SKIN AND SUBCUTANEOUS TISSUE, ARTERIOVENOUS
Descriptor
131 SA837S MALFORMATION/HEMANGIOMA/LYMPHANGIOMA ON 4A
change
FACE, HANDS, GENITALIA, EXCISION
SKIN AND SUBCUTANEOUS TISSUE, ARTERIOVENOUS
Descriptor
132 SA838S MALFORMATION/HEMANGIOMA/LYMPHANGIOMA >3CM 3A
change
EXCLUDING FACE, HANDS, GENITALIA, EXCISION
SKIN AND SUBCUTANEOUS TISSUE, ARTERIOVENOUS
Descriptor
133 SA839S MALFORMATION/HEMANGIOMA/LYMPHANGIOMA 3CM/MULTIPLE) LACERATIONS, REPAIR/TOILET & 3B Existing
SUTURE, WITH/WITHOUT DEBRIDEMENT
SKIN AND SUBCUTANEOUS TISSUE, LACERATION
137 SA843S 1B Existing
(SUPERFICIAL) OF LESS THAN 7CM, REPAIR
SKIN AND SUBCUTANEOUS TISSUE, LACERATION
138 SA844S 2C Existing
(SUPERFICIAL) OF MORE THAN 7CM, REPAIR
SKIN AND SUBCUTANEOUS TISSUE,
139 SA845S NEUROFIBROMATOSIS OF FACE AND NECK, EXCISION 5C Existing
(LARGE >3CM AND COMPLICATED/MULTIPLE)
SKIN AND SUBCUTANEOUS TISSUE,
140 SA846S NEUROFIBROMATOSIS OF FACE AND NECK, EXCISION 4A Existing
(LARGE)
SKIN AND SUBCUTANEOUS TISSUE,
141 SA847S NEUROFIBROMATOSIS OF FACE AND NECK, EXCISION 3A Existing
(MODERATE)
SKIN AND SUBCUTANEOUS TISSUE,
142 SA848S NEUROFIBROMATOSIS OF FACE AND NECK, EXCISION 2A Existing
(SMALL3CM),
144 SA850S 2B Existing
EXCISION WITH/WITHOUT BIOPSY
SKIN AND SUBCUTANEOUS TISSUE, SINUS Descriptor
145 SA851S 1B
(SHALLOWSA - INTEGUMENTARY
SKIN AND SUBCUTANEOUS TISSUE, WOUND,
147 SA853S 1A Existing
DEBRIDEMENT 3CM), SECONDARY SUTURE
SKIN AND SUBCUTANEOUS TISSUE, WOUND
149 SA855S MSP Existing
(SMALLSA - INTEGUMENTARY
SOFT TISSUE, TUMOR (MALIGNANT), RADICAL EXCISION
183 SA889S 5C Existing
BIOPSY >7CM OTHER THAN UPPER/LOWER LIMBS
SUBCUTANEOUS TISSUE (ABDOMEN), OBESITY,
184 SA890S 3B Existing
LIPOSUCTION
SUBCUTANEOUS TISSUE (BUTTOCKS), OBESITY,
185 SA891S 3B Existing
LIPOSUCTION
186 SA892S SUBCUTANEOUS TISSUE (FACE), OBESITY, LIPOSUCTION 2C Existing
187 SA893S SUBCUTANEOUS TISSUE (THIGH), OBESITY, LIPOSUCTION 3C Existing
SUBCUTANEOUS TISSUE (UPPER LIMBS), OBESITY,
188 SA894S 3A Existing
LIPOSUCTION
SUBCUTANEOUS TISSUE, OBESITY, LIPECTOMY,
TRANSVERSE WEDGE EXCISION OF ABDOMINAL
Descriptor
189 SA895S APRON/LIPECTOMY WITH EXCISION OF SKIN, FOLLOWING 4A
change
WEIGHT LOSS SURGERY
(SF702S/SF703S/SF713S/SF803S/SF804S)
SUBCUTANEOUS TISSUE, OBESITY, LIPECTOMY,
EXCISION WITH UNDERMINING OF SKIN EDGES AND
STRENGTHENING OF ABDOMINAL WALL/RADICAL Descriptor
190 SA896S 5C
ABDOMINOPLASTY WITH REPAIR OF ABDOMINAL WALL change
AND TRANSPOSITION OF UMBILICUS FOLLOWING WEIGHT
LOSS SURGERY (SF702S/SF703S/SF713S/SF803S/SF804S)
SWEAT GLAND, AXILLARY HYPERHIDROSIS, WEDGE
191 SA898S 2C Existing
EXCISION (UNILATERAL)
192 SA899S SKIN, INTRALESIONAL STEROID INJECTION MSP Existing
SUBCUTANEOUS TISSUE, OBESITY,
EXCISION/LIPECTOMY, LIMBS (UNILATERAL/BILATERAL)
193 SA900S 4A New
FOLLOWING WEIGHT LOSS SURGERY
(SF702S/SF703S/SF713S/SF803S/SF804S)
SUBCUTANEOUS TISSUE, OBESITY,
EXCISION/LIPECTOMY, THORAX/BACK/BUTTOCKS,
194 SA901S 4B New
FOLLOWING WEIGHT LOSS SURGERY
(SF702S/SF703S/SF713S/SF803S/SF804S)
SKIN, PRE-MALIGNANT LESIONS,
EXCISION/VAPORISATION BY LASER AND OTHER
195 SA902S ABLATIVE MODALITIES, THERAPEUTIC, UP TO 4 SESSIONS 1B New
IN 12 MONTHS*
*TO PROVIDE HISTOPATHOLOGY REPORT IF AUDITED
TENDON SHEATH AND SUBCUTANEOUS TISSUE,
196 SA700T 2B Uptable
GANGLION/LARGE BURSA, (>3CM) EXCISION BIOPSY
TENDON SHEATH AND SUBCUTANEOUS TISSUE,
197 SA800T 1C Uptable
GANGLION/SMALL BURSA, (SB – MUSCULOSKELETAL
S/N Code Description Table Classification
1 SB700A ANKLE, ANKLE FRACTURE, BIMALLEOLAR, ORIF 4A Existing
2 SB701A ANKLE, COMMINUTED PLAFOND FRACTURE ORIF 5A Existing
ANKLE, LIGAMENTOUS INSTABILITY, RECONSTRUCTION
3 SB702A 5A Existing
OF LIGAMENTS (EG. BOSTROM, CHRISMAN-SNOOK)
ANKLE, VARIOUS LESIONS, PRIMARY TOTAL JOINT
REPLACEMENT WITH AUGMENTATION, REQUIRING
4 SB703A 6B Existing
EXTRA IMPLANTS OR BONE GRAFTS,
OPEN/MIS/NAVIGATED
ANKLE, VARIOUS LESIONS, REVISION TOTAL JOINT
5 SB704A 6C Existing
REPLACEMENT, OPEN/MIS/NAVIGATED
6 SB705A ANKLE, THERAPEUTIC ARTHROSCOPY 4A Existing
ASPIRATION, DEEP MUSCULOSKELETAL TISSUES, UNDER
7 SB746A 1A Existing
RADIOLOGICAL GUIDANCE
8 SB800A ANKLE, DISLOCATION, OPEN REDUCTION 3B Existing
9 SB801A ANKLE, ANKLE FRACTURE, UNIMALLEOLAR, ORIF 3B Downtable
ANKLE, VARIOUS LESIONS, ARTHRODESIS (SURGICAL
10 SB802A 5A Existing
FUSION)
ANKLE, VARIOUS LESIONS, OPEN
11 SB803A EXCISION/INTERPOSITION ARTHROPLASTY, WITH OR 4C Existing
WITHOUT RESURFACING
12 SB804A ANKLE, VARIOUS LESIONS, REPAIR OF LIGAMENTS 3A Existing
13 SB805A ANKLE, VARIOUS LESIONS, SYNOVECTOMIES 3B Existing
ANKLE, VARIOUS LESIONS, PRIMARY TOTAL JOINT
14 SB806A 6A Existing
REPLACEMENT, OPEN/MIS/NAVIGATED
BONE (LOWER LIMB), TUMOR (BENIGN), >3 CM WITH
15 SB700B BONE GRAFTING +/- RECONSTRUCTION/INTERNAL 5A Existing
FIXATION
BONE (LOWER LIMB), TUMOR (MALIGNANT), RADICAL
16 SB701B EXCISION >6CM WITH RECONSTRUCTION AND BONE 6A Existing
GRAFT
BONE (SKULL), TUMOR (LARGE>3CM), EXCISION AND
17 SB702B 7B Existing
EXTENSIVE RECONSTRUCTION (DURA, SKULL, SKIN)
BONE (UPPER/LOWER LIMB), EXOSTOSIS, EXCISION
18 SB703B 3A Existing
BIOPSY (MORE THAN1/ BILATERAL)
BONE (UPPER LIMB), TUMOR (BENIGN), MAJOR EXCISION
19 SB704B >3 CM WITH BONE GRAFTING +/- 5A Existing
RECONSTRUCTION/INTERNAL FIXATION
BONE, TUMOUR, IMAGING GUIDED PERCUTANEOUS
LOCAL ABLATION, SIMPLE, > 1 LESION
20 SB705B 4A Existing
(RADIOFREQUENCY, CRYOTHERAPY, MICROWAVE,
LASER, ALCOHOL, ETC)
BONE, TUMOUR, IMAGING GUIDED PERCUTANEOUS
21 SB706B LOCAL ABLATION (RADIOFREQUENCY, CRYOTHERAPY, 3C Existing
MICROWAVE, LASER, ALCOHOL,ETC) , SINGLE LESION
BONE, TUMOR (MALIGNANT), AROUND JOINTS WITH LIMB
22 SB707B 7A Existing
RECONSTRUCTION AND JOINT REPLACEMENT
BONE, TUMOUR (MALIGNANT), WIDE/MAJOR RESECTION
23 SB708B 7B Existing
AND RECONSTRUCTION (VASCULARISED BONE GRAFT)
BONE, VARIOUS LESIONS, OPEN BIOPSY,
24 SB709B 1B Existing
CEMENTING/PLATE FIXATION
25 SB710B BONE/SOFT TISSUE, VARIOUS LESIONS, TRUCUT BIOPSY 1B Existing
BONE/ SOFT TISSUE, VARIOUS LESIONS, IMAGING
26 SB711B 2B Existing
GUIDED PERCUTANEOUS BIOPSY
12SB – MUSCULOSKELETAL
BURSA, BURSITIS, EXCISION BIOPSY (MORE THAN
27 SB712B 2C Existing
1/BILATERAL)
BONE, TUMOUR, IMAGING GUIDED PERCUTANEOUS
LOCAL ABLATION, COMPLEX, > 1 LESION
28 SB713B 4B Existing
(RADIOFREQUENCY, CRYOTHERAPY, MICROWAVE,
LASER, ALCOHOL, ETC)
BONE, CYST/TUMOUR BENIGN/BENIGN AGGRESSIVE,
29 SB800B 4A Existing
CURRETTAGE/BURRING/BONE GRAFTING/CEMENTING
BONE (LOWER LIMB), DEFORMITIES, CORRECTIVE
30 SB801B SURGERY WITH INTERNAL FIXATION WITH OR WITHOUT 5C Existing
FLUOROSCOPY
BONE (LOWER LIMB), DEFORMITIES, CORRECTIVE
31 SB802B 4A Existing
SURGERY WITH OSTEOTOMY ALONE
BONE (LOWER LIMB), DEFECT/NON UNION,
32 SB803B 3B Existing
IMPLANTATION OF BONE STIMULATOR
BONE (LOWER LIMB), FRACTURE/DISLOCATION,
33 SB804B 3B Existing
MANIPULATION AND KIRSCHNER WIRE FIXATION
BONE (LOWER LIMB), GRADE 1 AND 2 OPEN
34 SB805B FRACTURES/OPEN DISLOCATION OR OPEN FRACTURE- 2B Existing
DISLOCATION WOUND DEBRIDEMENT
BONE (LOWER LIMB), OSTEOMYELITIS, DRAINAGE WITH
35 SB806B 4A Existing
CURETTAGE AND IRRIGATION
36 SB807B BONE (LOWER LIMB), OSTEOMYELITIS, SIMPLE DRAINAGE 2B Existing
BONE AND JOINTS (LOWER LIMB), PLATES AND Descriptor
37 SB808B 2B
SCREWS/NAILS, REMOVAL change
BONE AND JOINTS (LOWER LIMB), REMOVAL OF SIMPLE
Descriptor
38 SB809B IMPLANTS (E.G. RUSH RODS/WIRES/K- 1C
change
WIRES/PINS/SCREWS)
BONE (LOWER LIMB), TUMOR (BENIGN),SB – MUSCULOSKELETAL
BONE (UPPER LIMB), OSTEOMYELITIS, EXTENSIVE
51 SB823B 4A Existing
CURETTAGE/DEBRIDEMENT AND IRRIGATION
52 SB824B BONE (UPPER LIMB), OSTEOMYELITIS SIMPLE DRAINAGE 2B Existing
BONE AND JOINTS (UPPER LIMB), PLATES AND SCREWS, Descriptor
53 SB825B 2B
REMOVAL change
BONE AND JOINTS (UPPER LIMB), REMOVAL OF SIMPLE
Descriptor
54 SB826B IMPLANTS (E.G. RUSH RODS/WIRES/K- 1C
change
WIRES/PINS/SCREWS)
BONE (UPPER LIMB), TUMOR (BENIGN), MAJOR EXCISION
55 SB827BSB – MUSCULOSKELETAL
ELBOW, DISLOCATION , LIGAMENT REPAIR (COMPLEX,
80 SB703E 4A Existing
WITH/WITHOUT IMPLANT)
81 SB704E ELBOW, DISLOCATION , LIGAMENT REPAIR (SINGLE) 3A Existing
ELBOW, FRACTURE/DISLOCATION, OPEN REDUCTION
82 SB705E 3C Existing
AND INTERNAL FIXATION (ORIF)
ELBOW, SUPRACONDYLAR FRACTURE, M&R,
83 SB706E 3C Existing
PERCUTANEOUS PINNING
ELBOW, VARIOUS LESIONS, PRIMARY TOTAL JOINT
ARTHROPLASTY WITH AUGMENTATION, REQUIRING
84 SB707E 6B Existing
EXTRA IMPLANTS OR BONE GRAFTS,
OPEN/MIS/NAVIGATED
ELBOW, VARIOUS LESIONS, PRIMARY TOTAL JOINT
85 SB708E 6A Existing
ARTHROPLASTY, OPEN/MIS/NAVIGATED
ELBOW, VARIOUS LESIONS, REVISION TOTAL JOINT
86 SB709E 6C Existing
ARTHROPLASTY, OPEN/MIS/NAVIGATED
ELBOW (MEDIAL EPICONDYLE), FRACTURE, EXCISION
87 SB800E 2B Existing
BONY FRAGMENT
ELBOW, FRACTURE/ DISLOCATION, REPAIR OF
88 SB801E 4B Existing
LIGAMENTS/ ORIF
89 SB802E ELBOW, TENNIS ELBOW, RELEASE 2B Existing
ELBOW, VARIOUS LESIONS, RECONSTRUCTION WITH OR Descriptor
90 SB803E 5A
WITHOUT SYNOVECTOMY change
FACE, FRACTURE, ENDOSCOPIC REDUCTION AND
91 SB700F 5C Existing
FIXATION
FACE, FRACTURES (PANFACIAL), OPEN REDUCTION AND
92 SB701F 7C Existing
INTERNAL FIXATION
FEMUR, DELAYED/NON UNION, WITH RE-INTERNAL
93 SB702F 5A Existing
FIXATION AND BONE GRAFTING
FEMUR, FRACTURE (COMPLEX INTRA-ARTICULAR), OPEN
94 SB703F REDUCTION AND INTERNAL FIXATION (ORIF) WITH PLATE 5C Existing
AND SCREWS
FEMUR, FRACTURE (MULTIFRAGMENTARY),
95 SB705F 5A Existing
INTRAMEDULLARY NAILING (WITH OR WITHOUT LOCKING)
FEMUR, FRACTURE (INTERCONDYLAR), OPEN
96 SB706F 5A Existing
REDUCTION AND INTERNAL FIXATION (ORIF)
FEMUR, NECK OF FEMUR FRACTURE (PAEDIATRIC), PIN
97 SB707F 4B Existing
FIXATION
FEMUR, FRACTURE (PAEDIATRIC SHAFT),
98 SB708F 4A Existing
INTRAMEDULLARY FLEXIBLE NAILING
FEMUR, FRACTURE (SINGLE CONDYLAR), OPEN
99 SB709F 4B Existing
REDUCTION AND INTERNAL FIXATION (ORIF)
FEMUR, SLIPPED CAPITAL FEMORAL EPIPHYSIS (SCFE),
100 SB710F 4B Existing
SCREW FIXATION
FINGER, DEFECT/CONTRACTURE (MULTIPLE),
101 SB711F 4C Existing
RECONSTRUCTION
FINGER, VARIOUS LESIONS, RAY AMPUTATION
102 SB712F 3C Existing
(MULTIPLE)
FOREARM, RADIAL HEAD FRACTURE, OPEN REDUCTION
103 SB713F 4A Existing
OF RADIAL HEAD FOR MISSED MONTEGGIA
FOREARM, RADIUS/ULNA SHAFT FRACTURE,
104 SB714F 4B Existing
INTRAMEDULLARY ROD
105 SB715F FOOT, ACHILLES TENDON RECONSTRUCTION 4A Existing
FOOT, CONGENITAL TALIPES EQUINOVARUS (CTEV),
106 SB716F 6A Existing
BILATERAL RELEASE
15SB – MUSCULOSKELETAL
FOOT, CONGENITAL TALIPES EQUINOVARUS (CTEV),
107 SB717F 4A Existing
MEDIAL RELEASE
FOOT, CONGENITAL TALIPES EQUINOVARUS (CTEV),
108 SB718F 4C Existing
POST MEDIAL RELEASE
FOOT, CONGENITAL TALIPES EQUINOVARUS (CTEV),
109 SB719F 4A Existing
POST RELEASE
FOOT, CONGENITAL TALIPES EQUINOVARUS (CTEV),
110 SB720F 5C Existing
POSTERIOR MEDIAL RELEASE WITH REVISION
FOOT, FRACTURES, COMPLEX, MULTIPLE, INCLUDING
111 SB721F TALUS AND CALCANEUM, OPEN REDUCTION AND 5A Existing
INTERNAL FIXATION
112 SB722F FOOT, FRACTURES, SIMPLE, SINGLE 3A Downtable
113 SB724F FOOT, HAGLUND'S DEFORMITY, OSTEOTOMY 3C Existing
FOOT, ONE BONE OSTEOTOMY WITH SOFT TISSUE
114 SB725F 5A Existing
RELEASE, CUBOID
FOOT, ONE BONE OSTEOTOMY WITH SOFT TISSUE
115 SB726F 5A Existing
RELEASE, DWYER’S (CALCANEAL)
116 SB727F FOOT, MULTIPLE FOOT OSTEOTOMIES 5C Existing
FOOT, POSTERIOR TIBIAL TENDON DYSFUNCTION (PTTD),
117 SB728F 4A Existing
POSTERIOR TIBIALIS RECONSTRUCTION
FOOT, TENDON TRANSFERS, SPLIT TIBIALIS ANTERIOR
118 SB729F 4A Existing
TENDON TRANSFER (SPLATT)
FOOT, TENDON TRANSFERS, SPLIT TIBIALIS POSTERIOR
119 SB730F 4A Existing
TENDON TRANSFER (SPLOTT)
120 SB731F FOOT, TENDON TRANSFERS, TIBIA ANTERIOR TRANSFER 4A Existing
FOOT, HALLUX VALGUS/HAMMER TOE, PROXIMAL
121 SB732F OSTEOTOMY, WITH OR WITHOUT SOFT TISSUE 3C Existing
RECONSTRUCTION
FACE, CONTOUR DEFECT, RECONSTRUCTION /
122 SB800F 4A Existing
INSERTION OF IMPLANT(S)
FACE, DEFECT / DEFORMITY, RECONSTRUCTION /
123 SB801F 5C Existing
INSERTION OF IMPLANT
FACE, FRACTURES (MORE THAN 2), OPEN REDUCTION
124 SB802F 6B Existing
AND INTERNAL FIXATION
FACE, INFECTION / OSTEOMYELITIS, MAJOR
125 SB803F 3B Existing
DRAINAGE/SEQUESTRECTOMY
FACE, INFECTION / OSTEOMYELITIS, SIMPLE DRAINAGE
126 SB804F 2C Existing
/SEQUESTRECTOMY
127 SB805F FACE, INTRAOSSEOUS TUMOR (LARGE), EXCISION 5C Existing
128 SB806F FACE, INTRAOSSEOUS TUMOR (SMALL), EXCISION 3A Existing
FASCIA PALMAR, DUPUYTREN'S CONTRACTURE,
129 SB807F 5C Existing
FASCIECTOMY (MULTIPLE)
FASCIA PALMAR, DUPUYTREN'S CONTRACTURE,
130 SB808F 4A Existing
FASCIECTOMY (SINGLE)
131 SB809F FEMUR, DELAYED/NON UNION, WITH BONE GRATING 4A Existing
FEMUR, FRACTURE (FEMUR SHAFT), INTRAMEDULLARY
132 SB810F 5A Existing
NAILING/ROD (WITH OR WITHOUT LOCKING)
FEMUR, FRACTURE, OPEN REDUCTION AND INTERNAL
133 SB811F 5A Existing
FIXATION WITH PLATE AND SCREWS
FINGER, DEFECT/CONTRACTURE (SINGLE),
134 SB812F 3C Existing
RECONSTRUCTION
135 SB813F FINGER, DEFORMITIES, CORRECTION 4A Existing
136 SB814F FINGER, INJURY, DEBRIDEMENT 1B Existing
137 SB816F FINGER, RING CONSTRICTION (SINGLE), CORRECTION 3B Existing
138 SB817F FINGER, RING CONSTRICTION (MULTIPLE), CORRECTION 5C Existing
16SB – MUSCULOSKELETAL
FINGER, SWAN NECK/BOUTONNIERE DEFORMITY
139 SB818F 4A Existing
(SINGLE), CORRECTION
140 SB819F FINGER, SYNDACTYLY (MULTIPLE), SEPARATION 5C Existing
141 SB820F FINGER, SYNDACTYLY (SINGLE), CORRECTION 4A Existing
142 SB821F FINGER, TRAUMA, REPLANTATION (MULTIPLE) 7B Existing
FINGER, TRAUMA, REPLANTATION/TRANSPLANTATION
143 SB822F 6B Existing
(SINGLE)
144 SB823F FINGER, TRAUMA, TERMINALISATION (MULTIPLE) 3B Existing
145 SB824F FINGER, TRAUMA, TERMINALISATION (SINGLE) 2C Existing
146 SB825F FINGER, VARIOUS LESIONS, AMPUTATION (MULTIPLE) 2C Existing
147 SB826F FINGER, VARIOUS LESIONS, AMPUTATION (SINGLE) 2A Existing
148 SB827F HAND, FREE TOE PULP TRANSFER 7C Existing
149 SB828F FINGER, VARIOUS LESIONS, RAY AMPUTATION (SINGLE) 3A Existing
FINGER, VARIOUS LESIONS, SYNOVECTOMY WITH SOFT
150 SB829F 5C Existing
TISSUE RECONSTRUCTION
FOOT, CRUSH INJURIES (COMPLEX), WOUND
151 SB830F 3B Existing
DEBRIDEMENT
152 SB831F FOOT, CRUSH INJURIES (SIMPLE), WOUND DEBRIDEMENT 1B Existing
FOOT, HALLUX VALGUS/HAMMER TOE, SOFT TISSUE
153 SB832F 3B Existing
RECONSTRUCTION
154 SB833F FOOT, POLYDACTYLY, EXCISION 1A Existing
FOOT, POLYDACTYLY, EXCISION WITH
155 SB834F 4A Existing
RECONSTRUCTION
FOOT, VARIOUS LESIONS, OSTEOTOMY, WITH OR
156 SB835F 3A Existing
WITHOUT TENDON RECONSTRUCTION
FOOT, VARIOUS LESIONS, MORE THAN ONE JOINT,
157 SB836F 5C Existing
ARTHRODESIS
FINGER, MACRODACTYLY, SURGICAL REDUCTION OF
158 SB837F 3A Existing
ENLARGED ELEMENTS, SINGLE DIGIT
FINGER, MACRODACTYLY, SURGICAL REDUCTION OF
159 SB838F 4A Existing
ENLARGED ELEMENTS, MULTIPLE DIGITS
HIP/KNEE, THERAPEUTIC ARTHROSCOPY, WITH/WITHOUT
Descriptor
160 SB700H SYNOVECTOMY/ LABRAL REPAIR /FAI RESECTION FOR 4A
change
HIP
HAND AND WRIST, RHEUMATOID HAND
RECONSTRUCTION INCLUDING MULTIPLE JOINT
161 SB701H SYNOVECTOMY, BONE/JOINT PROCEDURES WITH 6C Existing
ARTHROPLASTY (MULTIPLE) AND SOFT TISSUE
PROCEDURES
HAND AND WRIST, RHEUMATOID HAND
RECONSTRUCTION INCLUDING SYNOVECTOMY,
162 SB702H BONE/JOINT PROCEDURES WITH/WITHOUT 5C Existing
REPLACEMENT ARTHROPLASTY, AND SOFT TISSUE
PROCEDURES
Descriptor
163 SB703H HAND, CLOSED FRACTURE, ORIF (MULTIPLE), NON-JOINT 5A
change
HAND, CLOSED FRACTURE, ORIF/PLATE AND SCREWS Descriptor
164 SB704H 3C
(SINGLE), JOINT/NON-JOINT change
HAND, CLOSED FRACTURE, ORIF WITH K-
165 SB705H 2C Existing
WIRE/CERCLAGE WIRE FIXATION
HAND, COMPLEX INJURIES, DEBRIDEMENT WITH
166 SB706H REPAIR/RECONSTRUCTION (MORE THAN 2 TENDONS 5C Existing
INVOLVED OR MORE THAN 2 FRACTURES)
HAND, COMPLEX INJURIES, MICROSURGICAL
167 SB707H 6B Existing
REPAIR/RECONSTRUCTION, >1 DIGIT
17SB – MUSCULOSKELETAL
HAND, FLEXOR TENDON, TRIGGER FINGER (MULTIPLE),
168 SB708H 3A Existing
RELEASE
HAND, FLEXOR TENDON, TRIGGER FINGER (SINGLE),
169 SB709H 2A Existing
RELEASE
HAND, FRACTURE OF FINGERS/METACARPALS,
170 SB710H 3B Existing
EXTERNAL FIXATION
HAND, FRACTURE OF FINGERS/METACARPALS, NON-
171 SB711H 4C Existing
UNION, BONE-GRAFTING AND FIXATION (MULTIPLE)
HAND, FRACTURE OF FINGERS/METACARPALS, NON-
172 SB712H 3C Existing
UNION, BONE-GRAFTING AND FIXATION (SINGLE)
Descriptor
173 SB713H HAND, CLOSED FRACTURE, ORIF (MULTIPLE), JOINT 5C
change
HAND, OPEN FRACTURE, DEBRIDEMENT AND ORIF
174 SB714H 6A Existing
(MULTIPLE), JOINT
HAND, OPEN FRACTURE, DEBRIDEMENT AND ORIF
175 SB715H 5B Existing
(MULTIPLE), NON-JOINT
HAND, OPEN FRACTURE, DEBRIDEMENT AND ORIF
176 SB716H 4A Existing
(SINGLE), JOINT
HAND, OPEN FRACTURE, DEBRIDEMENT AND ORIF
177 SB717H 3B Existing
(SINGLE), NON-JOINT
178 SB718H HAND, SOFT TISSUE TUMOR, EXCISION >1.5CM SIZE 2C Existing
HIP, ACETABULUM, FRACTURE, DOUBLE COLUMN
179 SB719H 6B Existing
FIXATION
HIP, ACETABULUM, FRACTURE, SINGLE COLUMN
180 SB720H 5C Existing
FIXATION
HIP, OPEN REDUCTION WITH ACETABULAR OR FEMORAL
181 SB721H 5B Existing
OSTEOTOMIES
182 SB722H HIP, SOFT TISSUE RELEASE AND OPEN REDUCTION ONLY 4C Existing
HIP, VARIOUS LESIONS, PRIMARY TOTAL JOINT
REPLACEMENT WITH AUGMENTATION, REQUIRING
183 SB723H 6B Existing
EXTRA IMPLANTS OR BONE GRAFTS,
OPEN/MIS/NAVIGATED
HIP, VARIOUS LESIONS, REVISION TOTAL JOINT
184 SB724H 6C Existing
REPLACEMENT, OPEN/MIS/NAVIGATED
HIP/KNEE, REMOVAL OF PROSTHESES WITH OR
185 SB725H 5A Existing
WITHOUT SPACER
HUMERUS, CUBITUS VARUS, CORRECTIVE OSTEOTOMY
186 SB726H 4B Existing
WITH CAST OR PINNING
HUMERUS, CUBITUS VARUS, CORRECTIVE OSTEOTOMY
187 SB727H 5A Existing
WITH PLATING
HUMERUS, DELAYED/NON-UNION, RECONSTRUCTION
188 SB728H 4B Existing
WITH BONE GRAFTING WITHOUT INTERNAL FIXATION
HUMERUS, HUMERUS SHAFT FRACTURE, CLOSED
189 SB729H 4A Existing
INTERLOCKING INTRAMEDULLARY NAIL
HUMERUS, HUMERUS SHAFT FRACTURE, COMPLEX
190 SB730H 4C Existing
MULTI-FRAGMENTARY INTRAMEDULLARY NAIL
191 SB733H HAND, FLEXOR TENDON, PULLEY RECONSTRUCTION 4B Existing
192 SB800H HAND, AMPUTATED DIGIT(S), TOE TO HAND TRANSFER 7B Existing
HAND, CLOSED FRACTURE/DISLOCATION, OPEN
193 SB801H 2C Existing
REDUCTION AND FIXATION (SINGLE)
HAND, COMPLEX INJURIES, DEBRIDEMENT WITH
194 SB802H REPAIR/RECONSTRUCTION (1-2 TENDONS INVOLVED OR 5A Existing
1-2 FRACTURES)
HAND, COMPLEX INJURIES, MICROSURGICAL
195 SB803H 5C Existing
REPAIR/RECONSTRUCTION, SINGLE DIGIT
18SB – MUSCULOSKELETAL
HAND, CRUSH INJURIES (COMPLEX), WOUND
196 SB804H 3C Existing
DEBRIDEMENT
197 SB805H HAND, CRUSH INJURIES (SIMPLE), WOUND DEBRIDEMENT 1C Existing
198 SB806H HAND, DEEP INFECTION, DRAINAGE 2C Existing
HAND, DEFORMITIES, MAJOR RECONSTRUCTIVE
199 SB807H 5C Existing
PROCEDURES
200 SB808H HAND, DEFORMITIES, OSTEOTOMY 3B Existing
HAND, DEFORMITY, INTRINSIC MUSCLE
201 SB809H 5C Existing
RELEASE/TRANSFER/EXTENSOR RELOCATION
202 SB810H HAND, EXTRA DIGIT, AMPUTATION/STUMP REVISION 1C Existing
HAND, FLEXOR TENDON INJURIES, INSERTION OF
203 SB811H 5C Existing
SILASTIC ROD(S)
HAND, FOREIGN BODY (DEEP), REMOVAL WITH
204 SB812H 3A Existing
MOBILISATION OF NEUROVASCULAR BUNDLE
HAND, FOREIGN BODY (SUPERFICIAL), REMOVAL WITH
205 SB813H 2A Existing
MOBILISATION OF NEUROVASCULAR BUNDLE
HAND, FRACTURES/DISLOCATION, OPEN REDUCTION
206 SB814H 5C Existing
AND INTERNAL FIXATION (MULTIPLE)
HAND, POLYDACTYLY, AMPUTATION WITH
207 SB815H 4A Existing
RECONSTRUCTION
208 SB816H HAND, SCAR, REVISION 2C Existing
209 SB817H HAND, SOFT TISSUE TUMOR, EXCISIONSB – MUSCULOSKELETAL
HUMERUS, DELAYED/NON-UNION, RECONSTRUCTION
232 SB840H 5B Existing
WITH INTERNAL FIXATION AND BONE GRAFTING
HUMERUS, PROXIMAL HUMERUS OR SUPRACONDYLAR
233 SB841H 4A Existing
FRACTURE, ORIF
HUMERUS SUPRACONDYLAR AND INTERCONDYLAR
234 SB842H 5A Existing
FRACTURE
JOINTS (TEMPOROMANDIBULAR), VARIOUS LESIONS,
235 SB700J 2C Existing
ARTHROSCOPY (UNILATERAL)
JOINTS (TEMPOROMANDIBULAR), VARIOUS LESIONS,
236 SB701J 3B Existing
ARTHROSCOPY (BILATERAL)
237 SB702J JOINTS, ARTHROSCOPY, DIAGNOSTIC 2C Existing
JOINTS (LOWER LIMB, HIP), SEPTIC ARTHRITIS,
238 SB703J 4A Existing
CURETTAGE/DEBRIDEMENT AND IRRIGATION
JOINTS (LOWER LIMB, HIP), SEPTIC ARTHRITIS, SIMPLE
239 SB704J 3A Existing
DRAINAGE
JOINTS, VARIOUS LESIONS, PRIMARY TOTAL JOINT
REPLACEMENT WITH AUGMENTATION, REQUIRING
240 SB705J 6B Existing
EXTRA IMPLANTS OR BONE GRAFTS,
OPEN/MIS/NAVIGATED
JOINTS, VARIOUS LESIONS, REVISION TOTAL JOINT
241 SB706J 6C Existing
REPLACEMENT, OPEN/MIS/NAVIGATED
JOINTS (SHOULDER), VARIOUS LESIONS, IMPINGEMENT
242 SB707J 5A Existing
SYNDROME
JOINTS (TEMPOROMANDIBULAR), VARIOUS LESIONS,
243 SB708J 3A Existing
ARTHROCENTESIS (BILATERAL)
JOINTS (TEMPOROMANDIBULAR), VARIOUS LESIONS,
244 SB709J 2B Existing
ARTHROCENTESIS (UNILATERAL)
JOINTS (TEMPORO-MANDIBULAR), VARIOUS LESIONS,
245 SB710J 4B Existing
CONDYLECTOMY/CORONOIDECTOMY/MENISECTOMY
JOINTS (TEMPORO-MANDIBULAR), VARIOUS LESIONS,
246 SB711J 4A Existing
CONDYLOTOMY
JOINTS (TEMPORO-MANDIBULAR), VARIOUS LESIONS,
247 SB712J 7A Existing
CONDYLECTOMY WITH RECONSTRUCTION (BILATERAL)
JOINTS (TEMPORO-MANDIBULAR), VARIOUS LESIONS,
248 SB713J 7A Existing
RECONSTRUCTION (BILATERAL)
JOINTS (UPPER LIMB, SHOULDER), SEPTIC
249 SB714J ARTHRITIS/EFFUSION, CURETTAGE/DEBRIDEMENT AND 4A Existing
IRRIGATION
JOINTS (UPPER LIMB, SHOULDER), SEPTIC
250 SB715J 3A Existing
ARTHRITIS/EFFUSION, SIMPLE DRAINAGE
JOINTS (UPPER LIMB), VASCULAR INJURY, MAJOR
251 SB716J 5A Existing
VASCULAR RECONSTRUCTION/ANASTOMOSIS/GRAFT
JOINTS, MAJOR INTRA-ARTICULAR FRACTURE WITH
252 SB717J DISCONTINUITY OR BONE LOSS, RECONSTRUCTION (FOR 5C Existing
LOWER LIMB)
JOINTS, MAJOR INTRA-ARTICULAR FRACTURE WITH
253 SB718J DISCONTINUITY OR BONE LOSS, RECONSTRUCTION (FOR 5A Existing
UPPER LIMB)
JOINT, VARIOUS LESIONS, JOINT
254 SB745J 1A Existing
ASPIRATION/ARTHROCENTESIS/INJECTION
JOINTS (FINGER), CONTRACTURE,
255 SB800J 4A Existing
CAPSULECTOMY/CAPSULOTOMY
256 SB801J JOINTS (FINGER), VARIOUS LESIONS, ARTHRODESIS 3C Existing
JOINTS (FINGER), VARIOUS LESIONS, EXCISION
257 SB802J 3C Existing
ARTHROPLASTY
20SB – MUSCULOSKELETAL
JOINTS (FINGER), VARIOUS LESIONS, REPLACEMENT
258 SB803J 4C Existing
ARTHROPLASTY
JOINTS (FOOT EXCLUDING ANKLE), SYNOVITIS,
259 SB804J 2C Existing
SYNOVECTOMY
JOINTS (FINGER, INTERPHALANGEAL JOINTS,
Descriptor
260 SB805J METACARPOPHALANGEAL JOINTS), SYNOVITIS, 2C
change
SYNOVECTOMY
JOINTS (LOWER LIMB), SMALL, VARIOUS LESIONS,
261 SB806J 3C Existing
ARTHROPLASTY
JOINTS (LOWER LIMB), DEFORMITIES, CORRECTIVE
262 SB807J 4A Existing
SURGERY WITH OSTEOTOMY ALONE
JOINTS (LOWER LIMB), DEFORMITIES, CORRECTIVE
263 SB808J 5C Existing
SURGERY WITH PLATE FIXATION AND FLUOROSCOPY
JOINTS (LOWER LIMB), DISLOCATIONS, MANIPULATION
264 SB809J 3B Existing
AND KIRSCHNER WIRE FIXATION
JOINTS (LOWER LIMB), DISLOCATIONS, WOUND
265 SB810J 2B Existing
DEBRIDEMENT
266 SB811J JOINTS (LOWER LIMB), LOOSE BODIES, REMOVAL 3B Existing
BONE/JOINTS (LOWER LIMB), MAJOR CRUSH INJURIES,
267 SB812J 3B Existing
WOUND DEBRIDEMENT
JOINTS (LOWER LIMB, EXCEPT HIP), SEPTIC ARTHRITIS,
268 SB813J 3C Existing
DRAINAGE WITH CURETTAGE AND DEBRIDEMENT
JOINTS (LOWER LIMB, EXCEPT HIP), SEPTIC ARTHRITIS,
269 SB814J 2B Existing
SIMPLE DRAINAGE
JOINTS (LOWER LIMB), VARIOUS LESIONS,
270 SB816J 5C Existing
EPIPHYSIOLYSIS WITH/WITHOUT MICROSURGERY
JOINTS (OTHER THAN FINGER), VARIOUS LESIONS,
271 SB817J 6A Existing
TOTAL JOINT REPLACEMENT
JOINTS (OTHER THAN HAND AND WRIST), VARIOUS
272 SB818J 5C Existing
LESIONS, ARTHRODESIS
JOINTS (WRIST, DISTAL RADIOULNAR JOINT), SYNOVITIS, Descriptor
273 SB819J 4A
SYNOVECTOMY change
JOINTS (TEMPORO-MANDIBULAR), DISLOCATION,
274 SB820J MSP Existing
REDUCTION WITHOUT GENERAL ANAESTHESIA
JOINTS (TEMPORO-MANDIBULAR), DISLOCATION,
275 SB821J 1C Existing
REDUCTION UNDER GENERAL ANAESTHESIA
JOINTS (TEMPORO-MANDIBULAR), VARIOUS LESIONS,
276 SB822J 6B Existing
CONDYLECTOMY WITH RECONSTRUCTION (UNILATERAL)
JOINTS (TEMPORO-MANDIBULAR), VARIOUS LESIONS,
277 SB823J 6B Existing
RECONSTRUCTION (UNILATERAL)
JOINTS (TEMPORO-MANDIBULAR), VARIOUS LESIONS,
278 SB824J 4A Existing
PLICATION OF DISC
JOINTS (UPPER LIMB), CONTRACTURE,
279 SB825J 5C Existing
CAPSULECTOMY/CAPSULOTOMY (MULTIPLE)
JOINTS (UPPER LIMB), DEFORMITIES/CONTRACTURE,
280 SB826J 4B Existing
CORRECTIVE SURGERY
JOINTS (UPPER LIMB),
281 SB828J MSP Existing
FRACTURES/DISLOCATION/SPRAIN, FULL CAST
JOINTS (UPPER LIMB, EXCEPT SHOULDER), SEPTIC
282 SB831J ARTHRITIS, DRAINAGE WITH CURRETAGE AND 3C Existing
DEBRIDEMENT
JOINTS (UPPER LIMB, EXCEPT SHOULDER), SEPTIC
283 SB832J 2B Existing
ARTHRITIS, SIMPLE DRAINAGE
JOINTS (UPPER LIMB), VARIOUS LESIONS,
284 SB834J 7C Existing
VASCULARISED JOINT TRANSFER
21SB – MUSCULOSKELETAL
285 SB835J JOINTS (WRIST), VARIOUS LESIONS, ARTHRODESIS 4B Existing
KNEE, ARTHROSCOPY, KNEE LIGAMENT
286 SB700K 5C Existing
RECONSTRUCTION (1 OR MORE)
KNEE, LIGAMENTS/MENISCUS/CARTILAGE/BONE
287 SB701K 5C Existing
COMBINED, MIS ACL OR PCL RECONSTRUCTION
KNEE, HEMARTHROSIS, ASPIRATION UNDER LOCAL
288 SB702K MSP Existing
ANESTHESIA
KNEE, LIGAMENTS/MENISCUS/CARTILAGE/BONE
289 SB703K COMBINED, MIS LIGAMENT RECONSTRUCTION WITH 5C Existing
MENISCAL REPAIR
KNEE, LIGAMENTS/MENISCUS/CARTILAGE/BONE
290 SB704K COMBINED, MIS LIGAMENT RECONSTRUCTION WITH 5C Existing
MENISCECTOMY
KNEE, LIGAMENTS/MENISCUS/CARTILAGE/BONE
291 SB705K COMBINED, MIS LIGAMENT RECONSTRUCTION WITH 5C Existing
MICROFRACTURE
KNEE, LIGAMENTS/MENISCUS/CARTILAGE/BONE
292 SB706K COMBINED, MIS PRIMARY DOUBLE BUNDLE ACL OR PCL 6A Existing
RECONSTRUCTION
KNEE, LIGAMENTS/MENISCUS/CARTILAGE/BONE
293 SB707K 5C Existing
COMBINED, MIS REVISION ACL RECONSTRUCTION
KNEE, LIGAMENTS/MENISCUS/CARTILAGE/BONE
294 SB708K 5C Existing
COMBINED, MIS REVISION PCL RECONSTRUCTION
KNEE, LIGAMENTS/MENISCUS/CARTILAGE/BONE
295 SB709K COMBINED, AUTOLOGOUS CHONDROCYTE 6A Existing
IMPLANTATION WITH OSTEOTOMY
KNEE, LIGAMENTS/MENISCUS/CARTILAGE/BONE
296 SB710K COMBINED, MOSAICPLASTY OR OSTEOARTICULAR 6A Existing
TRANSFER SYSTEM (OATS) WITH OSTEOTOMY
KNEE, LIGAMENTS/MENISCUS/CARTILAGE/BONE
297 SB711K COMBINED, MULTI-LIGAMENTED KNEE 6A Uptable
RECONSTRUCTION (3 OR MORE LIGAMENTS)
KNEE, MENISCUS/CARTILAGE (SMALL DEFECTS),
298 SB712K 5C Existing
MIS/OPEN MOSAICPLASTY OR OATS
KNEE, MENISCUS/CARTILAGE, MIS ASSISTED ALLOGRAFT
299 SB713K 5C Existing
MENISCAL TRANSPLANTATION
KNEE, MENISCUS/CARTILAGE, MIS CARTILAGE
300 SB714K 4A Existing
HARVESTING
301 SB715K KNEE, MENISCUS/CARTILAGE, MIS MENISCAL REPAIR 5A Existing
KNEE, VARIOUS LESIONS, PRIMARY TOTAL JOINT
REPLACEMENT (UNILATERAL) WITH AUGMENTATION,
302 SB716K 6B Existing
REQUIRING EXTRA IMPLANTS OR BONE GRAFTS,
OPEN/MIS/NAVIGATED
KNEE, VARIOUS LESIONS, REVISION TOTAL JOINT
303 SB717K 6C Existing
REPLACEMENT, OPEN/MIS/NAVIGATED
KNEE LIGAMENTS, DISRUPTION, RECONSTRUCTION AND
304 SB800K 5C Existing
REPAIR
KNEE, DISLOCATION, OPEN REDUCTION WITH REPAIR OF
305 SB801K 5C Existing
LIGAMENTS
KNEE, HEMARTHROSIS, ASPIRATION UNDER GENERAL
306 SB802K 1A Existing
ANESTHESIA
307 SB803K KNEE, VARIOUS LESIONS, ARTHRODESIS 5A Existing
308 SB804K KNEE, VARIOUS LESIONS, ARTHROTOMY 3B Existing
KNEE, VARIOUS LESIONS, ARTHROTOMY AND
309 SB805K 4A Existing
SYNOVECTOMY
22SB – MUSCULOSKELETAL
KNEE, VARIOUS LESIONS, EXCISION/INTERPOSITION
310 SB806K 4A Existing
ARTHROPLASTY
KNEE, VARIOUS LESIONS, MENISCECTOMY
311 SB808K 4A Existing
WITH/WITHOUT ARTHROSCOPY
KNEE, VARIOUS LESIONS, TOTAL JOINT REPLACEMENT
312 SB809K 7B Existing
(BILATERAL)
KNEE, VARIOUS LESIONS, PRIMARY TOTAL JOINT
313 SB810K 6A Existing
REPLACEMENT (UNILATERAL), OPEN/MIS/NAVIGATED
LOWER LIMB, OPEN TENDON RELEASE (INCLUDING OPEN
314 SB700L SOFT TISSUE RELEASES E.G. GASTROCNEMIUS 4B Existing
RECESSION)
LOWER LIMB, OPEN TENDON RELEASES AND CAST
315 SB701L 3A Existing
APPLICATION, HAMSTRING RELEASES
LOWER LIMB, PERCUTANEOUS TENOTOMY AND CAST
316 SB702L 3A Existing
APPLICATION, ADDUCTOR TENOTOMY
LOWER LIMB, PERCUTANEOUS TENOTOMY AND CAST
317 SB703L 3A Existing
APPLICATION, TA TENOTOMY
LOWER LIMB, CRUSH INJURIES (EXTENSIVE),
318 SB800L DEBRIDEMENT WITH REPAIR OF BONE AND SOFT 6B Existing
TISSUES
LOWER LIMB, CRUSH INJURIES (LIMITED), DEBRIDEMENT
319 SB801L 5A Existing
WITH REPAIR OF BONE AND SOFT TISSUES
320 SB802L LOWER LIMB, DEFORMITIES, EPIPHYSIODESIS 4A Existing
LOWER LIMB, FRACTURES, OPEN REDUCTION AND
321 SB803L 6B Existing
FIXATION WITH REPAIR OF ARTERIAL INJURIES
LOWER LIMB, FRACTURES/DISLOCATION, MANIPULATION
322 SB804L 1B Existing
AND REDUCTION WITH/WITHOUT APPLICATION OF CAST
LOWER LIMB, LENGTH DISCREPANCIES, LENGTHENING
323 SB805L 4B Existing
PROCEDURES
LOWER LIMB, LENGTH DISCREPANCIES, SHORTENING
324 SB806L 6B Existing
PROCEDURES
UPPER LIMB/LOWER LIMB, OPEN FRACTURES WITH
325 SB807L 4B Existing
DEBRIDEMENT AND EXTERNAL FIXATION
LOWER LIMB, TRAUMATIC AMPUTATION, MAJOR
326 SB808L 7C Existing
REPLANTATION
327 SB809L LOWER LIMB, VARIOUS LESIONS, AMPUTATION 4A Existing
328 SB810L LOWER LIMB, VARIOUS LESIONS, APPLICATION OF CAST MSP Existing
LOWER LIMB, VARIOUS LESIONS, HINDQUARTER
329 SB811L 6B Existing
AMPUTATION
330 SB812L LOWER LIMB, VARIOUS LESIONS, HIP DISARTICULATION 6B Existing
UPPER LIMB/LOWER LIMB, CLOSED FRACTURES,
331 SB813L EXTERNAL FIXATION WITHOUT DEBRIDEMENT OR OTHER 3B New
PROCEDURES
332 SB814L LOWER LIMB, ISCHEMIA, FASCIOTOMY 3A New
MANDIBLE AND MAXILLA, VARIOUS LESIONS,
333 SB700M OSTEOTOMY AND INSERTION OF DEVICE FOR 7C Existing
DISTRACTION OSTEOGENESIS
MANDIBLE OR MAXILLA, BONY PROTUBERANCE,
334 SB701M 1B Existing
EXCISION
MANDIBLE OR MAXILLA, DENTAL IMPLANT(S),
335 SB702M OSSEOINTEGRATED, TREPHINE REMOVAL (X NUMBER OF 1C Existing
IMPLANTS REMOVED)
MANDIBLE OR MAXILLA, TUMOR, MARGINAL RESECTION
336 SB703M 6B Existing
WITH BONE GRAFT
23SB – MUSCULOSKELETAL
MANDIBLE OR MAXILLA, VARIOUS LESIONS, SEGMENTAL
337 SB704M OSTEOTOMY AND INSERTION OF DEVICE FOR 5B Existing
DISTRACTION OSTEOGENESIS AND BONE TRANSPORT
MANDIBLE OR MAXILLA, VARIOUS LESIONS,
338 SB705M 3C Existing
VESTIBULOPLASTY, COMPLEX
MANDIBLE OR MAXILLA, VARIOUS LESIONS,
339 SB706M 2B Existing
VESTIBULOPLASTY, SIMPLE
MANDIBLE OR MAXILLA, VARIOUS LESIONS,
340 SB707M DENTOALVEOLAR OSTEOTOMY AND INSERTION OF 5A Existing
DEVICE FOR DISTRACTION OSTEOGENESIS
MANDIBLE, ATROPHY, LATERALISATION OF INFERIOR
341 SB708M DENTAL NERVE WITH IMPLANT FIXTURES PLACEMENT, 5A Existing
BILATERAL.
MANDIBLE, ATROPHY, LATERALISATION OF INFERIOR
342 SB709M DENTAL NERVE WITH IMPLANT FIXTURES PLACEMENT, 4B Existing
UNILATERAL
MANDIBLE AND MAXILLA, OLD FRACTURES/OSTEOTOMY,
343 SB710M 3B Existing
REMOVAL OF PLATES OR WIRES
MANDIBLE, VARIOUS LESIONS, BODY OR RAMUS
344 SB711M OSTEOTOMY WITH INSERTION OF DISTRACTION 5C Existing
OSTEOGENESIS DEVICE
MAXILLA, VARIOUS LESIONS, RESECTION WITH
345 SB712M 6B Existing
RECONSTRUCTION
MAXILLA, DEFORMITY, LE FORT I OSTEOTOMY AND
346 SB713M 5C Existing
INSERTION OF DISTRACTION OSTEOGENESIS DEVICE
MANDIBLE (EXCLUDING ALVEOLAR MARGINS), VARIOUS
347 SB800M 6B Existing
LESIONS, COMPLEX OSTEOTOMY/OSTECTOMY
MANDIBLE AND MAXILLA, VARIOUS LESIONS,
348 SB801M OSTEOTOMY INCLUDING SEGMENTAL OSTEOTOMY 7C Existing
WITH/WITHOUT GRAFTING
MANDIBLE OR MAXILLA, ALVEOLAR DEFECT/DEFORMITY,
COMPLEX ALVEOLOPLASTY/UNILATERAL (LATERAL
349 SB802M 3A Existing
WINDOW) SINUS LIFT/RIDGE AUGMENTATION WITH
GRAFTING
MANDIBLE OR MAXILLA, ALVEOLAR DEFECT/DEFORMITY,
350 SB803M SIMPLE ALVEOLOPLASTY/BONE REGENERATIVE 2C Existing
PROCEDURE
MANDIBLE, FRACTURE (COMMINUTED), OPEN
351 SB804M 5C Existing
REDUCTION AND FIXATION
MANDIBLE, FRACTURE, CLOSED REDUCTION AND
352 SB805M 3B Existing
FIXATION
353 SB806M MANDIBLE, FRACTURE, OPEN REDUCTION AND FIXATION 5A Existing
MANDIBLE OR MAXILLA, ODONTOGENIC CYST (11- 20MM),
354 SB807M 3A Existing
ENUCLEATION
MANDIBLE OR MAXILLA, ODONTOGENIC CYST (20MM OR
355 SB808M 4A Existing
LARGER OR MULTIPLE CYSTS), ENUCLEATION
MANDIBLE OR MAXILLA, ODONTOGENIC CYST (10MM OR
356 SB809M 2C Existing
SMALLER), ENUCLEATION
MANDIBLE OR MAXILLA, ODONTOGENIC CYST,
357 SB810M 2B Existing
MARSUPIALIZATION
MANDIBLE OR MAXILLA, OLD FRACTURES / OSTEOTOMY,
358 SB811M 2B Existing
REMOVAL OF PLATES OR WIRES
359 SB812M MANDIBLE OR MAXILLA, TUMOR, MARGINAL RESECTION 5C Existing
MANDIBLE, VARIOUS LESIONS, ALVEOLECTOMY (PER
360 SB813M 2C Existing
QUADRANT)
24SB – MUSCULOSKELETAL
MANDIBLE OR MAXILLA, VARIOUS LESIONS,
ALVEOLOPLASTY WITH EPITHELIAL GRAFT OR
361 SB814M BILATERAL SINUS-LIFT PROCEDURE OR RIDGE 4A Existing
AUGMENTATION (MULTIPLE QUADRANTS) WITH
GRAFTING
MANDIBLE, VARIOUS LESIONS, GENIOPLASTY (COMPLEX
362 SB815M 5C Existing
- NOT AS A COMBINED PROCEDURE)
MANDIBLE OR MAXILLA, VARIOUS LESIONS, INSERTION
OF ENDOSSEOUS DENTAL IMPLANT (SINGLE)(FOR
363 SB816M 2C Existing
MULTIPLE PLACEMENT OF IMPLANTS, NUMBER OF
CLAIMS = NUMBER OF IMPLANTS PLACED )
MANDIBLE AND/OR MAXILLA, VARIOUS LESIONS,
364 SB817M INSERTION OF TRANSMANDIBULAR IMPLANT/ 5A Existing
SUBPERIOSTEAL IMPLANT/ ZYGOMATICUS IMPLANT
MANDIBLE, VARIOUS LESIONS, MANDIBULAR
365 SB818M RAMUS/BODY OSTECTOMY/OSTEOTOMY WITH 6B Existing
SEGMENTAL OSTEOTOMY
MANDIBLE, VARIOUS LESIONS, MANDIBULAR
366 SB819M RAMUS/BODY OSTECTOMY/OSTEOTOMY WITHOUT 5C Existing
SEGMENTAL OSTEOTOMY
MANDIBLE, VARIOUS LESIONS, RECONSTRUCTION WITH
367 SB820M 5C Existing
BONE
MANDIBLE, VARIOUS LESIONS, SEGMENTAL
368 SB821M 5A Existing
OSTECTOMY/OSTEOTOMY (ONE SEGMENT ONLY)
MANDIBLE, VARIOUS LESIONS, SEGMENTAL RESECTION
369 SB822M 6B Existing
WITH BONE GRAFT
MANDIBLE, VARIOUS LESIONS, GENIOPLASTY (SIMPLE -
370 SB823M 5A Existing
NOT AS A COMBINED PROCEDURE)
MAXILLA (EXCLUDING ALVEOLAR MARGINS) AND/OR
371 SB824M ZYGOMA, VARIOUS LESIONS, COMPLEX 6B Existing
OSTECTOMY/OSTEOTOMY
MAXILLA, ALVEOLAR CLEFT (BILATERAL COMPLETE),
372 SB825M 6B Existing
BONE GRAFT AND CLOSURE OF NASO BUCCAL FISTULA
MAXILLA, BILATERAL INCOMPLETE ALVEOLAR CLEFT,
373 SB826M 6A Existing
BONE GRAFT
374 SB827M MAXILLA, DEFORMITY - LEFORT I, OSTEOTOMY 5C Existing
375 SB828M MAXILLA, DEFORMITY - LEFORT II, OSTEOTOMY 6B Existing
376 SB829M MAXILLA, DEFORMITY - LEFORT III, OSTEOTOMY 7C Existing
MAXILLA, FRACTURE - LEFORT I, CLOSED REDUCTION
377 SB830M 4A Existing
AND FIXATION
MAXILLA, FRACTURE - LEFORT I, OPEN REDUCTION AND
378 SB831M 5C Existing
FIXATION
MAXILLA, FRACTURE - LEFORT II / III, CLOSED
379 SB832M 5A Existing
REDUCTION AND FIXATION.
MAXILLA DEFORMITY, LE FORT II OSTEOTOMY AND
380 SB833M 6B Existing
INSERTION OF DISTRACTION OSTEOGENESIS DEVICE
MAXILLA, FRACTURE - LEFORT II (COMPLEX), OPEN
381 SB834M 6B Existing
REDUCTION AND FIXATION.
MAXILLA DEFORMITY, LE FORT III OSTEOTOMY AND
382 SB835M 7B Existing
INSERTION OF DISTRACTION OSTEOGENESIS DEVICE
MAXILLA, FRACTURE - LEFORT III, OPEN REDUCTION AND
383 SB836M 6B Existing
FIXATION
MAXILLA, FRACTURE - LEFORT III, OPEN REDUCTION AND
384 SB837M 7C Existing
FIXATION USING CRANIOFACIAL APPROACH
25SB – MUSCULOSKELETAL
MAXILLA, ALVEOLAR CLEFT (UNILATERAL COMPLETE),
385 SB838M 5B Existing
BONE GRAFT AND CLOSURE OF NASO BUCCAL FISTULA
MAXILLA, ALVEOLAR CLEFT (UNILATERAL INCOMPLETE),
386 SB839M 4B Existing
BONE GRAFT
MAXILLA, VARIOUS LESIONS, OSTECTOMY/OSTEOTOMY
387 SB840M 6B Existing
(MORE THAN 1 SEGMENT)
MAXILLA, VARIOUS LESIONS,
388 SB841M RESECTION/HEMIMAXILLECTOMY (OPEN OR 5C Existing
ENDOSCOPIC METHOD)
MAXILLA, VARIOUS LESIONS, OSTECTOMY/OSTEOTOMY
389 SB842M 5A Existing
(ONE SEGMENT ONLY)
390 SB843M MUSCLE (LOWER LIMB), DEEP ABSCESS, DRAINAGE 2A Existing
391 SB844M MUSCLE (LOWER LIMB), RUPTURE, REPAIR 2C Existing
MUSCLE (LOWER LIMB), VARIOUS LESIONS, MARGINAL
392 SB845M 2A Existing
EXCISION
MUSCLE (LOWER LIMB), VARIOUS LESIONS, WIDE
393 SB846M 3A Existing
EXCISION
LOWER LIMB, MUSCLE (QUADRICEPS)/TENDON
Descriptor
394 SB847M (INCLUDING PATELLAR TENDON), DISRUPTION, REPAIR 3A
change
OR RECONSTRUCTION
MUSCLE (UPPER LIMB), DEEP ABSCESS, INCISION AND
395 SB848M 2A Existing
DRAINAGE
396 SB849M MUSCLE (UPPER LIMB), RUPTURE, REPAIR 2C Existing
MUSCLE (UPPER LIMB), VARIOUS LESIONS, MARGINAL
397 SB850M 2C Existing
EXCISION
MUSCLE (UPPER LIMB), VARIOUS LESIONS, WIDE
398 SB851M 3C Existing
EXCISION
MUSCULOSKELETAL SYSTEM, VARIOUS LESIONS, FREE
399 SB852M 7B Existing
COMPOSITE TISSUE GRAFT
MUSCULOSKELETAL SYSTEM, VARIOUS LESIONS,
400 SB853M MSP Existing
STEINMAN PINS INSERTION
DIGIT(S), NAIL BED, DEFORMITY/DEFECT,
401 SB800N 4B Existing
RECONSTRUCTION
402 SB801N NAIL BED, LACERATION, REPAIR (MULTIPLE) 2C Existing
403 SB802N NAIL BED, LACERATION, REPAIR (SINGLE) 1C Existing
404 SB803N NAIL, INFECTION/INJURY, AVULSION 1A Existing
405 SB804N NECK, TORTICOLLIS, CORRECTION 3B Existing
406 SB700O OTHERS, AUTOLOGOUS CHONDROCYTE IMPLANTATION 5A Existing
PATELLA, HABITUAL DISLOCATION- LATERAL RELEASE,
407 SB700P 4B Existing
MEDIAL PLICATION
PELVIS, FRACTURE, FIXATION OF ANTERIOR AND
408 SB701P 5C Existing
POSTERIOR RING
409 SB702P PELVIS, FRACTURE, PLATE/SCREW FIXATION 5C Existing
PATELLA, FRACTURE, OPEN REDUCTION AND INTERNAL
410 SB800P 3B Existing
FIXATION
PATELLA, RECURRENT DISLOCATION/CHONDROMALACIA,
411 SB801P 4B Existing
RECONSTRUCTION
412 SB802P PATELLA, VARIOUS LESIONS, PATELLECTOMY 3A Existing
PELVIS, FRACTURE (DOUBLE COLUMNS), OPEN
413 SB803P 6B Existing
REDUCTION AND INTERNAL FIXATION
PELVIS, FRACTURE, OPEN REDUCTION AND INTERNAL
414 SB804P 5C Existing
FIXATION
RADIUS AND ULNA, FRACTURE/DISLOCATION, NON
415 SB700R UNION/DELAYED UNION BONE GRAFTING AND RE- 5A Existing
FIXATION
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