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GASTRO-OESOPHAGEAL balloon intubation, for control of bleeding from gastric oesophageal varices

Multiple Operation Rule

Fee: $203.00 Benefit: 75% = $152.25 85% = $172.55

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Management of labour and birth, or birth alone, (including caesarean section), on or after 23 weeks gestation, if in the course of antenatal supervision or intrapartum management one or more of the following conditions is present, including postnatal care for 7 days:

(a) fetal loss;

(b) multiple pregnancy;

(c) antepartum haemorrhage that is:

(i) of greater than 200 ml; or

(ii) associated with disseminated intravascular coagulation;

(d) placenta praevia on ultrasound in the third trimester with the placenta within 2 cm of the internal cervical os;

(e) baby with a birth weight less than or equal to 2,500 g;

(f) trial of vaginal birth in a patient with uterine scar where there has been a planned vaginal birth after caesarean section;

(g) trial of vaginal breech birth where there has been a planned vaginal breech birth;

(h) prolonged labour greater than 12 hours with partogram evidence of abnormal cervimetric progress as evidenced by cervical dilatation at less than 1 cm/hr in the active phase of labour (after 3 cm cervical dilatation and effacement until full dilatation of the cervix);

(i) acute fetal compromise evidenced by:

(i) scalp pH less than 7.15; or

(ii) scalp lactate greater than 4.0;

(j) acute fetal compromise evidenced by at least one of the following significant cardiotocograph abnormalities:

(i) prolonged bradycardia (less than 100 bpm for more than 2 minutes);

(ii) absent baseline variability (less than 3 bpm);

(iii) sinusoidal pattern;

(iv) complicated variable decelerations with reduced (3 to 5 bpm) or absent baseline variability;

(v) late decelerations;

(k) pregnancy induced hypertension of at least 140/90 mm Hg associated with:

(i) at least 2+ proteinuria on urinalysis; or

(ii) protein-creatinine ratio greater than 30 mg/mmol; or

(iii) platelet count less than 150 x 10⁹/L; or

(iv) uric acid greater than 0.36 mmol/L;

(l) gestational diabetes mellitus requiring at least daily blood glucose monitoring;

(m) mental health disorder (whether arising prior to pregnancy, during pregnancy or postpartum) that is demonstrated by:

(i) the patient requiring hospitalisation; or

(ii) the patient receiving ongoing care by a psychologist or psychiatrist to treat the symptoms of a mental health disorder; or

(iii) the patient having a GP mental health treatment plan; or

(iv) the patient having a management plan prepared in accordance with item 291;

(n) disclosure or evidence of domestic violence;

(o) any of the following conditions either diagnosed pre-pregnancy or evident at the first antenatal visit before 20 weeks gestation:

(i) pre-existing hypertension requiring antihypertensive medication prior to pregnancy;

(ii) cardiac disease (co-managed with a specialist physician and with echocardiographic evidence of myocardial dysfunction);

(iii) previous renal or liver transplant;

(iv) renal dialysis;

(v) chronic liver disease with documented oesophageal varices;

(vi) renal insufficiency in early pregnancy (serum creatinine greater than 110 mmol/L);

(vii) neurological disorder that confines the patient to a wheelchair throughout pregnancy;

(viii) maternal height of less than 148 cm;

(ix) a body mass index greater than or equal to 40;

(x) pre-existing diabetes mellitus on medication prior to pregnancy;

(xi) thyrotoxicosis requiring medication;

(xii) previous thrombosis or thromboembolism requiring anticoagulant therapy through pregnancy and the early puerperium;

(xiii) thrombocytopenia with platelet count of less than 100,000 prior to 20 weeks gestation;

(xiv) HIV, hepatitis B or hepatitis C carrier status positive;

(xv) red cell or platelet iso-immunisation;

(xvi) cancer with metastatic disease;

(xvii) illicit drug misuse during pregnancy

(Anaes.)

Fee: $1,793.40 Benefit: 75% = $1,345.05

(See para TN.4.7 of explanatory notes to this Category)

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INITIATION OF MANAGEMENT OF ANAESTHESIA for procedures on oesophagus, thyroid, larynx, trachea, lymphatic system, muscles, nerves or other deep tissues of the neck, not being a service to which another item in this Subgroup applies

(6 basic units)

Fee: $130.80 Benefit: 75% = $98.10 85% = $111.20

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INITIATION OF MANAGEMENT OF ANAESTHESIA for open procedures on the oesophagus

(15 basic units)

Fee: $327.00 Benefit: 75% = $245.25 85% = $277.95

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INITIATION OF MANAGEMENT OF ANAESTHESIA for all closed chest procedures (including rigid oesophagoscopy or bronchoscopy), not being a service to which another item in this Subgroup applies

(6 basic units)

Fee: $130.80 Benefit: 75% = $98.10 85% = $111.20

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CERVICAL OESOPHAGOSTOMY or CLOSURE OF CERVICAL OESOPHAGOSTOMY with or without plastic repair

Multiple Operation Rule

(Anaes.) (Assist.)

Fee: $490.30 Benefit: 75% = $367.75 85% = $416.80

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CERVICAL OESOPHAGECTOMY with tracheostomy and oesophagostomy, with or without plastic reconstruction; or LARYNGOPHARYNGECTOMY with tracheostomy and plastic reconstruction

Multiple Operation Rule

(Anaes.) (Assist.)

Fee: $1,940.25 Benefit: 75% = $1,455.20

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Oesophagoscopy (not being a service associated with a service to which item 41822 applies), gastroscopy, duodenoscopy or panendoscopy (1 or more such procedures), with or without biopsy, not being a service associated with a service to which item 30478 or 30479 applies.

Multiple Operation Rule

(Anaes.)

Fee: $194.95 Benefit: 75% = $146.25 85% = $165.75

(See para TN.8.17 of explanatory notes to this Category)

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Oesophagoscopy (other than a service associated with a service to which item 41822 or 41825 applies), gastroscopy, duodenoscopy, panendoscopy or push enteroscopy, one or more such procedures, if:

(a) the procedures are performed using one or more of the following endoscopic procedures:

(i) polypectomy;

(ii) sclerosing or adrenalin injections;

(iii) banding;

(iv) endoscopic clips;

(v) haemostatic powders;

(vi) diathermy;

(vii) argon plasma coagulation; and

 

(b) the procedures are for the treatment of one or more of the following:

(i) upper gastrointestinal tract bleeding;

(ii) polyps;

(iii) removal of foreign body;

(iv) oesophageal or gastric varices;

(v) peptic ulcers;

(vi) neoplasia;

(vii) benign vascular lesions;

(viii) strictures of the gastrointestinal tract;

(ix) tumorous overgrowth through or over oesophageal stents;

 

other than a service associated with a service to which item 30473 or 30479 applies

Multiple Operation Rule

(Anaes.)

Fee: $270.35 Benefit: 75% = $202.80 85% = $229.80

(See para TN.8.17 of explanatory notes to this Category)

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Endoscopy with laser therapy, for the treatment of one or more of the following:

(a) neoplasia;

(b) benign vascular lesions;

(c) strictures of the gastrointestinal tract;

(d) tumorous overgrowth through or over oesophageal stents;

(e) peptic ulcers;

(f) angiodysplasia;

(g) gastric antral vascular ectasia;

(h) post-polypectomy bleeding;

 

other than a service associated with a service to which item 30473 or 30478 applies

Multiple Operation Rule

(Anaes.)

Fee: $524.00 Benefit: 75% = $393.00 85% = $445.40

(See para TN.8.17 of explanatory notes to this Category)

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