Medicare Benefits Schedule - Item 39330

Neurolysis by open operation without transposition, other than a service associated with:

(a) a service to which item 39321, 39328, 39329, 39332, 39336, 39339, 39342, 39345, 49774 or 49775 applies; or

(b) a service to which item 30023 applies that is performed at the same site

(H)

Multiple Operation Rule

(Anaes.) (Assist.)

Fee: $315.30 Benefit: 75% = $236.50

(See para TN.8.196, TN.8.200, TN.8.254, TN.8.283 of explanatory notes to this Category)

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• Removal of prominent bone or osteophytes can be billed as an isolated procedure under 48430 or when through a separate incision to other procedures. 
• When an osteotomy is performed through the bone to correct a deformity then the appropriate number is chosen from 48400, 48403, 48406, 48409, 48418 or 48421. 
• Not to be used when performing joint arthroscopy (49703, 49730 or 49732), bunion correction (49827, 49830, 49833, 49836, 49837 or 49838), neurolysis (39330), wound debridement (30023) or an arthrodesis procedure unless performed at a site separate to the excluded items.

Related Items: 39330 48400 48403 48406 48409 48421 48430 49703 49827 49833 49836 49837 49838

• An arthrodesis consists of joint preparation, removal of surrounding osteophytes, intraarticular joint correction and fixation by any means.
• Bone procedure items (48430, 48400, 48403, 48406, 48409, 48419, or 48420) are not to be claimed unless performed at a separate site to the arthrodesis.
• Neurolysis (39330), wound debridement (30023) and ganglion excision (30107) items are not to be claimed unless performed at a site separate to the arthrodesis site.

Related Items: 30023 39330 48400 48403 48406 48409 48419 48420 48430 49712 49740 49742 49744 49760 49776 49777 49778 49779 49780 49781 49789 49790 49791 49792 49793 49794 49795 49796 49797 49798 49814 49815 49845 49851 50118

Exposure of the facial nerve and the great auricular nerve with or without mobilisation are considered integral parts of parotid gland surgery and hence part of the complete procedure for items 30247, 30250, 30251 and 30253. As such, co-claiming of items 39321, 39324, 39327, 39330 is not appropriate.

Related Items: 30247 30250 30251 30253 39321 39324 39327 39330

Items 39303, 39309-39315, 39329-39345, 46335, 46339-46341, 46348-46360, 46364, 46387, 46390-46395, 46408, 46414, 46423, 46434, 46450, 46453, 46522, 46525, 49717, 49740, 49744, 49771-49776, 49782, 49866, 49881-49890 all include the phrase "other than a service associated with a service to which item 30023 applies that is performed at the same site".

This indicates that an additional benefit is not payable for debridement of a soft tissue wound under item 30023 where it is performed at the same site on the same occasion.

These procedures are considered to be performed at the same site as the wound debridement (item 30023) where:

• Any incision for the orthopaedic or neurosurgical procedures involves the wound that is debrided.
• Debridement of the wound is required as part of the surgical approach and is considered an inherent part of the orthopaedic or neurosurgical procedure.

Related Items: 30023 39303 39309 39312 39315 39329 39330 39331 39332 39336 39339 39342 39345 46335 46339 46340 46341 46348 46351 46354 46357 46360 46364 46387 46390 46393 46394 46395 46408 46414 46423 46434 46450 46453 46522 46525 49717 49740 49744 49771 49773 49774 49775 49776 49782 49866 49881 49884 49887 49890