1. If insured diagnostic ultrasound procedures yield abnormal findings or if they would yield information which in the opinion of the interpreting physician would be insufficient governed by the needs of the patient and the requirements of the referring physician or practitioner, the interpreting physician may add further views and claim for them (if listed).
  2. Ultrasound of the abdomen, pelvis or breast, rendered in an independent health facility or a hospital out-patient department, is insured when referred by a registered nurse holding an extended certificate of registration.

L. Community Medicine, Occupational Medicine and Public Health
Specialists qualified in the above specialties are assigned billing numbers with the Internal Medicine suffix (13). To reflect this existing policy, the title of the Internal Medicine section of "Consultations and Visits" is amended to:


M. Clarification of Lung Transplantation Fee Description
Page P6 is changed to clarify the description of fee code M155:

M155 # Lung transplant (one lung)




N. Practice in General Codes Billed by Specialists
General Preamble section B.17, p. xxix is changed to add the services counselling, HIV primary care and palliative care support to the list of ‘Practice in General’ codes which can be claimed by specialists.

O. Oximetry at Rest Professional Fee
The Professional Fee for J323 O2 Saturation by Oximetry at Rest has been removed from the OMA Schedule. The parallel change to Pulmonary Function Studies page H2 is made by placing "-"in the Professional (P) Fee column:




J323 O2 saturation by oximetry at rest, with or without O2...............



P. Cataract Assistant Fees
Page Y2, word "NIL" is replaced with blank space for surgical assistant’s basic units for E140 and E950 to allow claims on an Independent Consideration using code M400B in accordance with General Preamble.

Q. Circumcision
Page U1, description of S573 is changed to clarify that prior approval of medically necessary circumcision is ONLY required for patients less than one year of age:

Circumcision - for physical symptomatology only
#S573 - for patients aged one year or older 3 82.90 4
- for infants less than one year of age. Prior approval
#S577 required. Circumcision for neonatal phimosis not a benefit 3 82.90 4

R. Perianal Warts

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