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December 2018 Vol. 144

Seasons Greetings

We, here at SpesNet, would like to take this opportunity to thank all our valued clients for their continued support during this year and to extend our warmest wishes to you and your families for a blessed Holiday Season.

 

Payment Arrangements

With the start of the new year just a few weeks away, please be mindful of the fact that most payment arrangements provisions, as agreed upon between the practitioner and the relevant medical scheme, will remain in place unless specifically varied or cancelled.

It may be of importance to review these existing payment arrangements, especially in light of the registration of new medical aid options and plans within some of the medical schemes as well as the envisaged merge between Spectramed and Resolution Health.

 

SpesNet Subscription Increase for 2019

Key features of the product enhancements for 2018/2019 are:
• Enhancement of the clinical coding database, Health Code Index, pertaining to ICD-10, RPL and CPT4.
• Enrichment of the clinical cross matches between these 3 code sets,
• Additions of Medical Scheme tariffs in certain specialities

We look forward to your continued support! Here is a breakdown of our 2019 monthly fees:

• Plan 2 subscribers – R598.90*
• Plan 3 subscribers – 768.50*

For the updated pricelist on Chargeable Services, please refer to our website.
*Please note that fees exclude VAT.

 

 

Holiday Coding Corner

Coding for the festive season:

Sunburn:
Should the patient be dehydrated and admitted to hospital for rehydration, then the dehydration code, E86, will be coded primary position.

Adding an external cause code in these cases is not compulsory, but advisable.

Primary codes

L55 Sunburn
L55.0 Sunburn of first degree
L55.1 Sunburn of second degree
L55.2 Sunburn of third degree
L55.8 Other sunburn
L55.9 Sunburn, unspecified

E86 Volume depletion

External cause code

X32 Exposure to sunlight

Remember to add a 4th and 5th character for the place of occurrence and activity

Sting by a jellyfish / marine animal /sea anemone / shellfish / star fish

T63 Toxic effect of animals
T63.0 Snake venom, sea-snake venom
T63.1 Venom of other reptiles, lizard venom
T63.2 Venom of scorpion
T63.3 Venom of spider
T63.4 Venom of other arthropods, insect bite or sting, venomous
T63.5 Toxic effect of contact with fish, excludes: poisoning by ingestion of
fish (T61.0 - T61.2)
T63.6 Toxic effect of contact with other marine animals, jellyfish, sea
anemone, shellfish, starfish, excludes: poisoning by ingestion of
shellfish (T61.2), sea-snake venom (T63.0)
T63.8 Toxic effect of contact with other venomous animals, venom of
amphibian
T63.9 Toxic effect of contact with unspecified venomous animal

External cause code

Lead terms: Sting (venomous) (see also Contact, with, by type of sting) X29

– ant X25
– arthropod NEC X25
– – nonvenomous W57
– bee X23
– caterpillar X25
– centipede X24
– coral X26
– hornet X23
– insect NEC X25
– – nonvenomous W57
– jelly fish X26
– marine animal or plant X26
– millipede, venomous X24
– nematocysts X26
– scorpion X22
– sea anemone, cucumber, or urchin (spine) X26
– wasp X23

Remember to add a 4th and 5th character for the place of occurrence and activity

The 4th character for places such as the beach, campsite mountain, lake, park river, sea is: .8 Other specified place

The 5th character if on holiday is seen as a leisure activity and therefore the 5th character is: .1 while engaged in leisure activity

Interesting:

D67 Hereditary factor IX deficiency, including: Christmas disease
Deficiency: • factor IX (with functional defect)
• plasma thromboplastin component [PTC] haemophilia B

 

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