Payable only for Internal medicine specialists who do not hold a sub specialty.
For hospital in-patients, paid once per patient per hospital admission.
Written consultation report includes advice or recommendations for treatment regarding 3 or more of the conditions listed in note iv), below.
iv) Payable for patients that have 3 or more of the following listed chronic diseases. Exceptions to this rule could be made if the patient has two diagnoses from this list and one alternative diagnosis not on the list can be submitted with correspondence/note record, outlining the medical necessity.
Each case will be reviewed on an independent consideration basis.
(Diagnostic codes in brackets):
Other HIV infection (044)
DM including complications (250)
Disorders of Lipid Metabolism (272)
Thyroid disorders (246)
Purpura, thrombocytopenia and hemorrhagic conditions (287)
Anemia, unspecified (285.9)
Senile dementia, presenile dementia (290)
Acute confusional state (293)
Congestive Heart Failure (428)
Diseases of the aortic and mitral valve (396)
Essential hypertension (401)Coronary atherosclerosis (414)
Neoplasm of uncertain behaviour of other and unspecified sites. "Not for minor or superficial skin malignancies." (238)
Cardiac dysarrhythmias (427)
Cerebral atherosclerosis (437)
Asthma allergic bronchitis (493)
Other bacterial pneumonia (482)
Non infective enteritis and colitis (557.1)
GI hemorrhage (578)
Chronic liver diseases and cirrhosis of the liver (571)
Disorders of fluid, electrolyte and acid base balance (276)
Venous thrombosis and embolism (453)
Pulmonary fibrosis (515)
Rheumatoid Arthritis (714)
Systemic Lupus Erythematosus (710)