These fees are intended for the Trauma Team Leader (TTL) within the facility (or facilities) that a trauma patient may arrive at, requiring treatment.
Trauma Team Leader Assessment and Support fees (P10087, P10088, and P10089) will be paid for services to patients demonstrating any one of the following criteria:
Trauma Team Activation Criteria:
i) Shock - confirmed Blood Pressure < 90 at any time in adults.
ii) Airway Compromise including intubations.
iii) Transfer patients from other Emergency Departments receiving blood to maintain vital signs.
iv) Unresponsiveness Ð Glasgow Coma Score < 8 with a mechanism suggestive of injury.
v) Gunshot or other penetrating wounds to head, neck, chest, abdomen or proximal extremity (at or above knee or elbow).
vi) Autolaunched Trauma Patient.
vii) Pediatric Trauma Patient under 16 years of age.
viii) Special consideration will be given for patients with significant co-morbidities, pregnant patients, and patients <5 years of age and >65 years of age.
Trauma Team Consults:
i) Spinal cord injury (confirmed or suspected).
ii) Vascular compromise of an extremity with a traumatic mechanism.
iii) Amputation proximal to the wrist or the ankle.
iv) Crush to the chest or pelvis.
v) Two or more proximal long bone fractures (ie: humerus, femur).
vi) Burns- Partial thickness (2o) burn ³ 10% and full thickness (3o) burn
- Electrical or lightning burn
- Chemical burn or Inhalation injury
- Burn injury in patients with significant co-morbidities
- Burn injury with concomitant trauma
vii) Obvious significant injury and - Falls > 20 feet.
viii) Obvious significant injury and - Pedestrian hit (thrown or run over).
ix) Obvious significant injury and - Motorcycle crash with separation of the rider and bike.
x) Obvious significant injury and -Motor vehicle crash with either- Ejection - Rollover- Speed > 70 kph- A death at the scene
xi) Patients with possible head injury and GCS less than 13.
All Trauma Assessment and Support fees include:
- Consultation and assessment
- subsequent examinations of the patient
- family counselling
- teleconference with higher level trauma facilities
- ongoing and active daily surgical management of trauma patients including but not limited to:
¥ performing tertiary and quaternary survey physical exams
¥ assessment and management of active and passive body core warming
¥ care of traumatic wounds or burns (including suturing) not requiring a general anesthetic
¥ obtaining appropriate surgical consultations and transfer to higher level facilities when needed
¥ coordinating with the transplant organ retrieval team, family counselling (related to organ donation) and obtaining consent for organ procurement
- usual resuscitative procedures such as endotracheal intubation, tracheal toilet and artificial ventilation
- extraordinary resuscitative procedures such as resuscitative thoracotomy or emergency surgical airway
- all necessary measures for respiratory support
- insertion of intravenous lines, peripheral and central
- bronchoscopy- chest tubes- lumbar puncture
- arterial and/or venous catheters and insertion of SWAN-GANZ catheter
- pressure infusion sets and pharmacological agents
- insertion of CVP lines
- cardio-version and usual resuscitative measures
- insertion of urinary catheters and nasal gastric tubes
- securing and interpretation of laboratory tests
- oximetry- transcutaneous blood gases
- intra-cranial pressure (ICP) monitoring, interpretation and assessment when indicated
- suturing of wounds not requiring a general anesthetic
- ensuring adequate DVT prophylaxis
- reduction of fractures and dislocations (including casting) not requiring a general anesthetic
- clearance of C-spines or appropriate referral
Not paid on same date of service as P10087 or P10089.
Not paid unless P10087 has been previously claimed (on same PHN).
iii) Start and end times to be recorded on patientÕs chart.
v) Not paid with any consult, visit or emergency care fees, by the same practitioner on the same date of service.
vi) Paid to only one physician for one patient, per facility, per day.
Please reference the billing pre-amble for these relevant interpretations of this billing code:See Pre-Amble Notes