Out of office premiums 01212 - Weekend and stat holiday surcharge - operative

General Info

Billing Amount: $37,611.00

Minimum number of minutes per unit: 0 Mins

Max units / day / patient: 0

Max units / year / patient: 0

Description

Service rendered between 0800 hours and 2300 hours.) 37.85% of surgical (or assistant) fee. Minimum charge - $53.38, maximum charge - $368.28.

Notes:

OPERATIVE - applicable only to emergency surgery or to elective surgery which, because of intervening emergency surgery, commences within the designated times. Applicable only to surgical procedure(s) requiring general, spinal or epidural anesthesiology and/or requiring at least 45 minutes of surgical time.

These items are not applicable to full or part time emergency practitioners, designated by a hospital emergency room as the on duty/on site physician and billing under the Emergency Medicine Section of the Payment Schedule.

0.0

i) When surgery commences within evening time period (1800 Ð 2300 hrs) and continues into night time period (2300 Ð 0800 hrs), the appropriate item for billing is determined by the period in which the major portion of the surgical time is spent.
ii) When emergency surgery commences prior to 1800, even if the major portion of surgical time is after 1800, surgical surcharges are not applicable.
iii) If emergency surgery commences prior to 0800 and continues after 0800, surcharges are applicable to the entire surgical time.
iv) Claim must state time surgery commenced.

Pre-Amble References:

Please reference the billing pre-amble for these relevant interpretations of this billing code:

See Pre-Amble Notes