Obstetrics and gynaecology P042 - Caesarean section including hysterectomy

General Info

Billing Amount: $837.25

Anesthetic units:

8
8

Surgical Assist units:

8
8

Billing Additions

Code Description Amount
E500 for the third and each subsequent delivery, subject to the payment rules set out below, for each additional delivery, to P006, P018, P020, P041 or P042, add $148.60
E499 for the second caesarian delivery, subject to the payment rules set out below, to P018, P041 or P042 $397.75

Notes:

Payment rules:
For vaginal delivery of the first infant followed by caesarean section, one of P018, P041 or P042 as appropriate is eligible for payment, in addition to 85% of P006 or P020 as appropriate, and E500 for the third and each subsequent delivery.

For multiple deliveries by caesarean section only (with or without trial of labour), one of P018, P041 or P042 as appropriate is eligible for payment, in addition to E499 for the second delivery and E500 for the third and each subsequent delivery.

Despite payment rules above, for multiple deliveries by caesarean section only between 20 and 23 weeks gestational age, only one of P018, P041 or P042 as appropriate is eligible for payment, in addition to E499 for the second delivery. E500 is not eligible for payment for the third or subsequent deliveries.

For delivery of one or more fetuses known to be stillborn in addition to delivery of one or more live fetuses, only the delivery of live fetuses is eligible for payment in accordance with the payment rules above. If all fetuses are known to be stillborn, only one of P006, P018, P020, P041 or P042 as appropriate, is eligible for payment.