GOVERNMENT GAZETTE OF THE / REPUBLIC OF NAMIBL( N$2.52 WINDHOEK - 1 January] 996 No. 1239 / CONTENTS ~e~~ec~ ~o~.~ Page 'o{j . \~1o\9\ GOVERNMENT NOTICE No.6 Employees' Compensation Act, 1941: Tariff of Fe for Private Hospitals and Unattached ?perating Theatre Units ............................................... MINISTRY OF LAB R AND HUMAN RESOURCES D VELOPMENT No.6 1996 EMPLO EES' COMPENSATION ACT, 1941: TARIFF 0 FEES FOR PRIVATE HOSPITALS AND UNA: ~CHED OPERATING THEATRE UNITS Under section 79 of the Employees' Compensation Act, 1941 (Act 30 of 1941) I hereby with effect om 1 January 1996 prescribe the Tariff of Fees for Private Hospitals and Unatt hed Operating Theatre Units and the general rules and general modifiers appli ble thereto, as set out in the Schedule. The fees as stout in the Schedule are applicable in respect of payments authorized for services endered on or after 1 January 1996. ADV. G. . HINDA CHAI ERSON OF THE SOCIAL SECU 'ty COMMISSION Windhoek, 6 December 1995 2 Government Gazette 1 January 1996 No. 1239 ----, Il\'DEX GENERAL I I Page . 3 I RULES ...................................... MODIFIERS 0002 AND 0003 ............................... . . 4 5 5 1. I ACCOMMODATION (Ward fees) ..... . ............ 1.1 General Wards ............................ Maternity cases . I 1.2 1.3 ............................ . . . . Intensive areUnit. . . . . . . . . . . . . . . . . . . . . . . . . . . C II Private Wards ............................ Special Care Wards ........................ Specialised .leu ............................ 5 6 6 6 I 'I High Care Ward ..........................., Non chargeable items and equipment in Wards, High Care Wards and ICU. ............... . ....... j 7 7 I . I . I I I I I I 7 , I , I I I, II I Globalfee for the Rehabilitationand Psychiatry. . . . . . . 8 9 9 ( 9 9 9 10 10 10 JI 12 12 12 12 12 13 13 13 14 17 17 17 I I II :I II II II II I' ,i I I 2. I' I' d 1/ PROCEDURE R,OOMffHEATRE FEES. . . . .. .......... 2.1 Emergtfucy Unit Fee . . .. ............ " 2.2 Proced~re Room ., ,........... Time ir! procedure room ........... Ii 2.3 2.4 Operafing theatre . . . . . . . , . . . . . Time ih theatre ............................. I Speciahsed theatre After pours . . . . . . . . . . . . . . . .. ......... .............. ....... Ii i' I I I I I I I Non ~argeable theatre items and equipment . . . . . , . . . j Non 1hargeable in Catheterisation Laboratory ........ PROCEDUR~L FEES ,..................... 3.1 Procfdures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.2 Ho~ Nursing ,...,.................... 3.3 Radrtion Oncology ......................... Simtilation - Fixed custom made ... ............. Treatment Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . Ted~ical Aids . . . . . . .. ..................... Lin$r Accelerator Treatment . . . . . . . . . . . . . , . , . . . J ' STANDARD !cHARGES FOR EQUIPMENT AND MATERIAL I. . . . . . . . . . . . . . . . . . . . . .. .............. I STANDARDIDRUG AND MATERIAL CHARGES . . . . . . . . . 5.1 Ov4r the counter and proprietary items . . . . . . . . . . . I I I 3. 'I II /' 4. i 15. I 5.2 Dis ensed items ............................ I 5.3 5.4 5.5 oule ex broken bulk . . . . . . , . . . . . . . . . . . . . . . 18 18 18 . Fr ctional charge ........................... 5. .I Disposable drills, burrs, blades and laryngeal mask .... . I\, No. 1239 Government Gazette 1 January 1996 3 INDEX 5.5.2 Surgicallaser fibreoptic leads, handpiecesand probesor scalpels . . . . . . . . . . . . . . . . . . . . . Page 18 18 5.6 5.7 Consumable, disposable and surgical items ........ Gases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. Oxygenand NitrousOxide .............. Oxygen ward use . . . . . . . . . . . . . . . . . . . . .... Oxygen recovery room . . . . . . . . . . . . . .. Carbon Dioxide , ........ ,.. Laser .. _ . . . . . . . . . . . . . . . . . . . . . ..... Entonox ............ 5.8 5.9 5.10 Inhalation anaesthetics !.............. 18 18 18 19 19 19 19 19 19 19 Prostheses (Surgicallyimplanted)! . . . . . . . . . . . . . . . Medical artificial items (non-prostheses) .......... Electronic requisites .... Transportation Price increases Charges , , 5.11 5.12 .5.13 5.14 5.15 , . . 19 20 20 .1 . 20 I, j i Incise Drapes .. ........................... .................. ,........ VAT 20 I I NON STANDARD ITE S/SERVICES Open ~eart and cardiac y-pass surgery 20 20 OTE: FEES INCLUDE / . I" 4 Government Gazette 1 January 1996 No. 1239 GENERAL RULES SCHEDULE A. The Scale of Benefits stout in Sections 1 - 6 hereof, shall apply in respect of private hospitals and unattache operating theatre units with practice code numbers commencing with the digits 57, 58 r 77. The charges relating to each types of hospitaUunattached in the relevant colum opposite the item codes. operaring theatre unit are indicated B. C. in Section 5 hereof, are applicable to both categories of such hospitals ing theatre units. D. E.l E.Ll ed in the Scale of Benefits shall be deemed to be inclusive of Value A committee of (three) members shall be established, and shall consist of 2 (two) members nomina d by the Representative Association of Medical Schemes and I (one) member nomina d by representatives of the Private Hospital Industry to consider applications by 'vate hospitals to be classified as private hospital having practice code numbers comme cing with the digits 57 to 58 and for the approval of specialised intensive care units, speci ised theatres, catheterisation laboratories and trauma units. Tne criteria to be applied and he procedures for considering such appJications of for conducting any inspections, sha be laid down by the said committee and the decision of the said committee shaH be final. The fee payabl by a private hospital for the inspection for classification will be N$2 280.00 or such other e as may be determined by the committee from time to time. In addition, any such priv e hospitaJ shaH also be liable for all travelling andlor accommodation costs reasonably in ITed. E.I.2 E.2 The fee paya Ie by a private hospital for the inspection of specialised intensive care units, catheterisatio laboratories and specialised theatres will be N$456.00 or such other fee as may be dete mined by the committee from time to time. In addition any such private hospital sha I also be liable for aH travelling andlor accommodation costs reasonably incurred. The said co mittee shall also have the power to receive and investigate complaints that any private hos ital having practice code numbers commencing with the digits 57 to 58 no longei me s the criteria required for such classification. The said committee may conduct such re-in ections as it considers desirable, and shall afford any such private hospital no longer me ting such criteria a reasonable opportunity to rectify matters, failing which said committee may rt"'classifyany such private hospital as an institution having a practice code number c mmencing with the digits 90. The provo ions refeITed to in E.3.1 shall apply mutatis mutandis to an approved intensive care unit , specialised theatres, catheterisation laboratories and trauma units. s for the reclassification of unattached operating theatre units with 76 practice ~' ..... E.3.J E.3.2 El El.l A com ittee of 3 (three) members shan be established, and shall consist of 2 (two) membe nominated by the Representative Association of Medical Schemes and I (one) membe nominated by the South African Day Clinics Association to consider applications from u attached operating theatre units having practice code numbers commencing with the digits 6 to be reclassified as approved unattached operating theatre units having practice . '" No. 1239 Government Gazette 1 January 1996 5 code numbers commencing with the digits 77. The criteria to be applied and the p cedure for considering such applications or for conducting any inspections, shall be lai down by the said committee and the decision of the said committee shaH be final. F.l.2 The fee payable by an unattached operating theatre unit for an inspection for eclassification shall be N$l 140.00 or such other fee as may be determined by the com ittee from time to time. In addition any such unattached operating theatre unit shall al be liable for all travel and/or accommodation costs reasonably incurred. The said comInittee shall also have power and investigate complai s that any unattached operating theatre unit having a practice code number commenci with the digits 77 no longer meets the criteria required for such classification. The sai committee may conduct such re-inspections as it considers desirable and shall afford an); such unattached operating theatre unit, no longer meeting such criteria, a reasonable 0 ortunity to rectify matters, failing which said committee may reclassify and such unatta hed operating theatre unit as a unit having a practice code number commencing with th digits 76. All accounts submitted by private hospitals/unattached 0 erating theatre units shall comply with all of the requirements of Regulation 7 promuJgat in terms of the Medical Schemes Act, Act No. 72 of 1967, as amended by Act 23 of 93. Where ptJssible, such accounts shall also reflect the practice code numbers of the urgeon. The anaesthetist and of any assistant surgeon who may have been present duri g the course of an operation. All accounts shall be accompanied by a copy of e relevant theatre accounts specifying all details of items charged, as well as the proced re performed. Medical schemes shall have the right to inspect the original source docume s at the hospital/unattached operating theatre unit concerned. All accounts containing items which are subject to a discount in terms of the Scale of Benefits shail indicate such items indivi Ially and shall show separately the gross amount of the discount. F.2 G. H. 1. 0002 A surcharge shall be applicable' respect of item ..123 only if the specialised theatre has been approved in terms of G eral Rule E.l.1. 0003 A surcharge shall be appli ble in respect of item ..123 only if the specialised theatre has been approved in terms f General Rule E.1.!. 6 1. Government Gazette 1 January 1996 No. 1239 ACCOMMODATION WARD FEES Hospitals and nattached operating units shall indicate the exact time of admission and discharge on 1 accounts. In the case f hospitals, ward fees shall be charged at fully daily rate if the patient is not discharged efore 23HOOand day admission fees shall be charged in respect of all patients admitted a day patients and discharged before 23HOOon the same date. The items/appearing under code ..081 shall be deemed to be included in ward fees, and no charge is ;espect thereof may be levied. I I Code 57/58/77 Description I Practice Number Code 57/58 I . 1.1 001 N$ N$ ~r I I 'eneral Wards urgical Cases: per day ..................... . 379-20 003 , fhoracic and neurosurgical cases, including aminectomies and spinal fusion: per day ......... . i 392-40 005 I Medical and neurologicaJ cases: per day . . . . . . . . . . . 379-20 009 Day admission which includes all patients disch&rgedby I 23HOOon date of admission .................. . 187-70 I 011 I Overnight fee (subject to ongoing review and a I maximum of one night) ,.................... . I i I I - i I I ! 187-70 105-00 - I Maternity I cases births I I Natural , I I 021 023 025 I i I Maternity cases: Rates by arrangement with the scheme concerned . . . . . . . . . . . . . . ................ . First day (Day of confinement) ................ . Subsequent day(s) , I I I * ................ <......... . I - 027 Use of epidural anaesthesia for natural births ...... Caesarean - * - """'" * . 029 031 First day (Day of confinement) ................ Subsequent day(s) ......................... . * - * * To be advisee during 1996. To above mater ity fees EXCLUDE ward and theatre drugs in INCLUDE all other charges such as multiple births, after-hour deliveries including caesareans, labour ward or other ward fees, nursery fees, theatre an equipment fees and surgical items. The above fees also EXCLUDE the costs of special treatmen of newly born infants certified as necessary by the attending practitioner, which shall be dealt with in accordance with the Scale of Benefits for private hospitals and the rules of relevant scheme pertaini g to such dependents. RAMS and the ospital Industry agreed to re-negotiate the recommended maternity fee after further research and co sultation have been completed. . ',," No. 1239 Government Gazette 1 January 1996 7 A neonate required specialised treatment in an ICU shaH be considered to be a patient in its own right and, for that reason, the Scale of Benefits shall be applied to such neonate. Ward and Theatre Drugs The amount charged shall not exceed the trade unit price, exclusive of VAT, as listed in th Ethical Price List prevailing from time to time, plus 25.4% (which shall be inclusive of mark-up d VAT), plus a dispensing fee of N$2.80 which is of VAT. Code 57/58 Description N$ 1.2 041 Private Wards Private wards on doctor's request. If accommodation in 'a private ward has been prescribed by a medical practitioner for medical reasons, fees for such accommodation may not exceed the rate shown. 518-00 I Hospitals shall obtain a certificate motivating the neces ity for accommodation in a private ward from the attendant practitioner and such certific e shall be forwarded to the relevant scheme together with the account. 043 Private ward on member's request. If a schem undertakes to pay for a private ward requested by a member, a 10% discount on the ruling pri~ate ward rate will apply if the hospital is paid direct by the scheme conceme . , Special Care Ward Hospitals shall obtain a certificate mati ating the necessity for accommodation in any specialised or other intensive care unit 0 in high care ward from the attendant practitioner, and such certificate shall be forwarde to the relevant medical scheme together with the account. No charge may be levied for spe ial nursing whilst a patient is accommodated in a specialised intensive care unit, inte sive care unit or high care ward. 1.3 Code 57/58 pescription Practice Code Number 57/58 N$ ..061 s approved by the joint committee al Rule E.!.l) . . . . . . . . . . . . . . . . I 770-00 . '" 8 Government Gazette 1 January 1996 No. 1239 (Subject to a maximum of 3 days, whereafter the fee under item ..063 will apply. Use of this unit shall be limited cardia-thoracic, cardia-vascular and neuro-surgery cases) ~ Code 57/58 I Description Practice Code Number 57/58 N$ ..063 Intensive Carl Unit: Per day . . ................. I 331-00 Intensive Care and High Care Units to follow in 1996. 1 (The charges refer ed to under items ..061 and ..063 include the use of all equipment except. Bennett MA, Ser 0 and Beares respirators or equivalent apparatus plus the cost of oxygen) Note: Definitions J Code 57/58 Description Practice Code Number 57/58 N$ 065 High Ca e Ward: per day 820-00 All admission! to units/wards referred to under ..063 and ..065 shall be confirmed with the relevant scher e for each 72 hours. ..081 Non chargeat e items and equipment in Wards, High Care Wards and all Intensive Care Units (Which would always include the equivalent to the items named). Acetone Alcohol or s irits Betadine ski cleanser scrub, Shampoo and Spray Body lotion powders, cream, oils and shampoo Catavlon Cidex and a I sterilising fluid Collection c arges (pathology) Connection adaptors Dettol Ins lrument Dettol Douche can~ Disinfectan s - e.g. Biocide ET tube int oducers ET tube (n n-disposable) Face mask Formalin i saline Fractional tems Strapph g - e.g. Elastoplast,Microspore,Transpore,Dermicel,Zinc oxide * Ophtha mclear/nose drops, creams and ointments - e.g. Sofradex,Maxitrol. * - Lacrilurn Topical . ''>0 Sprays - e.g. Opsite, Disdine * Jellies - ~.g. KY * * Creams e.g. Terracortril, EABS Gloves fo non sterile procedures (except for barrier nursing) Gowns an briefs including disposable (except for barrier nursing) Habitan ill solutions Humidifie'S (except Aquapac) Iodine - s lution for prepping * naesthetics - e.g. Remicaine, Cocaine. Zylocaine - No. 1239 Government Gazette 1 January 1996 9 Labstix, Multistix, Dextrostix (except when marked ITO) Lancets and autolets Linen, linen savers, draw sheets including disposable linen Liquid soups except for bums and haemorrhoidectomies Meals ex kitchen or catering services, milk substitutes, baby foods and excluding hyperalimentation - e,g, tube feeds Medicine glasses, spoons and syringes for feeding Merthiolate, mercurochrome for prepping Nursing Packs (sterile) (except for items ..491 and ..493) Patient controlled analgesia single use disposable requirements of item ..413 Prep equipment - shaving trays, razors, scrub-up brushes, depilatory creams Receptal liners Savlon Sheepskins Shut-off valves Spatulas, tongue depressors and orange sticks Spigots and safety pins - Spray topbottles , Sputum cups Sterile water (except for flushing of wound Sterilisation of instruments or materials Stich cutters and staple removers Onclu ng disposable) Thermometers except temperature pr e in NNUIICU (1 per patient) Trays (except items ..491 and ..493) - Ventilator circuits, Bacterial - Viral ters and tubing (applicable to items ..417, ..425) NON-CHARGEABLE EQUIP * * * * * * * 1.4 Dinamapp and Sphyg omanometer ECG and paper - ele trodes chargeable Oximeter Oxisensor except i Neonatal ICU (1 per case) Oxygen analysers hoods and attachments, (disposable attachments excluded) Peak flow meter , excluding disposable mouth piece Stethoscopes Global fee for Rehabili Under discussion r . I" 10 Government Gazette 1 January 1996 No. 1239 2. PROCEDURE ROOMffHEATRE FEES The items under (;ode..181 shl¥lbe deemedto be includedin theatreor procedureroom fees, and no chargein respectjbereOfmay be levied. I Code 57/58/77 Practice Code Number 57/58 77 , I N$ ,I I N$ I 2.1 ..101 For consultative 0 similar services involving the use of the bed or couch ut with minimal input from nursing staff. These char es specifically exclude routine consultations by edical practitioners. ........,... Services other t an those under.. 101 that require the use of facilities and/or equipment outside of the theatre complex invoJ ng nursing staff input such as 'I 10-50 j 10-50 ~. ..103 II II II I, observation or ounsclling and limited to the use of items such as mall dressings. injections, stitching and app!ication. re air or removal of plaster of paris casts. . 2.2 Procedure R om II 95-40 95-40 " II ,I !I I. 'I II A facility w re simple procedures which require limited inst mentation and drapery, minimum nursing input and n general anaesthetic, are carried out. No Sophisticate monitoring is required but resuscitation II II II equipment Time in p ust be available in the procedure room. I The exact ime of admission to and discharge from the procedure oom shall be stated upon which the procedure room charge shall be calculated as follows ..121 ,I ~2.3 =:.!::::........................ Time in heatre The exa time of admissionto and dischargefrom theatres all be stated,upon which the theatrecharge shall be alculated as follows: . 4-80 4-80 I' I ..123 Charge er minute .......................... 15-20 15-20 ... ;"'" . '\0 No. 1239 Government Gazette 1 January 1996 11 Specialist Theatre In addition to the theatre charge calculated as above, a surcharge (modifier 0002 shall be allowed in cases where specialised theatres referred to in General Rule E.l.l. re utilised for the performance of any of the undermentioned procedures, whether carried out individually or in combination with each other, which surcharge shall be de med to cover the use of all specialised equipment required for such procedures. ~ Code 57/58/77 Description 77 N$ I Mod ' 1. I ~2 Orthopaedic, Neurosurgical and Vascular' (Modifier 0002) Joint replacements (only hip, knee, shou Cler ankle or elbow) Femoral popliteal bypasses Carotid endarterectomies 423-00 I II 'LL W I I. II !I I Code 57/581i7 I I Description 11 Ii 11 I I I I ~::::; I Cod, 57/58 N$ 77 N$ I I I 2.4 After hours I L13i I After hours: per case, for cases mitted to theatre from 19HOOto 07HOOon weekdays, rom l3HOO on Saturdays to 07HOOon Monda s, and public holidays. 114-LJ ...181 Non chargeable theatre items (w ch would always include the equivalent to the item named) Acetone Alcohol, spirits or any prep so tion containing these Anaesthetic circuits, masks, fi ers, humidifiers, rebreathing bags Anaesthetic tray Collection charges (patholo Connections and adaptors Disinfectant r - e.g. Biocid Disposable gowns and dr ers, C arm drapers, Mayo table drapers except: Disposable paper based barrier gowns and eatre table drapers may be charged for in the following instances: Hip, knee, sh ulder and elbow joint replacement * Open heart ,d cardiac bypass surgery * Vascular sur. ery * Neuro-surg ry (Brian and spinal cord) * Arthrosco y * Spinal su gery where extensive internal fixation is used * ET tube introduce ET tubes (non-di osable) Face masks, hea covers and overshoes Formalin in sali e Fractional ite . I" 12 Government Gazette 1 January 1996 No. 1239 . . · · · Strapping- e.g. Elastoplast, Microspore, Transpore, Dennicel, Zinc oxide Ophthalmic/ear/nasal drops, creams and ointments - e.g. Sofradex, Maxierol, Lacrilube - e.g. Remicaine,Cocaine,Xylocaine Sprays- e.g. Opsit Disadine Jellies - e.g. KY d Cardiotrace Topical anaestheticS' · Creams - e.g. Te acortril Glass syringes, utensils a apparatus Gloves not used by stenl surgical item Linen and linen savers i eluding incontinent pads and sheets Patient Controiled Anal esia single use disposable pumps Preptics/webcols Preparation items - sha ing trays, razors Receptal liners Recovery room Re-usable operating i struments and dental ENT drills, burrs, bits and cutters except for items referred to in S ction 5 Skin preparation sol ions, antiseptic solutions and soaps · · · · · · * · · · Bioscrub Betadine s rub, skincleanser, spray Cetavlon Chlorhex dine gluconate Dettol Hibitane ail solutions Iodine - II solutions Liquid saps e.g. Gill Merthio ate and mercurochrome j Povido e Iodine Scrub-up materia s, solutions, creams, soaps, brushes Spigots and safe pins Standard packs Sterile trays Sterilising of in truments or materials and Steripeel Sterilising solu ons, gases or tablets used to sterilise instruments e.g. · Bioci c · Cide or any solutionto steriliseinstruments Chlo hexadine gluconate Fo aiin tablets Hibi ane solution * * · Sterile water - except for flushing of wounds Suction cathe rs, handles, tips and nozzles (non-disposable) Stitch cutters nd staple removers (including disposable) Thermometer (except core temperature probes I only in Cardio Thoracic cases) X-ray detectable swab except during thoracic, abdominal, deep orthopaedic, spinal, perinea!- and neuro-surgery. NON-CHARGEAB EQUIPMENT * * * * * * Anaesthetic machine Cautery, Di thermy and Fulguration HUmidifier (plates chargeable) Monitors, CG and Dinamapp (Electrodes chargeable) Patient Co1 trolled Anegesia pumps (programmable re-usable) Ventilators ES L'I CATHETERISATION LABORATORY (As per item ...181) but HP syringe used is chargeable). NON-CHARGEAB * Medrad pu p - high infuser (equipment non-chargeable, . I\, No. 1239 Government Gazette 1 January 1996 13 Code 57/58i77 Description Practice Code Number / 3. 3.1 ..201 ..203 ..205 'I I 77 N$ Procedural fees Procedures Hysterosalpingograms . . . . . . . . . . . . . . . . . . . . . . Angiograms .: Electroconvulsive therapy (ECT) 155.80 .... . 155.80 ..207 Cardiac or cerebral angiography or vascular catheterisation when carried out in a laboratory .equipped with a recognised monoplane unit and in a hospital equipped to perform the relevant surgery, as approved by the committee established in terms of j 558.00 General Rule E.1.l . . . . . . . . . . . . . . . . . . . . . . ..21I Cardiac or cerebral angiography or vascular catheterisation when caIried out in a laboratory equipped with a recognised bi-plane unit, and i a hospital equipped to perform the relevant sur ry, as approved by the committee established in te s of Generai Rule E.l.1 . . . . _ . . . . . . . . . . .. ...... 1 050.90 The fees quoted for items ..201 to ..211 shall be all-inclusiv and no additional charges of whatsoever nature may be raised, except for any items chargeable in erms of Section 15 hereof. NOTE: Ward fees will however be chargeable together. with items ..203, ..207, ..209 and ..211. r II Code 57/58/77 Practice Code Number 57/58 N$ 77 N$ II r. I. I 3.3 Radiation Oncology Simulation - Fixed custom ..251 Simple - Simulation of a s ngle area with either a single port or parallel op sed ports. Simple or no blocking or use of custo home made simulation Intermediate - Simulati n of three or more converging ports, two eparate treatment areas or multiple blocks ...................... '" 159.20 ..253 242.80 ..255 Comp1ex- Simulatio of tangential portals, three or more treatment are s, rotation or arc therapy, complex blocks, c stom shielding blocks, brachytherapy so rce verification, hyperthermia probe verification, any se of contrast . . . . . . . . . . . . . . . 318.40 318.40 ..257 I~ . ''0 . No. 1239 Government Gazette 1 January 1996 15 4. STANDARDCHARGES FOR EQUIPMENT AND MATERIAL Practice Code Number Description 57/58 N$ II 77 N$ ..401 ..403 I Stone basket for the removal of kidney-, bladder-, gallstones: Per case ..................... Stereotactic equipment for use in neuro-surgical procedures, when used in conjunction with x-rays, MRI scans or CAT scans: Per case .......... 515-00 515-00 49{)-00 /39-00 39-00 ..405 ..407 I ContinuousPassiveExerciser:Per day . . . . . . . . 'Operating microscope - motorised. This is applicable to a binocular operating microscope with motorised focusing, positioning and zoom magnification changer. Spinal, intra-cranial and ophthalmic surgery only (aU ENT and other surgery excluded): Per case . . . . . . . . . . . . . . . . I I Ii Ii 1 108-00 108-00 I I h I I ij " ..409 I I, ..411 II Operating microscope - manually operated. Applicable to a binocuJar operating microscop with manual focusing, positioning, and multis p magnification changer. Microscopic surgery ly: Per, case. . , . . . . . . . . . . . . . . . . . . . . .. .... Laparoscopic equipment for surgery appJi able only to operative endoscopic laparoscopi s where more than 3 instruments, inclusive for t e telescope, are inserted into the thoracic or abdominal cavities of simultaneous us . The equipment must include a high-resol ion camera system with 2 monitors. Per case. . . . . . . . . . . . Patient-controlled analgesia pump, eing a programmable analgesia infusion ystem, providmg patient control andlor continuous analgesia modes with mechanisms to limit self a inistration per time period and with lockout i erval. Applicable only to administration of anal sics. Per day . . . . Monitors (3 channel Hellige I' equivalent - in high care wards only) Moni rs: per day or part thereof . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Ventilators, (Bennett PR2 I' equivalent - in high care, general and private ards only) (excluding oxygen): Per day or part hereof ............ Croupettes (excluding thereof . . . . . . . . . . II I I 54-00 54-00 I I 230-00 230-00 ..413 r. 4]-50 41-50 ..415 45-20 ..417 32-40 ..419 ..421 ..423 32-40 I . 9-20 Incubators (excluding oxygen) per day or part thereof . . . . . . . .. 17-40 15-00 '10 . Oxygen tents (exclu ing oxygen) per day or part thereof . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Government Gazette 1 January 1996 No. 1239 / Practice Code Number Code 57/58/77 Descr'tion 57/58 N$ Bennet MA, Servo and eares respirator, or equivalent (in ICU and igh care ward only) (excluding oxygen): pe day or part thereof ... . CUSA (plus lowest av li1able manufacturer's price, excluding VAT, or C U A pack, plus 25.4% which shall be inclusive of ark-up and Value Added Tax) . . . . . . . . . . . ................... . 77 N$ ..425 145-00 - ..427 704-00 218-00 281-00 - ..429 Lasers - Argon (oph almic) . . . . . . . . . . . . . . . ..431 ..433 Lasers - C02 (surgi al) ................. Lasers - Copper Va our (Rates by arrangement with the scheme co cemed). NB: This instrume t may be used for cosmetic procedures. . - j , . I ..435 ..437 Occutomes ... . ..................... 92-00 I 92-00 245-00 , Lasers - YAG (op tha!mic) . . . . . . . . . . . . . . . . 245-00 ..439 ..441 Lasers - YAG(su gical) .....,........... Ballistic Lithotri ylLithoclast: First lithotripsy treatment for am or more stones in same kidney or gall bladder ~!hic are eliminated in one h treatmentlBallist ese litotripsie . . . . . . . . . . . . . . 306-00 I 306-00 I I . 264-70 264-70 ..443 Ballistic Lithotr' psylLithoclast: Second lithotripsy treatment on sa pe kidney or gall bladder (Hospitals shall provide a certificate by the attending surge n certifying that a second treatment was J~edically necessary) ........ . Laser Lithotrip y: First lithotripsy treatment for one or more st nes in same kidney or gall bladder which are eUm nated in one treatment. . . . . . . . . Laser Lithotrir same kidney 0 provide a certi certifying that necessary. .. y: Second lithotripsy treatment on gall bladder. Hospitals shall cate by the attending surgeon secand treatment was medically 177-50 177-50 ..445 960-30 960-30 ..447 .. . ..................... . 643-30 2 934-00 643-30 - ..449 ..451 First *ESWL catment on samekidneywhichare eliminatedip ( ne treatment. .............. . Second *EjW ~treatment samekidney on (Hospitals ha providea certificateby the . I ""nding ..453 treatment "''''r edically necessary). . . . . . . . . . . jvas First *ES WLtreatment for one or more stones in gall blad er which are eliminated in one treatment. ,""fying tho(· ",oond I 966-00 2 934-00 1 966-00 2 934-00 . '" No. 1239 Government Gazette 1 January 1996 17 Description 57/58/77 ..455 Second *ESWL treatment on gall bladder (Hospitals shall provide a certificate by the attending surgeon certifying that a second 77 N$ treatmentwas medicallynecessary) ..,..,.... Note: The fees in respect of items ..441 to ..455 are inclusive of all equipment and components but exclusive of theatre fees and items chargeable under Section 5. ..457 C Arm (not chargeable when Modifiers 0002 or 0003 applies) . . . . . . . . . . . . . . . . . . . . . . . . . . 91-00 15,-00 1 966-00 91-00 153-00 ..459 Ultrasonicimagingequipment . . . . . . . . . , . . . . (Limited to real-time imaging equipment for trans rectal applications with needle-biopsy capability or Doppler ultrasound for vascular anatomy and haemo-dynamics). I ..461 ..463 ..465 ..467 ..469 ..471 ..473 ..475 ..477 ..479 Screening table (including all radiographic equipment) ........................... Gastroscope (fibre opticlflexibie only) Colonoscope (fibre optic/flexible only) Duodenoscope (fibre optic/flexible only) . . . . . . . Sigmoidoscope (fibre optic/flexible onl) Bronchoscope (rigid or flexible) .., ...... ,.. I 205-70 46-00 46-00 46-00 46-00 23.00 23-00 23-00 23-00 23-00 205-70 I 46-00 46-00 46-00 46-00 23.00 23-00 23-00 23-00 23-00 23-00 23-00 23-00 46-00 23-00 6-90 5-30 I Laryngoscope (fibre optic/rigid or fI xible excluding routine intubation) . . . . . . . . . . . . . . . Sinoscope (fibre optic/flexible onl ) Oesophagoscope....................... Laparoscope (not chargeable i fixed fee procedures) ..... .......... ..481 Hysteroscope.., . . . . . .. ..483 Colposcope ................ ..485 CystoUrethroscope ..................... ..487 ..489 ..491 ..493 Arthroscope (with closed circuit television facilities and power tool ) ,.... 23-00 23-00 23-00 46-00 23-00 6-90 5-30 ................. Arthroscope (without t e additional items listed under..487) Large sterile trays I I f. . . . . . . . . . . . . . . . . . . . tray (excluding theatre) - Jer Sterile swabbing and ENT trays - per tray (excluding theatre) !. . . . . . . . . . . . . . . . . . . . . '10 . 18 No. 1239 Practice Code Number Code 57/58/77 57158 N$ Specialised instru ents/equipment for integrated osseous implants (Hospitals/unattached operating theatre units sh provide a certificate by the practitioner con emed that the instruments/eq pment were used. .......,.. . Soluble bags I per patient pe Transcranial ~rbarrier nursing only, limited to 2 day. .................... . oppler ................... , . 77 N$ ..495 37-90 5-70 253-40 37-90 ..50] ..503 ..505 ..507 Harmonic Sc Ipel ...................,. I 69-70 I 69-70 27-90 II II tJ-90 I I I used with s rgery on internalorgansand in II Note: The standard el ""'"' rgon Beamer trosurgery will not apply where a unit is used. It can only be L II il I neurosurge '. I II 'I 168-60 ] 68-60 I ..5091 ,.511 513 I I 504-90 609-30 504-90 609-30 I I I' ..515 I I 33] -80 238-40 33] -80 238-40 ..517 S. In respect of it ms not otherwise dealt with in the Scale of Benefits. Hospitals/unattached operating thea e units shall, where possible, show all items which patients take home as ITO on accou ts. 5.1 Over the cou ter and proprietary items (Only substa ces controlled by the Medicine Control Council) The amount harged shall not exceed the trade unit price, exclusive of VAT, as listed in the Ethical Pric List prevailing from time to time, plus 25.4% (which shall be inclusive of mark-up an VAT), plus a dispensing fee of N$2.80 which is inclusive of VAT. 57/58/77 57/58/77 57/58/77 57/58/77 5.2 6 6 6 6 ] 5 7 3 Pharmacy Ward stock Theatre To take out Dispensed 'terns (Only subs nces controlled by the Medicine Control Council) The amoun charged shall not exceed the trade unit price. exclusive of VAT,as listed in the Ethical Pri e List prevailing from time to time. plus 25.4% (which shall be inclusive of mark-up a VAT), plus a dispensing fee of N$2.80 which is inclusive of VAT. . '\0 No. 1239 Government Gazette 1 January 1996 19 57/58/77 601 57/58/77 605 57/58/77 603 5.3 Pharmacy Ward stock To take out Disposable drills, burrs, cutters, blades (e.g. Stryker or equivalent) and lary 57/58/77 57/58/77 57/58/77 57/58/77 57/58/77 57/58/77 621 623 625 627 629 631 Neuro/Craniotomy Arthroscopy Orthopaedic ! .aryngeal masks MaxiJIo-Facial drills and burrs Flouroshield gloves (l pair per procedure) 33 1/3% 20% 33 1/3% 4% 33 1/3% 33 1/3% 5.4 Surgical laser fibre optic leads, hand pieces and probes or scalpe 57/58/77 621 57/58/77 623 Vascular surgery General surgery 100% 12'12% Hospitals/unattached operating theatre units shall slow the name and reference number of each item together with the manufacturer's name, and scheme allj}ave the right to call for such invoices from the institution concerned. Consumable, disposable, and surgical items, including sut res, drapes and skin graft blades, trephines and Beaver blades not otherwise dealt ith in section 5. (When used in ward or theatre) Lowest available manufacturer's price exclusive of V ,plus inclusive of mark-up a.11d AT). Items to be fully specifi d, V 57/58i77 601 57/58/77 605 57/58/77 607 25.4% (which shall be Pharmacy Ward stock Theatre 5.5 GASES Oxygen and Nitrous Oxide For both gases together per minute ..701 ..703 ..705 ..707 ..709 ..711 ..712 5.6 PWV area . . . . . . . . . . . . . . . . . . . . . . . . .. Cape Town Port Elizabeth East London Durban . . . . . . . . . . . . . . . . . . . . . . . . .. Other areas Namibia Oxygen ward use N$ 1.20 1.65 1.47 1.65 1.51 1.35 2.90 Fee for oxygen, per quarter hour or part t ereof, outside the operating theatre complex ..713 ..715 ..717 ..719 ..721 ..723 ..725 PWV area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cape Town Port Elizabeth East London Durban . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 'Other areas Namibia 1.77 2.94 2.82 2.71 2.30 2.18 2.94 . 'I. 20 5.7 Government Gazette 1 January 1996 No. 1239 Oxygen, recovery room Flat rate for oxygen per case / ..725 .727 ..729 ..731 ..733 ..735 ..736 PWV area . . . . . . . . . . . .. Cape Town Port Elizabeth East London Durban . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Other areas Namibia Carbon ., , ,. , 3.53 5.87 5.64 5.41 4.60 4.37 4.37 5.8 ..741 5.9 ..743 5.10 ..745 5.11 ..747 ..749 ..751 5.12 57/58/ 77 651 Dioxide Per minute Laser Mix O.22c Perminute Entonon Per 30 minutes. . . . . . . . . Inhalation anaesth ics , c , 4.24 . . . . . . . . . . . . . . . . . . . . 40.28 HalothanelFluothan : per minute '. . . . . . . . . . . . . . . . . . . . 0.67 Ethane: per mmute . . . . . . . . . . . . . . . . . . . . . . , . . . . . . , . . . . . . . . . 3.04 Forane: per minute . . . . . . . . . . , , , . . . . . . . . . . . . . . . . . . . . . . . . , " . . . . . . . . 3.32 Prostheses (surgic Ily implanted) A prosthesis shall ean a fabricated or artificial substitute for a diseased or missing part of the body, surgicall implanted, and shal! be deemed to include all componems such as pins, rods, screws, plate or similar items, forming and integral and necessary part of the device so implanted, and shall be charged as a single unit. Pins, rods, screws, plates or similar items, when used i dependently of a prosthesis and for the purpose of furthering any healing process, shall be hargeable under item ..607. Hospitals/unattac ed operating theatre units shall show the name and reference number of each item togeth r with the manufacturer's name, and schemes shall have the right to call for such invoices from the institution concerned. Lowest availabl manufacturer's price, exclusive of VAT, plus 25.4% (which shall be inclusive of mar -up and VAT), up to a maximum of N$l 500,00. 5.13 57/58/ 77661 Medical artifici I items (non-prostheses) According to a reement with schemes concerned. (Examples of items included hereunder shall be artifici limbs, wheelchairs, crutches and exertion bags). Copies of invoices shall be supplied to hemes. Electronic req 5.14 57/58/ 77 671 Byarrangeme with schemes concerned . '\0 No. 1239 Government Gazette 1 January 1996 21 5.15 Transportation Charges An additional charge may be made to cover the cost of railage paid on i outside the supplier's free delivery area. 5.16 Price increases Should a change occur in the manufecturer's price of any item list under ...70J to ..705 the new price shall be as notified by the Representative Associatio of Medicine Schemes from time to time. 5.17 57/58/ 77 681 Blood collection charges Blood coJlection charges, when incurred in respect of blood or related products procured from a recognised blood bank for transfusion purposes, y be charged at N$8.15 per collection, plus N$1.63 per kilometre travelled. Incise' drapes 5.18 ..69] , Incise drapes: a maximum benefit of N$41.80 per proce ure, except for the following types of procedures: Surgery in respect of hip, knee, shoulder and elbow joint replacements * All open heart and cardiac bypass surgery with or ithout the insertion of prostheses * * All vascular surgery, with or without the insertion of prostheses Neuro-surgery * * Al1 arthroscopy * Spinal surgery ..695 Ophthalmic drapes: a maximum benefit of N$31 40 per procedure. Note: The name, item number and cost must b * Opsite 13 11 = N$30. 74 Steridrape 1037 N$24.43 * loban 6633 N$25.65 * = = NON STANDARD ITEMS/SERVICES Such items are not covered by the Scale of Benefits and schemes reserves the right to decide individually how these items/servi es will be dealt with. 57/58/ 77 801 Items/services e.g. telephone calls/hire, elevision hire, boarding, extra meals, dry cleaning of clothing, extra nursing in ward etc. e nature of each service shaJl be specified. 57/58/ 77 851 Procedures: Open heart and cardiac y-pass surgery Total account by arrangement with t e scheme concerned. . '"