Billing & Coding

Administration of Oxygen in rooms (According to Discovery Health)

Practice can bill for the administration of Oxygen in the rooms using the NAPPI code 722593001/Air products medical oxygen 1L (0.28kg) – 0.54cents per minute. Please note – that this item is being reviewed and the use needs to be clearly documented to be supported should the practice be audited.

Prolonged Consultations, Discharge Codes & Patient Education (According to SAMA Coding Department)

For prolonged consultations, please refer to the guideline on item 0129:

Item 0129 – Prolonged attendance to a patient and/or family: ADD to either item 0193, or item 0175, as appropriate, for each 15-minute period only if service extends 10 minutes or more into the next 15-minute period following on the first 60 minutes (minimum of 70-minute consultation time)

Guidelines:

  • Item 0129 may only be added to item 0193 or item 0175, as appropriate, for consultations with a duration of longer than 60 minutes. (The consultation must extend at least 10 minutes – into the first 15 minutes period)
  • General practitioners providing counselling to patients use a consultation code for this service [please note that a general practitioner may not use items 2957, 2974 and 2975 (psychotherapy)] except if they have had proven accredited training in psychotherapy].
  • For counselling with a duration of longer than 60 minutes, item 0129 may be added to item 0193 or item 0175 as appropriate
  • Item 0129 is no longer applicable to Psychiatrists (Pr “22”)

Most funders do not accept item 0193 as part of their tariff structure, in this case the patient will be liable for payment. Nebulisation, item 1136, should not be coded in addition to the consultation item.

Coding for Flu vaccine: (According to SAMA Coding Department)

The administration of a flu injection forms part of the consultation and should not be coded in addition to the consultation. Dr may code for the materials / medicine used.

Split-Billing versus Balance -Billing

Most Frequently used codes in General Practice

Medscheme’s Interpretation of Codes 0145, 0146, 0147, 0148

Some light on Codes