FEES & CODES
PRE-AUTHORISATION & OPERATIVE CODES
For any procedure, several different codes will be required by the medical aid.
These codes are supplied by your surgeon’s or dentist’s administrative team and will be reflected on your invoice. The Sedationist’s administration will also be able to assist.
ICD 10 Codes: Supplied by the surgeon’s rooms
Example K02.1 / K08.1 is commonly used for dental procedures.
Operative procedure codes: Supplied by the surgeon’s rooms, for example
Example 1461 is commonly used for dental procedures.
Sedation Procedure Codes:
0020 Sedation outside a hospital operating room
0151 Pre-anaesthetic examination 0034 Sedation/anaesthetic time
0007 head/neck/shoulder modifier
0036/0023 Use of personal monitoring equipment
Sedation codes if applying for authorization
Typical Sedation Procedure codes:
0020 Sedation outside a hospital theatre
0151 Pre-anaesthetic assessment
0034 Head/neck or shoulder modifier
0036/0023 Sedation/ anaesthetic time
0007 Use of own monitoring equipment
0201 Drugs and consumables used during the sedation.
NAPPI CODES are provided for consumables used during the sedation and will be supplied by the sedationist on his invoice
What will be on my invoice?
On the final medical-aid friendly sedation invoice, you can expect to find the following:
- Your medical aid information
- The patient and member information
- Authorisation number from medical aid for surgical procedure
- Date, time and type of operation
- Surgeon’s name
- Surgery procedure codes
- ICD-10 disease codes
- Sedation procedural codes
- NAPPI codes for consumables
- Theatre time
- Time spent in recovery