ANNEX 1. LIST OF MEDICAL CASE RATES ICD CODE …

1 Case Rate Professional Fee Health Care Institution Fee cerebral irritabilityABNORMAL SENSORIUM IN THE NEWBORN12,000 3,600 8,400 cerebral depressionABNORMAL SENSORIUM IN THE NEWBORN12,000 3,600 8,400 ischemic encephalopathy of newbornABNORMAL SENSORIUM IN THE NEWBORN12,000 3,600 8,400 specified disturbances of cerebral status of newbornABNORMAL SENSORIUM IN THE NEWBORN12,000 3,600 8,400 of cerebral status of newborn, unspecifiedABNORMAL SENSORIUM IN THE NEWBORN12,000 3,600 8,400 J36 Peritonsillar abscess; Abscess of tonsil; Peritonsillar cellulitis; QuinsyABSCESS OF RESPIRATORY TRACT10,000 3,000 7,000 diseases of larynx; Abscess of larynx; Cellulitis of larynx; Disease NOS of larynx; Necrosis of larynx; Pachyderma of larynx; Perichondritis of larynx; Ulcer of larynxABSCESS OF RESPIRATORY TRACT10,000 3,000 7,000 and parapharyngeal abscess; Peripharyngeal abscessABSCESS OF RESPIRATORY TRACT10,000 3,000 7,000 abscess of pharynx; Cellulitis of pharynx; Nasopharyngeal abscessABSCESS OF RESPIRATORY TRACT10,000 3,000 7,000 diseases of pharynx; Cyst of pharynx or nasopharynx; Oedema of pharynx or nasopharynxABSCESS OF RESPIRATORY TRACT10,000 3,000 7,000 of lung with pneumoniaABSCESS OF RESPIRATORY TRACT10,000 3,000 7,000 of lung without pneumonia.

2 Abscess of lung NOSABSCESS OF RESPIRATORY TRACT10,000 3,000 7,000 of mediastinumABSCESS OF RESPIRATORY TRACT10,000 3,000 7,000 with fistulaABSCESS OF RESPIRATORY TRACT10,000 3,000 7,000 without fistula; Abscess of pleura; Abscess of thorax; Empyema; PyopneumothoraxABSCESS OF RESPIRATORY TRACT10,000 3,000 7,000 due to Vibrio cholerae 01, biovar choleraeACUTE GASTROENTERITIS6,000 1,800 4,200 due to Vibrio cholerae 01, biovar eltorACUTE GASTROENTERITIS6,000 1,800 4,200 , unspecifiedACUTE GASTROENTERITIS6,000 1,800 4,200 due to Shigella dysenteriae; Group A shigellosis [Shiga-Kruse dysentery]ACUTE GASTROENTERITIS6,000 1,800 4,200 due to Shigella flexneri;Group B shigellosisACUTE GASTROENTERITIS6,000 1,800 4,200 due to Shigella boydii; Group C shigellosis ACUTE GASTROENTERITIS6,000 1,800 4,200 due to Shigella sonnei; Group D shigellosisACUTE GASTROENTERITIS6,000 1,800 4,200 shigellosisACUTE GASTROENTERITIS6,000 1,800 4,200 , unspecified.

3 Bacillary dysentery NOSACUTE GASTROENTERITIS6,000 1,800 4,200 Escherichia coli infectionACUTE GASTROENTERITIS6,000 1,800 4,200 Escherichia coli infectionACUTE GASTROENTERITIS6,000 1,800 4,200 Escherichia coli infectionACUTE GASTROENTERITIS6,000 1,800 4,200 Escherichia coli infectionACUTE GASTROENTERITIS6,000 1,800 4,200 intestinal Escherichia coli infectionsACUTE GASTROENTERITIS6,000 1,800 4,200 enteritisACUTE GASTROENTERITIS6,000 1,800 4,200 due to Yersinia enterocoliticaACUTE GASTROENTERITIS6,000 1,800 4,200 due to Clostridium difficile; Foodborne intoxication by Clostridium difficile; Pseudomembranous colitisACUTE GASTROENTERITIS6,000 1,800 4,200 specified bacterial intestinal infectionsACUTE GASTROENTERITIS6,000 1,800 4,200 intestinal infection, unspecified.

4 Bacterial enteritis NOSACUTE GASTROENTERITIS6,000 1,800 4,200 staphylococcal intoxicationACUTE GASTROENTERITIS6,000 1,800 4,200 Clostridium perfringens [Clostridium welchii] intoxication. Enteritis necroticans. Pig-belACUTE GASTROENTERITIS6,000 1,800 4,200 Vibrio parahaemolyticus intoxicationACUTE GASTROENTERITIS6,000 1,800 4,200 Bacillus cereus intoxicationACUTE GASTROENTERITIS6,000 1,800 4,200 specified bacterial foodborne intoxicationsACUTE GASTROENTERITIS6,000 1,800 4,200 foodborne intoxication, unspecifiedACUTE GASTROENTERITIS6,000 1,800 4,200 ; Balantidial dysenteryACUTE GASTROENTERITIS6,000 1,800 4,200 [lambliasis]ACUTE GASTROENTERITIS6,000 1,800 4,200 GASTROENTERITIS6,000 1,800 4,200 ; Infection due to Isospora belli and Isospora hominis; Intestinal coccidiosis.

5 IsosporosisACUTE GASTROENTERITIS6,000 1,800 4,200 specified protozoal intestinal diseases; Intestinal trichomoniasis; Sarcocystosis; SarcosporidiosisACUTE GASTROENTERITIS6,000 1,800 4,200 intestinal disease, unspecified;Flagellate diarrhoea; Protozoal colitis; Protozoal diarrhoea; Protozoal dysenteryACUTE GASTROENTERITIS6,000 1,800 4,200 enteritisACUTE GASTROENTERITIS6,000 1,800 4,200 gastroenteropathy due to Norwalk agent; Small round structured virus enteritisACUTE GASTROENTERITIS6,000 1,800 4,200 enteritisACUTE GASTROENTERITIS6,000 1,800 4,200 viral enteritisACUTE GASTROENTERITIS6,000 1,800 4,200 intestinal infection, unspecified; Viral enteritis NOS; Viral gastroenteritis NOS.

6 Viral gastroenteropathy NOSACUTE GASTROENTERITIS6,000 1,800 4,200 specified intestinal infectionsACUTE GASTROENTERITIS6,000 1,800 4,200 diarrheaACUTE GASTROENTERITIS6,000 1,800 4,200 gastroenteritisACUTE GASTROENTERITIS6,000 1,800 4,200 and colitis due to radiationACUTE GASTROENTERITIS6,000 1,800 4,200 gastroenteritis and colitisACUTE GASTROENTERITIS6,000 1,800 4,200 FIRST CASE RATEANNEX 1. LIST OF MEDICAL CASE RATESGROUPDESCRIPTIONICD CODEPage 1 of 111 Case Rate Professional Fee Health Care Institution Fee FIRST CASE RATEANNEX 1. LIST OF MEDICAL CASE RATESGROUPDESCRIPTIONICD and dietetic gastroenteritis and colitis; Food hypersensitivity gastroenteritis or colitisACUTE GASTROENTERITIS6,000 1,800 4,200 specified noninfective gastroenteritis and colitis; Eosinophilic gastritis or gastroenteritisACUTE GASTROENTERITIS6,000 1,800 4,200 gastroenteritis and colitis, unspecified; Diarrhoea specified as noninfective, or NOS in countries where the conditions can be presumed to be of noninfectious origin; Enteritis specified as noninfective, or NOS in countries where the conditioACUTE GASTROENTERITIS6,000 1,800 4,200 bowel syndrome with diarrhoeaACUTE GASTROENTERITIS6,000 1,800 4,200 renal failure with tubular necrosis; Tubular necrosis NOS; Acute Tubular necrosis.

7 Renal Tubular necrosisACUTE RENAL FAILURE19,300 5,790 13,510 renal failure with acute cortical necrosis; Cortical necrosis NOS; Acute Cortical necrosis ; Renal Cortical necrosisACUTE RENAL FAILURE19,300 5,790 13,510 renal failure with medullary necrosis; Medullary papillary necrosis, NOS; Acute medullary papillary necrosis; Renal medullary papillary necrosisACUTE RENAL FAILURE19,300 5,790 13,510 acute renal failureACUTE RENAL FAILURE19,300 5,790 13,510 renal failure, unspecified;ACUTE RENAL FAILURE19,300 5,790 13,510 failure following abortion and ectopic and molar pregnancy; Oliguria Acute renal failure; Oliguria renal shutdown; Oliguria renal tubular necrosis; Oliguria UraemiaACUTE RENAL FAILURE19,300 5,790 13,510 J80 Adult respiratory distress syndrome; Adult hyaline membrane diseaseADULT RESPIRATORY DISTRESS SYNDROME32,000 9,600 22,400 adverse food reactions, not elsewhere classifiedALLERGIC REACTIONS6,200 1,860 4,340 oedema; Giant urticaria; Quinke's oedemaALLERGIC REACTIONS6,200 1,860 4,340 , unspecified; Allergic reaction NOS; Hypersensitivity NOS; Idiosyncracy NOSALLERGIC REACTIONS6,200 1,860 4,340 adverse effects, not elsewhere classifiedALLERGIC REACTIONS6,200 1,860 4,340 effect, unspecifiedALLERGIC REACTIONS6,200 1,860 4,340 adverse effect of drug or medicament.

8 Adverse effect of correct drug or medicament properly administered; Allergic reactiion to correct drug or medicament properly administered; Hypersensitivity to correct drug or medicament properly administeALLERGIC REACTIONS6,200 1,860 4,340 liver abscess; Hepatic amoebiasisAMOEBIASIS, HEPATIC10,000 3,000 7,000 amoebic dysentery; Acute amoebiasis; Intestinal amoebiasis NOSAMOEBIASIS, NONHEPATIC6,000 1,800 4,200 intestinal amoebiasisAMOEBIASIS, NONHEPATIC6,000 1,800 4,200 nondysenteric colitisAMOEBIASIS, NONHEPATIC6,000 1,800 4,200 of intestine; Amoeboma NOSAMOEBIASIS, NONHEPATIC6,000 1,800 4,200 amoebiasisAMOEBIASIS, NONHEPATIC6,000 1,800 4,200 AppendicitisAMOEBIASIS, NONHEPATIC6,000 1,800 4,200 amyloidosis; Localized amyloidosisAMYLOIDOSIS11,100 3,330 7,770 shock due to adverse food reactionANAPHYLACTIC SHOCK7,600 2,280 5,320 shock, unspecified; Allergic shock NOS; Anaphylactic reaction NOS; Anaphylaxis NOSANAPHYLACTIC SHOCK7,600 2,280 5,320 shock due to adverse effect of correct drug or medicament properly administeredANAPHYLACTIC SHOCK7,600 2,280 5,320 deficiency anaemia secondary to blood loss (chronic).

9 Posthaemorrhagic anaemia (chronic)ANEMIA10,000 3,000 7,000 dysphagia; Kelly-Paterson syndrome; Plummer-Vinson syndromeANEMIA10,000 3,000 7,000 iron deficiency anaemiasANEMIA10,000 3,000 7,000 deficiency anaemia, unspecifiedANEMIA10,000 3,000 7,000 B12 deficiency anaemia due to intrinsic factor deficiency; Addison Anaemia; Biermer Anaemia; CongenitalPernicious Anaemia; Congenital intrinsic factor deficiencyANEMIA10,000 3,000 7,000 vitamin B12 deficiency anaemiasANEMIA10,000 3,000 7,000 B12 deficiency anaemia, unspecifiedANEMIA10,000 3,000 7,000 folate deficiency anaemiaANEMIA10,000 3,000 7,000 deficiency anaemia, unspecified; Folic acid deficiency anaemia NOSANEMIA10,000 3,000 7,000 deficiency anaemia; Amino-acid deficiency anaemia; Orotaciduric anaemiaANEMIA10,000 3,000 7,000 megaloblastic anaemias, not elsewhere classified; Megaloblastic anaemia NOSANEMIA10,000 3,000 7,000 anaemiaANEMIA10,000 3,000 7,000 specified nutritional anaemias.

10 Anaemia associated with deficiency of copper; Anaemia associated with deficiency of molybdenum; Anaemia associated with deficiency of zincANEMIA10,000 3,000 7,000 anaemia, unspecified; Simple chronic anaemiaANEMIA10,000 3,000 7,000 due to glucose-6-phosphate dehydrogenase [G6PD] deficiency; Favism; G6PD deficiency anaemiaANEMIA10,000 3,000 7,000 Page 2 of 111 Case Rate Professional Fee Health Care Institution Fee FIRST CASE RATEANNEX 1. LIST OF MEDICAL CASE RATESGROUPDESCRIPTIONICD due to other disorders of glutathione metabolism; Anaemia due to enzyme deficiencies, except G6PD, related to the hexose monophosphate [HMP] shunt pathway; Anaemia due to haemolytic nonspherocytic hereditary, type IANEMIA10,000 3,000 7,000 due to disorders of glycolytic enzymes; Haemolytic nonspherocytic hereditary Anaemia, type II; Hexokinase deficiency Anaemia; Pyruvate kinase [PK] deficiency Anaemia; Trios