Manitoba Physician’s Manual

1 Manitoba physician S Manual APRIL 1, 2018 Issued by: The Minister of Health Table of Contents April 1, 2018 i TA B L E O F CO N T E N T S TABLE OF CONTENTS .. I NUMERIC TARIFF INDEX .. I CONTACT INFORMATION .. 1 Practitioner Registry/User Site Maintenance .. 1 Claims Unit Claims Enquiry .. 1 Registration/Client Services .. 2 Help Desk (Information Systems Branch) .. 2 CLAIMS SUBMISSION AND PAYMENT PROCEDURES .. 1 Part I Billing and Provision of Services .. 1 Part II Method of Claims Submission .. 1 Payment Cycle .. 1 Six (6) Month Deadline for Submission of Claims.

2 1 Reciprocal Billing for Non- Manitoba Residents (Canadians) .. 2 Patient Eligibility (Coverage under Provincial Health Plan) .. 2 Part III Remittance Advice .. 3 Pending Claims (EOB 77 ) .. 4 Part IV Fee Differentials .. 4 Part V Interest .. 4 Part VI By Report .. 5 Part VII Disputes .. 5 RULES OF APPLICATION .. 1 1 Visit or Examination .. 1 2 Specialist .. 1 3 Special Call/Special Call Rule of Application 3 .. 1 2 4 Complete History and Physical Examination .. 2 5 Regional History and Examination .. 2 6 Subsequent Visit .. 2 7 Consultation (Amended July 1, 2015).

3 3 8 Consultation (Amended October 1, 2008) .. 3 9 Treatment/Procedures Performed By A 3 (Amended October 1, 2008) .. 3 10 Subsequent Consultations (Amended October 1, 2008) .. 3 11 Deleted (October 1, 2008) .. 3 12 Hospital Care .. 3 13 Supportive Care .. 4 14 Concomitant Care .. 4 Table of Contents ii April 1, 2018 15 Deleted (July 1, 2005) .. 4 16 Personal Care Home Care .. 4 17 Gynaecological Examinations .. 5 17(a) Complete History and Physical Exam with Gynaecological Exam Including Cytological Smears Cervix .. 5 17(b) Complete History and Physical Exam with Gynaecological Exam Excluding Cytological Smears Cervix.

4 5 17(c) Regional Intermediate Visit with Gynaecological Examination Including the Taking of Cytological Smears Cervix .. 6 17(d) Regional Intermediate Visit with Gynaecological Examination Excluding the Taking of Cytological Smears Cervix .. 6 17(e) A Comprehensive Pelvic Examination .. 6 18 Chronic Care .. 7 19 Premature Baby Care .. 7 20 Child/Infant .. 7 Surgical Rules .. 7 21 Asterisked Procedure .. 7 22 Independent Procedure .. 7 23 Benefits for Major Surgical Services .. 7 24 Preoperative Care .. 8 25 Multiple Surgical Services Same Incision.

5 8 26 Multiple Surgical Services Separate Incisions .. 8 27 Multiple Surgical Services Performed by Different Surgeons .. 8 28 Bilateral Surgical Services .. 8 29 Additional Surgical Services .. 8 30 Two Surgeons .. 8 31 Postoperative Surgical Care .. 8 32 Surgical 9 33 Obstetrics .. 9 34 9 35 Fractures Requiring No 10 36 Multiple Fractures .. 10 37 Two Closed Reductions .. 10 38 Revision of a Closed Reduction .. 10 39 Closed Reduction .. 10 40 Open Reduction is Followed by a Second Open Reduction .. 10 41 Compound Fractures .. 10 42 Open Reduction.

6 10 43 Secondary Amputation or Excision .. 10 44 Dialysis .. 11 45 Chronic Renal Failure .. 11 46 Deputizing .. 11 Guidelines on Concomitant Care .. 11 47 Concomitant Care .. 11 Table of Contents April 1, 2018 iii 48 Concomitant Care/Major Additional Diagnoses .. 12 49 Deleted (April 1, 2007) .. 13 50 Deleted (April 1, 2007 .. 13 51 Deleted (April 1, 2007) .. 13 52 Deleted (April 1, 2007) .. 13 53 Deleted (July 1, 2007).. 13 54 Deleted (April 1, 2007) .. 13 55 Extraordinary Circumstance .. 13 56 Provisional Tariffs .. 14 57 Minimum Fee Under General Anesthesia.)

7 14 58 Registered Nurse (Extended Practice) .. 14 59 Clinical Assistant .. 14 60 Head and Neck Surgery .. 14 61 Technical Fees .. 14 14 VISITS/EXAMINATIONS INTERNAL MEDICINE (01) .. A-1 Office, Home Visits .. A-1 Special Call See General Schedule .. A-2 Hospital Care .. A-2 Concomitant Care .. A-4 Chronic Care See General Schedule .. A-4 NEUROLOGY (01-1) .. A-5 Office, Home Visits .. A-5 Special Call See General Schedule .. A-6 Hospital Care .. A-6 Concomitant Care .. A-8 Chronic Care See General Schedule .. A-8 GERIATRIC MEDICINE (01-2) .. A-9 Office, Home Visits.

8 A-9 Special Call See General Schedule .. A-10 Hospital Care .. A-10 Concomitant Care .. A-12 Chronic Care See General Schedule .. A-12 RHEUMATOLOGY MEDICINE (01-3) .. A-13 Office, Home Visits .. A-13 Special Call See General Schedule .. A-14 Hospital Care .. A-14 Concomitant Care .. A-16 Chronic Care See General Schedule .. A-16 Table of Contents iv April 1, 2018 CARDIOLOGY (01-4) .. A-17 Office, Home Visits .. A-17 Special Call See General Schedule .. A-18 Hospital Care .. A-18 Concomitant Care .. A-20 Chronic Care See General Schedule .. A-20 GASTROENTEROLOGY (01-5).

9 A-21 Office, Home Visits .. A-21 Special Call See General Schedule .. A-22 Hospital Care .. A-22 Concomitant Care .. A-24 Chronic Care See General Schedule .. A-24 NEPHROLOGY (01-6) .. A-25 Office, Home Visits .. A-25 Special Call See General Schedule .. A-26 Hospital Care .. A-26 Concomitant Care .. A-28 Chronic Care See General Schedule .. A-28 ALLERGY & CLINICAL IMMUNOLOGY (01-7) .. A-29 Office, Home Visits .. A-29 Special Call See General Schedule .. A-30 Hospital Care .. A-30 Concomitant Care .. A-31 Chronic Care See General Schedule .. A-31 MEDICAL GENETICS (01-8).

10 A-32 Office, Home Visits .. A-32 Special Call See General Schedule .. A-33 Hospital Care .. A-33 Concomitant Care .. A-35 Chronic Care See General Schedule .. A-35 PAEDIATRICS (02) .. A-36 Office, Home Visits .. A-36 Special Call See General Schedule .. A-40 Hospital Care .. A-40 Concomitant Care .. A-44 Neonatal and Paediatric Intensive, Comprehensive Critical Care and Ventilatory Support Fee Schedule .. A-44 Neonatal Intensive Care .. A-46 Comprehensive Care .. A-47 Critical Care (Without Ventilator Support) .. A-47 Table of Contents April 1, 2018 v Ventilatory Support.