Preventative screening

Procedure

Tariff Codes

Tariff description

Eligible Beneficiaries and Frequency

Disciplines allowed

Cholesterol Screening

4027

Blood Cholesterol (finger prick)

Once per Benefit year for all beneficiaries who are 20 years and older.

Pr 14/15

0013

Blood cholesterol and/or triglycerides

Pr 60

99384

Cholesterol screening

Pr 88

Glucose Screening

4050

Blood glucose finger prick in rooms

(Glucose strip-test with photometric reading)

Once per benefit year for all beneficiaries 20 years and older.

Pr 14/15

0012

Blood Glucose

Pr 60

99370

Glucose Screening Test

Pr 88

Osteoporosis Screening

Bone Densitometry scan

50120

X-ray bone densitometry

Once per benefit year for female beneficiaries who are 65 years and older.

Pr38

3604

Bone densitometry (to be charged once only for one or more levels done at the same session)

Pr 16, 18, 28

Pap Smear screening

0190 - 0193

Consultation/visit

Once per benefit year for female beneficiaries who are 12 – 65years

Pr14/15/16

0201, 0202, 0210

Procedure codes: 0201- Cost of material

0202 – setting of sterile tray

0210 – collection of specimen

Pr14/15/16

99385

Procedure code: Sterile tray and specimen handling fee

Pr14/15/ 16 and 88

005,006,001,002

Consultation

Pr 88

020,301

Procedure codes: 020 Specimen code

301 Consumables used

Pr 88

4566

Vaginal or cervical smear

Pr 37/52

4559

Cytology preparation using approved liquid-based cytology method: first unit

Pr 37/52

CER1

HPV Polymerase chain reaction

Pr 37/52

Blood Pressure Monitoring

0015

Blood Pressure Monitoring

Once per benefit year for beneficiaries 18 years and older.

Pr60

99371

Blood Pressure Monitor

Pr 88

HIV and AIDS Pre-

test Counselling

(no test done)

7016

Pre-counselling

Once per benefit

year, per

beneficiary.

Pr 14/15

0016

Pre-counselling

(Without going

ahead with the HIV test)

Pr 60

99376

HIV Pre-Test Counselling

Pr 88

HIV and AIDS testing (screening test, post-test counselling, confirmatory test, and condoms)

7017

Pre-counselling, Screen test, Post-test counselling, Confirmatory test (all-inclusive code)

Once per benefit year, per beneficiary.

Pr14/15

0017

HIV and AIDS Testing and Post Counselling

Pr 60

99377

HIV and AIDS testing and post-counselling

Pr 88

Peak Flow measurement

0019

Peak Flow Measurement

Once per benefit year for beneficiaries 4 years and older.

Pr 60

99383

Peak Flow Measurement

Pr 88

Mammography Screening

39175

Mammography: Unilateral or bilateral

Once per benefit year for female beneficiaries who are 40 years and onwards.

Pr39

3934100

X-ray mammography, including ultrasound

Pr 38

3605

Mammography: Unilateral or bilateral, including ultrasound and Doppler ultrasound examination, where necessary.

Pr 14, 15

Prostate Screening

4519

Prostate-specific antigen

Once per benefit year for male beneficiaries who are 45 – 69 years.

Pr 37, 52

Faecal Occult blood test

4352

Occult blood: Monoclonal antibodies

Once per benefit year for all beneficiaries who are 50 – 75 years.

Pr 37, 52

Neonatal Hypothyroidism

4507

Thyrotropin (TSH)

Once per neonatal beneficiary up to 28 days of age.

Pr 52

Glaucoma Screening

11202

Tonometry (non-contact)

Once per benefit year for all beneficiaries 40 years and older.

Pr 70,71

11212

Tonometry (Aplanation)

3014

Tonometry per test with a maximum of two (2) tests for provocative tonometry

(one or both eyes)

Pr 26

3017

Retinal threshold test inclusive of computer disc storage for Delta of Statpak programs

3018

Retinal threshold trend evaluation (additional to Item 3017)

Pregnancy Screening

0018

Pregnancy Screening

Once per benefit year for a female beneficiary 12 years and older.

Pr 60

99381

Pregnancy Screening

Pr 88

Urine Analysis

0014

Urine Analysis

Once per benefit year for beneficiaries of all ages.

Pr 60

99382

Urine analysis

Pr 88

Childhood hearing screening for children

1010

Audiology consultation. Duration 5 - 15 mins

Once per beneficiary for the period from age one up to seven years.

Pr82

1011

Audiology consultation. Duration 16 - 30 mins

1115

Speech audiogram screening

1100

Pure Tone Audiogram (Air conduction) (3273)

1105

Bone conduction pure tone audiogram

1200

Tympanometry

Childhood hearing screening for infants

1505

Diagnostic Audiological Click ABR (Auditory Brainstem

Evoked Response) – Bilateral Air conduction threshold determination using click stimuli.

Once per beneficiary for the period up to and including age 1 (excluding beneficiaries in the first three months of life).

Pr82

1010

Audiology consultation. Duration 5-15 mins

1011

Audiology consultation. Duration 16 - 30mins

1580

Evoked otoacoustic emissions (OAE); limited

Childhood optometry screening

94000

Individual Child Screening

Once per beneficiary for the period up to and including age seven (excluding beneficiaries in the first three months of life).

Pr70

Syphilis screening

3951

Quantitative Kahn, VDRL or other flocculation

Once per benefit year per beneficiary.

Pr52,37

3949

Qualitative Kahn, VDRL or other flocculation

Chlamydia/gonorrhoea screening

3946

IgM: specific antibody titre: ELISA/EMIT: per Ag

Once per benefit year per beneficiary.

Pr52,37

3948

IgG: specific antibody titre: ELISA/EMIT: per Ag

3923

Biochemical identification ofbacterium: abridged

3925

Serological identification of bacterium: abridged

3960

Gonococcal, listeria or echinoccoccus agglutination

TB screening

0221

Allergy: Skin-prick tests: Delayed hypersensitivity testing (Type IV reaction): Per antigen

Once per benefit year, per beneficiary (no age restriction).

Pr52, 14/15

Nappi 872938-027 Tuberculin PPD RT/23 Vial 1.5 ml)

Cost of material in treatment: This item provides for a charge for material used in treatment.