South Australia
Workers Rehabilitation and Compensation (Scales of Medical and Other Charges) Regulations 1995
under the Workers Rehabilitation and Compensation Act 1986

Contents
1	Short title
3	Interpretation
4	Scales of charges—Private hospitals
5	Scales of charges—Physiotherapy services
6	Scale of charges—Public hospitals
7	Scale of charges—Speech pathologists
8	Scales of charges—Registered occupational therapists
9	Increase in charges and fees for Goods and Services Tax
10	WorkCover may issue guidelines
Schedule 1—Scale of charges—private hospitals—services other than psychiatric services
Schedule 1A—Scale of charges—psychiatric services—private hospitals
Schedule 2—Scale of charges—physiotherapy services
Schedule 3—(Scales of charges—public hospitals)
Part A—Preliminary
1	Interpretation
5	Determination of applicable AN-DRG
Part B—Recognised hospitals: determination of fees for admitted patients
1	Interpretation
2	Inlier patients
3	Short stay outlier patients
4	Long stay outlier patients
5	Rehabilitation fee, Hampstead Centre
6	Medical or diagnostic services for private patients
7	Transportation fee
Part C—Recognised hospitals: fees for non-admitted patients
1	Interpretation
2	Fees for non-admitted public patients in metropolitan hospitals
3	Fees for non-admitted patients in country (etc) hospitals
4	Transportation fee
Part D—Recognised hospitals and incorporated health centres: accommodation, rehabilitation and domiciliary care fees
Part E—Recognised hospitals: classification of recognised hospitals
1	Metropolitan Hospitals
2	Country Hospitals
Schedule 4—Scales of charges—speech pathologists
Schedule 5—Scales of charges—Registered occupational therapists
Legislative history

1—Short title
This regulation may be cited as the Workers Rehabilitation and Compensation (Scales of Medical and Other Charges) Regulations 1995.
3—Interpretation
	(1)	In these regulations—
Act means the Workers Rehabilitation and Compensation Act 1986;
Claims Agent means a private sector body that is a party to a contract with the Corporation under the WorkCover Corporation (Claims Management—Contractual Arrangements) Regulations 1995;
GST means the tax payable under the GST law;
GST law means—
	(a)	A New Tax System (Goods and Services Tax) Act 1999 (Commonwealth); and
	(b)	the related legislation of the Commonwealth dealing with the imposition of a tax on the supply of goods, services and other things;
Self-Managed Employer means a registered employer who is managing claims brought by the employer's own workers under a contract or arrangement with the Corporation under section 14 of the WorkCover Corporation Act 1994;
WorkCover is the Corporation.
	(2)	A reference in these regulations to specified schedule guidelines is a reference to the guidelines of the specified name issued by WorkCover, as in force from time to time.
4—Scales of charges—Private hospitals
	(1)	Pursuant to subsection (11) of section 32 of the Act, the scales of charges set out in Schedule 1 are, subject to modification under regulation 9(1), prescribed as scales of charges for the purposes of that section for the provision of services (other than psychiatric services) in private hospitals.
	(2)	Pursuant to subsection (11) of section 32 of the Act, the scales of charges set out in Schedule 1A are, subject to modification under regulation 9(1), prescribed as scales of charges for the purposes of that section for the provision of psychiatric services in private hospitals.
5—Scales of charges—Physiotherapy services
Pursuant to subsection (11) of section 32 of the Act, the scales of charges set out in Schedule 2 are, subject to modification under regulation 9(1), prescribed as scales of charges for the purposes of that section for the provision of physiotherapy services.
6—Scale of charges—Public hospitals
Pursuant to subsection (11) of section 32 of the Act, the fees set out in Schedule 3 are, subject to modification under regulation 9(2), prescribed as scales of charges for the purposes of that section for the provision of services in or by—
	(a)	the hospitals and health services listed in Part E of that Schedule; and
	(b)	health centres within the ambit of Part D of that Schedule.
7—Scale of charges—Speech pathologists
Pursuant to subsection (11) of section 32 of the Act, the fees set out in Schedule 4 are, subject to modification under regulation 9(1), prescribed as scales of charges for the purposes of that section for the provision of services by speech pathologists.
8—Scales of charges—Registered occupational therapists
Pursuant to subsection (11) of section 32 of the Act, the scales of charges set out in Schedule 5 are, subject to modification under regulation 9(1), prescribed as scales of charges for the purposes of that section for the provision of services by registered occupational therapists.
9—Increase in charges and fees for Goods and Services Tax
	(1)	Where a service set out in Schedule 1, 1A, 2, 4 or 5 is subject to GST, the charge set out in the Schedule in respect of the service is increased so that after deduction of the GST in relation to the service the amount of the charge remaining is equal to the charge set out in the Schedule.
	(2)	Where a service set out in Schedule 3 is subject to GST, a fee that may be charged as determined under that Schedule is increased so that after deduction of the GST in relation to the service the amount of the fee remaining is equal to the amount of the fee as determined under that Schedule.
10—WorkCover may issue guidelines
WorkCover may issue guidelines from time to time for the purposes of these regulations.

Schedule 1—Scale of charges—private hospitals—services other than psychiatric services

Item No	Service Description		Charge	
	Accommodation-Group A			
	Advanced Surgical-Shared Room-Group A			
PR100	1 or more days but not more than 7 days	- per day	$463	
PR105	8 or more days but not more than 14 days	- per day	$398	
PR110	15 or more days	- per day	$273	
				
	Surgical-Shared Room-Group A			
PR120	1 or more days but not more than 7 days	- per day	$395	
PR125	8 or more days but not more than 14 days	- per day	$340	
PR130	15 or more days	- per day	$230	
				
	Medical-Shared-Group A			
PR180	1 or more days but not more than 7 days	- per day	$387	
PR185	8 or more days but not more than 14 days	- per day	$341	
PR190	15 or more days	- per day	$231	
				
	Accommodation-Group B			
	Advanced Surgical-Shared Room-Group B			
PR200	1 or more days but not more than 7 days	- per day	$402	
PR205	8 or more days but not more than 14 days	- per day	$363	
PR210	15 or more days	- per day	$275	
				
	Surgical-Shared Room-Group B			
PR220	1 or more days but not more than 7 days	- per day	$373	
PR225	8 or more days but not more than 14 days	- per day	$336	
PR230	15 or more days	- per day	$220	
				
	Medical-Shared Room-Group B			
PR280	1 or more days but not more than 7 days	- per day	$373	
PR285	8 or more days but not more than 14 days	- per day	$336	
PR290	15 or more days	- per day	$220	
				
	Other Accommodation Charges-Group A			
PR300	High Dependency Unit	- per day	$633	
PR310	Advanced Dependency	- per day	$795	
PR330	Intensive Care - no Ventilator	- per day	$1410	
PR340	Intensive Care - Ventilator	- per day	$2002	
PR400	Private room allocated on the basis of medical need	- per day	$11	
	Note: A private room can be allocated on the basis of a medical need determined by the treating/admitting medical practitioner. In such a case, the $11 per day will be paid for occupancy of the private room. In all other cases, the charge for a private room will be the same as the charge prescribed for a shared room.			
				
	Inpatient Pain Assessment/Management			
PR700	1 or more days but not more than 7 days	- per day	$362	
PR705	8 or more days but not more than 14 days	- per day	$340	
PR710	15 or more days	- per day	$221	
				
	Hospital Rehabilitation Services			
	Rehabilitation Orthopaedic Program			
PR600	1 or more days but not more than 21 days	- per day	$396	
PR605	22 or more days	- per day	$332	
	Note: Orthopaedic programs include physiotherapy, hydrotherapy, occupational therapy, case conferences and discharge planning.			
				
	Rehabilitation Trauma Program			
PR610	1 or more days but not more than 50 days	- per day	$492	
PR615	51 or more days	- per day	$444	
	Note: Trauma programs include physiotherapy, occupational therapy, psychology, hydrotherapy, dietitian, podiatry, case conferences and discharge planning.			
				
	Same Day Services and Charges-Group A and B			
PR410	Band 1, including gastrointestinal endoscopy, some minor surgical and non surgical procedures not normally requiring anaesthetic.		$193	
PR420	Band 2, including procedures other than Band 1 performed under local anaesthetic with no sedation.
Theatre time less than 1 hour.		$285	
PR430	Band 3, including procedures other than Band 1 performed under a general or regional anaesthesia or intravenous sedation.
Theatre time less than 1 hour.		$333	
PR440	Band 4, including procedures other than Band 1 performed under general or regional anaesthesia or intravenous sedation.
Theatre time 1 hour or more.		$353	
				
	Theatre Fee-Band			
PRT1A	1A		$85	
PRTO1	1		$275	
PRTO2	2		$351	
PRTO3	3		$488	
PRTO4	4		$706	
PRTO5	5		$906	
PRTO6	6		$1193	
PRTO7	7		$1632	
PRTO8	8		$1742	
PRT9A	9A		$2026	
PRTO9	9		$2324	
PRT10	10		$3042	
PRT11	11		$4317	
PRT12	12		$4635	
PRT13	13		$4383	
PRT50	Dental Minor		$260	
PRT55	Dental Major		$469	
	Note 1	Services in this section will be determined in accordance with the National Procedure Banding Schedule.
Note 2	Only one theatre fee is payable per session.			
	General Notes—
For the purpose of determining fees, hospitals are categorised by WorkCover Corporation into Groups A and B and Rehabilitation. For details of criteria and current hospital listings, contact WorkCover Corporation on 13 18 55.			

Schedule 1A—Scale of charges—psychiatric services—private hospitals

Item No	Service Description		Charge	
	Inpatient Services			
PR800	1 or more days but not more than 14 days	- per day	$421	
PR803	15 or more days but not more than 28 days	- per day	$324	
PR813	29 or more days but not more than 42 days	- per day	$248	
PR815	43 or more days	- per day	$189	
PR850	Private room allocated on the basis of medical need	- per day	$11	
	Note: A private room can be allocated on the basis of a medical need determined by the treating/admitting medical practitioner. In such a case, the $11 per day will be paid for occupancy of the private room. In all other cases, the charge for a private room will be the same as the charge prescribed for a shared room.			
				
	Intensive Care Unit			
PR825	Intensive Care-Maximum stay 5 days	- per day	$691	
				
	Same Day Service			
PRO81	Groupwork session		$54	
PRO82	Electro-convulsive therapy (ECT)		$135	
PRO83	Half-day program		$144	
PRO84	Day Program		$228	
PRO86	Day Program and procedure		$292	
PRO87	Marcain therapy		$135	
PRO88	Modecate Clinic		$54	
	Note: The item numbers for same day services begin with the letters "PRO" (not "PR" followed by a zero.)			

Schedule 2—Scale of charges—physiotherapy services

Item No.	Service Description	Charge	
	CORE PHYSIOTHERAPY SCHEDULE SERVICES		
	Refer to the Physiotherapy Service and Fee Schedule Guidelines for requirements regarding the delivery of core schedule services.		
	CONSULTATIONS		
	INITIAL CONSULTATION
It is recommended that the treating physiotherapist, on the commencement of physiotherapy treatment, notifies the Self-Managed Employer, Exempt Employer or Claims Agent in respect of any new claim.
An initial consultation involves some or all of the following elements, the components of which are at the discretion of the treating physiotherapist:		
		(i)	Subjective Reporting
Major symptoms and lifestyle dysfunction; current history and treatment; past history and treatment; pain, 24 hour behaviour, aggravating and relieving factors; general health, medication, risk factors.		
		(ii)	Objective Assessment
Movement – active, passive, resisted, repeated; muscle tone, spasm, weakness; accessory movements, passive intervertebral movements etc. Appropriate procedures/tests as indicated.		
		(iii)	Assessment Results
Provisional diagnosis; goals of treatment; treatment plan.		
		(iv)	Treatment
Discussion with the patient regarding working hypothesis and treatment goals and expected outcomes; initial treatment and response; advice regarding home care including any exercise programs to be followed.		
		(v)	Documentation
Recording all of the above in the clinical record of the patient, as well as: X-ray and results of other relevant tests; skin tests, warnings (if applicable).		
		(vi)	Communication
Communication of information relevant to the rehabilitation and return to work of the patient/injured worker to the employer, Self-Managed Employer, Exempt Employer, Claims Agent, or coordinating general practitioner.		
PT105	Initial consultation, assessment, treatment
Initial assessment and treatment of condition	$47.70	
	SUBSEQUENT CONSULTATIONS
Reassessment and treatment of condition. This consultation must involve some or all of the following elements, the components of which are at the discretion of the treating physiotherapist.		
		(i)	History Taking/Assessment
The history and assessment related to the condition previously treated and its behaviour following the previous treatment.		
		(ii)	Examination
Examination by the physiotherapist of the condition previously treated.		
		(iii)	Treatment
An appropriate treatment is performed.		
		(iv)	Reassessment
Reassessment by both the patient and the physiotherapist.		
		(v)	Discussion of the Management Program with Patient/Carer
The goals of treatment and management program are discussed with the patient and counselling given regarding care and/or action to be taken before the next consultation or if no further treatment is required, regarding care and preventative measures.		
		(vi)	Communication
The appropriate management of a case involves communicating standard information to key parties. Information relevant to the management of the claim should be communicated to the treating general practitioner, Claims Agent case manager, Claims Agent medical, rehabilitation or physiotherapy advisor or non-medical experts involved in the claim.		
		(vii)	Physiotherapy Treatment Form
This form is to be completed once only as part of a subsequent consultation and forwarded to the Claims Agent with their invoice. This form will be initiated by the physiotherapist and forwarded to the Claims Agent where treatment is expected to extend for longer than 6 weeks.
No additional fee is billable for the completion of this form.		
		(viii)	Clinical Records
Comprehensive clinical notes must be kept recording all of the above.		
PT205	Subsequent consultation – Level A
Assessment, treatment. This consultation must involve some, but not usually all, of the elements of a Subsequent Consultation and requires minimal practitioner contact time.	$22.00	
PT210	Subsequent consultation – Level B
Assessment, treatment. This consultation must involve some or all of the elements of a Subsequent Consultation.	$37.85	
PT215	Subsequent consultation – Level C
Assessment, treatment. This consultation must include all of the elements of a Subsequent Consultation, but because of the complexity of the injury, will require extra time for history taking, examination, treatment, documentation and liaison (eg injuries following major trauma, major surgery requiring intensive post-operative treatment).	$47.85	
PT220	Subsequent consultation – Level D
Assessment, treatment. This consultation must include all of the elements of a Subsequent Consultation but requires greater time and should only be required in a limited number of cases where the case and treatment are extremely complex (eg injuries following extensive burns, multi-trauma, major surgery requiring intensive post-operative treatment such as complicated hand injuries or joint reconstruction and some neurological conditions).	$63.70	
	CORRECTIVE/SERIAL SPLINTING
Refer to the Physiotherapy Service and Fee Schedule Guidelines for further details regarding the types of splints available to the physiotherapist and the conditions associated with the provision of these splints.		
PT300	Fabrication/Fitting/Adjustment of Splint	$103.40 per hour 	
PT390	Materials used to construct or modify a splint
(Note: 'DF' means derived fee. Each account will be considered on its merits.)	DF	
	AQUATIC PHYSIOTHERAPY AND EXERCISE SERVICES
Refer to Physiotherapy Service and Fee Schedule Guidelines for further details regarding delivery of Aquatic Physiotherapy services.		
	AQUATIC PHYSIOTHERAPY (HYDROTHERAPY)		
PT415	Initial/individual aquatic physiotherapy (hydrotherapy) consultation
The first aquatic physiotherapy session requires significant planning, supervision and monitoring of individual clients and this item should be used.
This item may then be used for the 2 subsequent aquatic physiotherapy consultations after the initial service. It may also be used for one review at week 4-6 of the program.
Only in exceptional circumstances should the item PT415 be utilised after the first three appointments (eg severe trauma, fear of water) where much closer supervision is required. Prior case manager approval is required in these circumstances.	$37.85	
PT420	Subsequent/group aquatic physiotherapy (hydrotherapy) consultation
Aquatic physiotherapy sessions after the first three visits are to be billed at this rate. Clients may be treated in a group but all the programs must be unique and individualised to the particular client.	$15.80 per person 	
	EXERCISE		
PT455	Individual exercise consultation
Individual reassessment and exercise treatment of condition planned and supervised by a physiotherapist. This consultation must involve some or all of the elements of a Subsequent Consultation and the client to physiotherapist ratio must be 1:1 for the duration of the consultation.	$37.85	
PT460	Group exercise consultation
Group exercise session planned and supervised by a physiotherapist. This consultation must involve some or all the elements of a Subsequent Consultation, with exercise treatment undertaken in a group. Each group must be comprised of a maximum of 8 patients per session.	$11.20 per person 	
PT429	Entry fee, aquatic physiotherapy (hydrotherapy) or exercise
Entry to a public or privately operated facility.
This item may be utilised when the physiotherapist supervises an individual or group exercise or aquatic physiotherapy session with a patient to reimburse them for entry paid for the patient. This item is not to be used if the physiotherapist is an employee of the exercise or hydrotherapy facility. For group sessions, this fee is applicable for each participant supervised by the physiotherapist.
(Note: 'DF' means derived fee. Each account will be considered on its merits.)	DF	
	TRAVEL		
	The treating physiotherapist must receive prior approval from the Self-Managed Employer, Exempt Employer or Claims Agent before providing this service.		
	All travel items refer to return trips to and from rooms to a workplace, hospital, patient’s home or case conference.		
	Refer to the Physiotherapy Service and Fee Schedule Guidelines for further details regarding travel.		
PT905	Travel
Travel up to 100km from Adelaide GPO	$90.00 per hour 	
PT900	Travel after 100km from Adelaide GPO
Travel with a destination more than 100km distance from GPO where the physiotherapist is based in the metropolitan area attracts a 20% loading to be charged under this item.	$100.00 per hour 	
	TELEPHONE CALLS		
	Refer to the Physiotherapy Service and Fee Schedule Guidelines for further details regarding telephone calls.		
PT552	Telephone call
Calls of case specific nature made to or received from the worker’s referring/treating medical expert, rehabilitation provider, claims agent, self-managed employer or self insured (exempt) case manager, employer, WorkCover Corporation Provider Consultant or worker advocate.
Excludes calls made during consultation and calls to or from the worker.	$15.00	
	TREATMENT REVIEW		
PT785	Functional Notification Form
Completion of the Functional Notification Form will be initiated primarily by the treating physiotherapist when information is identified which directly impacts upon the patient’s capacity to return to work and any other issues influencing the return to work process. This form must be forwarded directly to the treating general practitioner. The Functional Notification Form may only be completed when it complies with the criteria specified within the Physiotherapy Service and Fee Schedule Guidelines.	$15.00	
PT780	Independent clinical assessment
Includes a review of medical history, activity and a clinical examination to provide a differential diagnosis and/or make recommendations regarding ongoing treatment goals and return to work.
This service includes the provision of a report detailing relevant findings and recommendations.
The Self-Managed Employer, Exempt Employer or Claims Agent must be notified prior to the provision of this service to seek approval for payment.
This service will NOT be performed by the treating physiotherapist.
Refer to the Physiotherapy Service and Fee Schedule Guidelines for service standards and indicators for use regarding Independent Clinical Assessment.	$107.80 per hour 	
	SUPPLEMENTARY SCHEDULE SERVICES
Refer to the Physiotherapy Service and Fee Schedule Guidelines for requirements regarding the delivery of supplementary schedule services.		
	REHABILITATION AND RETURN TO WORK SERVICES		
	Refer to the Physiotherapy Service and Fee Schedule Guidelines for service requirements and indicators for use of each rehabilitation and return to work service listed within this Schedule.		
PT700	Functional Capacity Assessment (FCA) or Functional Capacity Evaluation (FCE) (Standardised)
This service is undertaken to determine a worker’s inferred work capacity based on assessment of a worker’s physical capabilities through a series of standardised tests that focus on selected work tolerances. Maximum time – 7 hours including report preparation.	$107.80 per hour 	
PT730	Worksite assessment
Involves attending the worksite in order to ascertain the availability of duties, including an overview of the following:
	—	physical environment;
	—	mental work demands;
	—	human behaviour;
	—	working conditions;
	—	educational requirements;
	—	other conditions.	$107.80 per hour 	
PT740	Job analysis
Aims to identify specific tasks or employment options that are within a worker’s capacity and ability to perform, through modifications to elements of the job, the provision of aids and equipment or training that will safely extend the worker’s capacity range.
The analysis consists of four main categories:
	—	workstation design;
	—	work demands (intellectual/physical/sensory/perceptual);
	—	equipment;
	—	work environment.	$107.80 per hour 	
PT750	Work hardening on site
Aims to increase a worker’s capacity, tolerance and endurance for the physical and intellectual demands of specified duties and employment, resulting in improved work performance and leading to a safe return to suitable employment.	$107.80 per hour 	
PT760	Activities of daily living assessment
Conducted in a worker’s home with the aim of meeting the following objectives:
	—	providing essential services for severely injured workers; and/or
	—	maintaining or improving a worker’s level of physical functioning at home;
	—	preventing further injury or aggravation;
	—	assisting in preventing the development of chronicity in a worker’s condition.	$107.80 per hour 	
	OTHER SERVICES		
PT810	Comprehensive report
A Self-Managed Employer, Exempt Employer or Claims Agent may request a comprehensive report in response to a series of specific questions.
A report will be taken to be comprehensive when requested by a Self-Managed Employer, Exempt Employer or Claims Agent and re-examination of the worker is a prerequisite for the preparation of the report.
All reports referred to under this item are chargeable on an hourly basis with a maximum time chargeable of 1.5 hours.	$103.40 per hour 	
PT820	Standard report
A Self-Managed Employer, Exempt Employer or Claims Agent may request a standard report in response to a series of specific questions.
A report will be taken to be standard when re-examination of the worker is not required and the report is based on a transcription of existing records.
All reports referred to under this item are chargeable on an hourly basis with a maximum time chargeable of 1 hour.
Refer to the Physiotherapy Service and Fee Schedule Guidelines for standards required for report writing.	$103.40 per hour 	
PT870	Case conference
Case conferences are used for the purpose of determining:
	—	details of limitations/recommendations relating to a sustainable return to work;
	—	options for management of a worker’s recovery;
	—	other related information.	$103.40 per hour 	
	A case conference may be requested by:
	—	a treating medical expert;
	—	an employer;
	—	a worker or worker advocate;
	—	a Self-Managed Employer, Exempt Employer, Claims Agent or appointed Rehabilitation Coordinator.		
	The holding of a case conference must be authorised by the Self-Managed Employer, Exempt Employer or Claims Agent before the case conference is convened.		
	Refer to the Physiotherapy Service and Fee Schedule Guidelines for further detail regarding case conferences.		
CURAP	Therapeutic appliance
Includes an appliance or aid for reducing the extent of a compensable disability or enabling a patient to overcome in whole or in part the effects of a compensable disability (eg TENS machine).
(Note: 'DF' means derived fee. Each account will be considered on its merits.)
Refer to the Physiotherapy Service and Fee Schedule Guidelines for further detail regarding therapeutic appliances.	DF	
PT999	Non scheduled services
The use of this item number requires the approval of the Self-Managed Employer, Exempt Employer or Claims Agent prior to the delivery of the service.
This item number is used when the provision of services not listed on the Core or Supplementary Fee Schedule is necessary, appropriate and reasonably required.
Refer to the Physiotherapy Service and Fee Schedule Guidelines for further detail regarding non-scheduled services.	$103.40 per hour 	

Schedule 3—(Scales of charges—public hospitals)
Part A—Preliminary
1—Interpretation
	(1)	In this Schedule, unless the contrary intention appears—
admission means the formal administrative process of a recognised hospital or incorporated health centre by which a patient commences a period of treatment, care and accommodation in that hospital or health centre;
admitted patient means a patient who has undergone the formal admission process of a recognised hospital or incorporated health centre;
AN-DRG means Australian National Diagnosis Related Group as referred to in the Manual (see also subclause (2));
country hospital means a recognised hospital specified in Part E as a country regional, country sub-regional or other country hospital;
country regional hospital means a recognised hospital specified in Part E as a country regional hospital;
country sub-regional hospital means a recognised hospital specified in Part E as a country sub-regional hospital;
discharge means the formal administrative process of a recognised hospital or incorporated health centre by which a patient ceases a period of treatment, care and accommodation in that hospital or health centre;
incorporated health centre means an incorporated health centre under the South Australian Health Commission Act 1976;
inpatient means a person who is admitted as a patient of a recognised hospital or incorporated health centre and is not discharged until a day subsequent to the day of admission;
the Manual means the Australian National Diagnosis Related Groups Definitions Manual Version 2.0 published in 1993 by the Commonwealth Department of Health, Housing, Local Government and Community Services;
metropolitan hospital means a recognised hospital specified in Part E as a metropolitan teaching hospital or other metropolitan hospital;
metropolitan teaching hospital means a recognised hospital specified in Part E as a metropolitan teaching hospital;
non-admitted patient means a patient who is not an admitted patient;
prescription item means—
	(a)	a pharmaceutical or other item supplied on the prescription of a medical practitioner, dentist or other person authorised to prescribe the item; or
	(b)	an ancillary item required for the administration of such pharmaceutical or other item;
private, in relation to a patient of a recognised hospital or incorporated health centre, connotes that the patient receives medical or diagnostic services from a medical practitioner selected by the patient;
public, in relation to a patient of a recognised hospital or incorporated health centre, connotes that the patient receives medical or diagnostic services from a medical practitioner nominated by the hospital or health centre;
recognised hospital or hospital means a hospital or health service specified in Part E.
	(2)	For the purposes of this Schedule—
	(a)	AN-DRG reference numbers or descriptions are as set out in Appendix A of the Manual, but excluding any codes in that Appendix used for compiling statistical information; and
	(b)	terms and abbreviations used in AN-DRG descriptions have the meanings given by the definitions contained in Appendix G of the Manual.
5—Determination of applicable AN-DRG
For the purposes of this Schedule, the AN-DRG applicable to a patient must be determined in accordance with the guidelines contained in Coding and DRGS, A Handbook for Clinical Staff, published by the South Australian Health Commission in 1993.
Part B—Recognised hospitals: determination of fees for admitted patients
1—Interpretation
In this Part, unless the contrary intention appears—
day means calendar day;
inlier patient means an admitted patient whose length of stay in a recognised hospital lies between the upper and lower trim points (or equals the upper or lower trim point) shown in the third and fourth columns of the table in this Part corresponding to the AN-DRG applicable to the patient (except where the upper trim point is zero, in which case an inlier patient is one whose length of stay is greater than the upper trim point);
leave day means a day on which an admitted patient is on leave from a hospital without being discharged from that hospital—
	(a)	counting the day on which the patient goes on leave as one day; and
	(b)	excluding the day on which the patient returns (unless it is also the day on which the patient goes on leave);
length of stay, in relation to an admitted patient in a recognised hospital, means the number of days between the day of admission of the patient into the hospital and the day of discharge of the patient from the hospital—
	(a)	counting the day of admission as one day; and
	(b)	excluding the day of discharge (unless it is also the day of admission); and
	(c)	excluding any leave days;
long stay outlier patient means an admitted patient whose length of stay in a recognised hospital is, where the upper trim point shown in the third column of the table in this Part corresponding to the AN-DRG applicable to the patient is more than zero, greater than that upper trim point;
short stay outlier patient means an admitted patient whose length of stay in a recognised hospital is less than the lower trim point shown in the fourth column of the table in this Part corresponding to the AN-DRG applicable to the patient.
2—Inlier patients
Subject to this Part, the fee to be charged by a recognised hospital for a period of treatment, care and accommodation of an admitted patient to whom an AN-DRG specified in the first and second columns of the table in this Part is applicable must, where the patient is an inlier patient, be calculated as follows:

where—
	(a)	the Benchmark Price is—
	(i)	in the case of a public patient: $2 776;
	(ii)	in the case of a private patient: $2 096;
	(b)	the Inlier Cost Weight is the inlier cost weight for that recognised hospital shown in the fifth or sixth columns of the table in this Part corresponding to the AN-DRG applicable to the patient;
	(c)	the Severity Index is—
	(i)	1.1 in the case of a metropolitan teaching hospital;
	(ii)	1.05 in the case of—
	(A)	a metropolitan hospital other than a metropolitan teaching hospital; or
	(B)	a country regional hospital;
	(iii)	1.0 in the case of any other hospital.
3—Short stay outlier patients
Subject to this Part, the fee to be charged by a recognised hospital for a period of treatment, care and accommodation of an admitted patient to whom an AN-DRG specified in the first and second columns of the table in this Part is applicable must, where the patient is a short stay outlier patient, be calculated as follows:

where—
	(a)	the Benchmark Price is—
	(i)	in the case of a short stay outlier patient who is a public patient—$532;
	(ii)	in the case of a short stay outlier patient who is a private patient—$426;
	(b)	LOS is the length of stay of the patient in the recognised hospital;
	(c)	the OBD Cost Weight is the OBD (occupied bed day) cost weight shown in the seventh column of the table in this Part corresponding to the AN-DRG applicable to the patient;
	(d)	the Benchmark Theatre Price is—
	(i)	in the case of a short stay outlier patient who is a public patient—$1 038;
	(ii)	in the case of a short stay outlier patient who is a private patient—$692;
	(e)	the Theatre Cost Weight is the theatre cost weight shown in the eighth column of the table in this Part corresponding to the AN-DRG applicable to the patient.
4—Long stay outlier patients
	(1)	Subject to this Part, the fee to be charged by a recognised hospital for a period of treatment, care and accommodation of an admitted patient to whom an AN-DRG specified in the first and second columns of the table in this Part is applicable must, where the patient is a long stay outlier patient, be calculated as follows:
	(a)	if the length of stay of the patient in the recognised hospital is less than or equal to 90 days—

	(b)	if—
	(i)	the length of stay of the patient in the recognised hospital is greater than 90 days; and
	(ii)	the upper trim point for the AN-DRG applicable to the patient is less than 90 days—

	(c)	if—
	(i)	the length of stay of the patient is greater than 90 days; and
	(ii)	the upper trim point for the AN-DRG applicable to the patient is greater than 90 days—

	(2)	For the purposes of subclause (1):
	(a)	Inlier Price is the fee that would have been chargeable by the recognised hospital under this Part in respect of that patient for the relevant period of treatment, care and accommodation had the patient been an inlier patient;
	(b)	Benchmark Price A is—
	(i)	in the case of a metropolitan hospital (other than Noarlunga Health Services Incorporated or Gawler Health Services Incorporated) or a country regional hospital—$325;
	(ii)	in the case of all other recognised hospitals (including Noarlunga Health Services Incorporated and Gawler Health Services Incorporated)—$234;
	(c)	LOS is the length of stay of the patient in the recognised hospital;
	(d)	OBD Cost Weight is the OBD (occupied bed day) cost weight shown in the seventh column of the table in this Part corresponding to the AN-DRG applicable to the patient;
	(e)	Benchmark Price B is $149;
	(f)	Upper Trim Point is the upper trim point shown in the third column of the table in this Part corresponding to the AN-DRG applicable to the patient.
5—Rehabilitation fee, Hampstead Centre
	(1)	Despite clauses 2, 3 and 4, the fee to be charged by the Hampstead Centre of the Royal Adelaide Hospital for a period of treatment, care and accommodation of an admitted patient for whom the applicable AN-DRG is AN-DRG 931 rehabilitation services is as follows:

	(a)	in the case of a public patient	$ 623 per day;	
	(b)	in the case of a private patient	$ 561 per day.	
	(2)	For the purposes of this clause—
day includes the day of admission, but does not include—
	(a)	a leave day; or
	(b)	the day of discharge (unless it is also the day of admission).
6—Medical or diagnostic services for private patients
In the case of a private patient, a fee determined in accordance with this Part does not include a fee for the cost of medical or diagnostic services provided by a medical practitioner selected by the patient.
7—Transportation fee
Where, in addition to providing a service referred to in this Part, a recognised hospital transports, or arranges for the transportation of, a patient to or from (or between different campuses of) the hospital, the hospital may charge an additional fee equal to the cost to the hospital of providing, or arranging for the provision of, that transportation.

COST WEIGHTS AND TRIM POINTS FOR AN-DRG CHARGES FOR ADMITTED PATIENTS
1.
AN-DRG (Version 2)	2.
DESCRIPTION	3.
Upper Trim Point (Days)	4.
Lower Trim Point (Days)	5.
Inlier Cost Weight (except W&CH, ACH)	6.
Inlier Cost Weight—W&CH, ACH	7.
OBD Cost Weight	8.
Theatre Cost Weight	
001	MOUTH, LARYNX OR PHARYNX DISORDER W TRACHEOSTOMY AGE >15	93.91	13.78	7.7835	7.8301	1.3792	2.3584	
002	MOUTH, LARYNX OR PHARYNX DISORDER W TRACHEOSTOMY AGE <16	48.25	4.64	7.2684	9.0429	2.2321	0.3135	
003	TRACHEOSTOMY OTH THAN FOR MOUTH, LARYNX OR PHARYNX DISORDER AGE >15	98.34	11.70	17.0910	14.7303	2.0982	1.9449	
004	TRACHEOSTOMY OTH THAN FOR MOUTH, LARYNX OR PHARYNX DISORDER AGE <16	67.64	6.10	9.6563	9.1457	2.2147	0.6538	
005	LIVER TRANSPLANT	101.62	14.75	28.8463	28.8702	4.2913	12.6019	
006	BONE MARROW TRANSPLANT	53.64	9.96	15.2238	18.4075	2.2787	1.4279	
020	CRANIOTOMY EXCEPT FOR TRAUMA AGE >9	39.96	5.16	4.4254	6.4610	1.2273	2.2093	
021	CRANIOTOMY FOR TRAUMA AGE >9	37.54	4.50	4.8300	7.9074	1.3686	1.4144	
022	VENTRICULAR SHUNT REVISION AGE <10	19.77	2.06	1.8485	1.8501	1.2825	0.7249	
023	CRANIOTOMY AGE <10 W CC	26.17	4.67	3.6559	3.6589	1.3973	0.7697	
024	CRANIOTOMY AGE <10 W/O CC	17.19	2.81	1.9952	2.0053	1.3051	0.7426	
025	SPINAL PROCEDURES	32.72	3.79	5.1186	3.3118	1.2053	1.2083	
026	EXTRACRANIAL VASCULAR PROCEDURES	21.63	2.48	2.3690	2.2732	1.3225	1.6239	
027	CARPAL TUNNEL RELEASE	7.69	-	0.5255	0.5368	1.1481	0.7628	
028	PERIPH & CRANIAL NERVE & OTHER NERV SYST PROC	14.91	1.37	1.7661	1.8661	1.1636	0.9158	
029	SPINAL DISORDERS & INJURIES	24.24	2.74	2.8431	2.2124	0.9697	0.0000	
030	NERVOUS SYSTEM NEOPLASMS	29.02	3.06	2.0999	5.5505	0.9547	0.0000	
031	DEGENERATIVE NERVOUS SYSTEM DISORDERS W CC	47.03	5.22	3.1203	2.6460	0.6664	0.0000	
032	DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O CC	77.52	5.33	1.8985	1.8431	0.6057	0.0000	
033	MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA	40.78	3.04	1.4568	1.5636	0.8600	0.0000	
034	SPECIFIC CEREBROVASCULAR DISORDERS EXCEPT TIA	50.26	4.77	2.8939	1.9904	0.7761	0.0000	
035	TRANSIENT ISCHAEMIC ATTACK & PRECEREBRAL OCCLUSIONS W CC	20.94	2.13	1.2655	1.0172	0.7442	0.0000	
036	TRANSIENT ISCHAEMIC ATTACK & PRECEREBRAL OCCLUSIONS W/O CC	13.09	1.38	0.6126	0.5634	0.7208	0.0000	
037	NONSPECIFIC CEREBROVASCULAR DISORDERS W CC	65.80	6.31	4.0288	2.2791	1.0427	0.0000	
038	NONSPECIFIC CEREBROVASCULAR DISORDERS W/O CC	44.42	3.82	1.8140	0.8904	0.6263	0.0000	
039	CRANIAL & PERIPHERAL NERVE DISORDERS W CC	53.96	4.89	3.0347	5.9162	1.0757	0.0000	
040	CRANIAL & PERIPHERAL NERVE DISORDERS W/O CC	22.59	2.04	1.8181	1.2704	1.4616	0.0000	
041	NERVOUS SYSTEM INFECTION EXCEPT VIRAL MENINGITIS	22.51	2.56	1.9557	2.5840	1.2352	0.0000	
042	VIRAL MENINGITIS	9.33	-	0.6236	0.6231	1.0337	0.0000	
043	HYPERTENSIVE ENCEPHALOPATHY	12.17	1.77	0.9713	0.9774	0.8782	0.0000	
044	NONTRAUMATIC STUPOR & COMA	14.35	-	0.7019	1.1100	1.0461	0.0000	
045	SEIZURE AGE >9 W CC	14.34	1.57	0.8635	1.4698	0.8506	0.0000	
046	SEIZURE AGE >9 W/O CC	11.90	-	0.5197	0.6502	0.9464	0.0000	
047	SEIZURE AGE <10	13.91	-	0.4104	0.4010	1.1506	0.0000	
048	HEADACHE	9.06	-	0.4708	0.4357	1.0386	0.0000	
050	TRAUMATIC STUPOR & COMA,COMA > 1 HOUR	10.60	-	0.9275	0.9344	1.3753	0.0000	
051	TRAUMATIC STUPOR & COMA, COMA < 1 HOUR	13.40	-	0.4664	0.4748	1.2764	0.0000	
052	CONCUSSION	4.75	-	0.3086	0.3207	1.1843	0.0000	
053	OTHER DISORDERS OF NERVOUS SYSTEM W CC	21.17	2.29	2.2046	3.7480	0.9897	0.0000	
054	OTHER DISORDERS OF NERVOUS SYSTEM W/O CC	17.72	1.67	1.1927	1.9318	1.0226	0.0000	
070	RETINAL PROCEDURES	11.84	1.58	1.3090	1.2071	1.0404	1.2618	
071	ORBITAL PROCEDURES	20.04	2.24	1.4511	2.0878	0.9352	0.9049	
072	PRIMARY IRIS PROCEDURES EXCEPT GLAUCOMA	2.00	-	0.8567	0.8678	0.9454	0.9696	
073	LENS PROCEDURES W CC	12.65	-	0.9102	1.2681	1.2272	1.0379	
074	LENS PROCEDURES W/O CC	9.10	-	0.6791	1.1731	1.3949	1.0013	
076	EXTRAOCULAR PROCEDURES EXCEPT BOTH ORBIT & LACRIMAL	9.11	-	0.6056	0.6037	1.2448	0.8130	
077	EXTRAOCULAR PROCEDURES EXCEPT RETINA, IRIS, LENS & GLAUCOMA	14.93	-	1.3107	1.5360	1.0471	1.2398	
078	MAJOR CORNEAL,SCLERAL & CONJUNCTIVAL PROCEDURES	13.95	1.55	1.4075	1.4915	1.1686	1.1314	
079	OTHER CORNEAL, SCLERAL & CONJUNCTIVAL PROCEDURES	22.47	2.29	1.0715	1.1793	1.0085	0.7898	
080	GLAUCOMA PROCEDURES	15.27	1.96	1.0321	0.9792	0.9795	1.0404	
081	LACRIMAL PROCEDURES	5.00	-	0.6771	0.6003	1.6355	0.8456	
082	HYPHEMA	7.16	-	0.5307	0.7788	0.8696	0.0000	
083	ACUTE MAJOR EYE INFECTIONS	16.97	1.94	0.7869	0.7661	0.8958	0.0000	
084	NEUROLOGICAL EYE DISORDERS	8.83	-	0.6859	0.7692	0.9242	0.0000	
085	OTHER DISORDERS OF THE EYE AGE >9 W CC	25.68	2.16	1.2715	0.9764	1.0115	0.0000	
086	OTHER DISORDERS OF THE EYE AGE >9 W/O CC	11.50	-	0.4733	0.5556	0.9510	0.0000	
087	OTHER DISORDERS OF THE EYE AGE<10	9.00	-	0.4399	0.4475	1.0851	0.0000	
110	MAJOR HEAD & NECK PROCEDURES	43.62	6.18	5.7339	4.7246	1.2496	2.8790	
111	SIALOADENECTOMY	8.64	-	0.9674	2.3338	0.9774	1.1555	
112	SALIVARY GLAND PROCEDURES EXCEPT SIALOADENECTOMY	5.94	-	0.6939	0.9663	0.9290	0.8024	
113	CLEFT LIP & PALATE REPAIR	11.14	2.26	1.7033	1.8863	1.0090	1.1048	
114	MOUTH PROCEDURES	9.60	-	0.8290	0.7958	1.1937	0.8084	
115	SINUS & MASTOID PROCEDURES	7.38	-	0.8238	1.0391	1.0621	1.0188	
117	MISCELLANEOUS EAR, NOSE MOUTH & THROAT PROCEDURES	6.66	-	0.5918	0.6606	1.1187	0.7697	
118	RHINOPLASTY	13.97	-	0.5374	0.7570	0.9895	0.8333	
119	T&A PROC, EXCEPT TONSILLECTOMY &/OR ADENOIDECT ONLY AGE >9	10.67	-	0.6512	0.6192	1.1662	0.7476	
120	T&A PROC, EXCEPT TONSILLECTOMY &/OR ADENOIDECT ONLY AGE <10	2.85	-	0.5410	0.5399	1.5744	0.5603	
121	TONSILLECTOMY &/OR ADENOIDECTOMY ONLY AGE >9	4.37	-	0.5188	0.5184	0.9609	0.5366	
122	TONSILLECTOMY &/OR ADENOIDECTOMY ONLY AGE <10	3.83	-	0.5083	0.5073	1.1765	0.5122	
123	MYRINGOTOMY W TUBE INSERTION AGE >9	4.87	-	0.4875	0.4404	1.3944	0.5808	
124	MYRINGOTOMY W TUBE INSERTION AGE<10	10.56	-	0.4238	0.4266	1.3767	0.5625	
125	OTHER EAR, NOSE MOUTH & THROAT O.R. PROCEDURES	12.61	1.62	1.2715	2.4499	1.1615	1.1293	
126	DENTAL & ORAL DIS EXCEPT EXTRACTIONS & RESTORATIONS AGE >9	10.19	-	0.4451	0.4701	1.1273	0.0000	
127	DENTAL & ORAL DIS EXCEPT EXTRACTIONS & RESTORATIONS AGE <10	6.85	-	0.3407	0.3243	1.1758	0.0000	
128	DENTAL EXTRACTIONS & RESTORATIONS	5.49	-	0.2814	0.2951	1.3242	0.0000	
129	EAR, NOSE MOUTH AND THROAT MALIGNANCY	21.39	2.20	1.6836	0.9392	0.9531	0.0000	
130	DYSEQUILIBRIUM	12.81	-	0.4534	0.3681	0.7250	0.0000	
131	EPISTAXIS	8.67	-	0.4186	0.3619	0.9628	0.0000	
132	EPIGLOTITIS	10.52	1.48	1.2441	1.2597	1.9315	0.0000	
133	OTITIS MEDIA & URI AGE >9 W CC	13.40	1.61	0.9724	0.9495	0.8717	0.0000	
134	OTITIS MEDIA & URI AGE >9 W/O CC	37.27	-	0.4187	0.4689	0.9306	0.0000	
135	OTITIS MEDIA & URI AGE <10	9.25	-	0.4098	0.4018	1.0704	0.0000	
136	LARYNGOTRACHEITIS	3.68	-	0.2939	0.2921	1.0814	0.0000	
137	NASAL TRAUMA & DEFORMITY	8.08	-	0.3046	0.3474	1.2675	0.0000	
138	OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES AGE >9	9.29	-	0.4430	0.5998	1.0986	0.0000	
139	OTHER EAR, NOSE, MOUTH AND THROAT DAIGNOSES AGE < 10	4.73	-	0.4168	0.4106	1.4021	0.0000	
160	MAJOR CHEST PROCEDURES W MAJOR CC	38.31	6.29	6.1531	5.4093	1.4040	3.2767	
161	MAJOR CHEST PROCEDURES W NON-MAJOR CC	24.54	3.88	4.3100	6.5209	1.1843	4.4948	
162	MAJOR CHEST PROCEDURES W/O CC	19.52	3.28	3.3174	2.1813	1.0667	3.9968	
163	OTHER RESP SYSTEM O.R. PROCEDURES W MAJOR CC	30.83	4.91	3.3981	3.9235	1.2008	1.1652	
164	OTHER RESP SYSTEM O.R. PROCEDURES W NON-MAJOR CC	37.63	3.43	2.5540	1.7900	0.9365	0.9319	
165	OTHER RESP SYSTEM O.R. PROCEDURES W/O CC	14.38	1.96	1.3952	1.3234	1.0685	1.1962	
166	RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT	27.49	3.34	2.9115	2.3578	1.6872	0.0000	
167	PULMONARY EMBOLISM	24.69	3.11	1.6315	1.5649	0.8894	0.0000	
168	RESPIRATORY INFECTIONS & INFLAMMATIONS AGE >9	33.95	3.84	2.5628	2.6949	1.0482	0.0000	
169	RESPIRATORY INFECTIONS & INFLAMMATIONS AGE <10	206.51	10.54	1.5479	3.4106	1.0739	0.0000	
170	RESPIRATORY NEOPLASMS	28.87	2.96	1.6759	2.2748	0.9269	0.0000	
171	MAJOR CHEST TRAUMA W CC	23.43	3.03	1.6292	1.5527	1.0300	0.0000	
172	MAJOR CHEST TRAUMA W/O CC	10.84	1.43	0.6745	0.6537	0.8441	0.0000	
173	CYSTIC FIBROSIS	35.07	5.15	2.8974	3.6167	1.2740	0.0000	
174	SLEEP APNOEA	14.35	-	0.4414	0.4051	1.3905	0.0000	
175	PLEURAL EFFUSION	17.04	2.00	1.3191	1.0927	0.8569	0.0000	
176	PULMONARY OEDEMA & RESPIRATORY FAILURE	18.14	2.08	1.5642	1.2530	0.9585	0.0000	
177	CHRONIC OBSTRUCTIVE AIRWAYS DISEASE	40.79	3.08	1.1955	2.3506	0.6804	0.0000	
178	SIMPLE PNEUMONIA & PLEURISY AGE >9 W CC	30.21	3.00	1.6672	1.6585	0.8941	0.0000	
179	SIMPLE PNEUMONIA & PLEURISY AGE >9 W/O CC	15.66	1.92	0.8226	0.6887	0.7356	0.0000	
180	SIMPLE PNEUMONIA & PLEURISY AGE <10	9.68	-	0.7298	0.7218	1.0212	0.0000	
181	INTERSITIAL LUNG DISEASE W CC	27.57	3.61	2.1149	1.8583	1.0528	0.0000	
182	INTERSITIAL LUNG DISEASE W/O CC	23.62	2.53	1.5459	2.4824	0.8066	0.0000	
183	PNEUMOTHORAX W CC	21.41	2.72	1.3794	0.8909	0.9356	0.0000	
184	PNEUMOTHORAX W/O CC	8.74	1.36	0.7226	0.8960	0.8024	0.0000	
185	BRONCHITIS & ASTHMA AGE >9 W CC	19.04	2.30	1.1182	1.1555	0.8048	0.0000	
186	BRONCHITIS & ASTHMA AGE <10	8.13	-	0.4868	0.4740	1.1188	0.0000	
187	RESPIRATORY SIGNS & SYMPTOMS W CC	12.47	1.52	0.9933	1.4980	0.9092	0.0000	
188	RESPIRATORY SIGNS & SYMPTOMS W/O CC	8.95	-	0.4108	0.5119	1.0242	0.0000	
189	OTHER RESPIRATORY SYSTEM DIAGNOSES W CC	23.57	2.56	1.3905	0.7048	0.9407	0.0000	
190	OTHER RESPIRATORY SYSTEM DIAGNOSES W/O CC	11.83	1.33	0.5585	0.7757	0.8028	0.0000	
191	BPD & OTH CHRONIC RESP DISEASES ARISING IN PERINATAL PERIOD	16.31	1.39	1.1022	1.6374	1.2686	0.0000	
192	OTHER RESPIRATORY PROBLEMS AFTER BIRTH	13.62	2.38	0.8669	0.8849	0.9066	0.0000	
193	BRONCHITIS & ASTHMA AGE >9 W/O CC	11.49	-	0.5061	0.5616	0.8456	0.0000	
220	HEART TRANSPLANT	-	-	9.1567	9.7738	1.9585	5.8642	
221	CARDIAC VALVE PROC W PUMP & W INVASIVE CARDIAC INVES PROC W CC	44.91	7.42	11.5386	11.2542	2.3454	5.1289	
222	CARDIAC VALVE PROC W PUMP & W INVASIVE CARDIAC INVES PROC W/O CC	-	-	4.8478	4.8524	1.1787	3.6888	
223	CARDIAC VALVE PROC W PUMP & W/O INVASIVE CARDIAC INVES PROC	25.97	4.68	6.6973	6.5478	2.0793	5.0731	
224	CORONARY BYPASS W INVASIVE CARDIAC INVESTIGATION PROCEDURE	32.35	5.83	6.6718	6.7727	1.8652	2.7312	
225	CORONARY BYPASS W/O INVASIVE CARDIAC INVESTIGATION PROCEDURE	19.75	3.59	3.9805	3.6390	1.6893	2.9249	
226	OTHER CARDIOTHORCIC OR VASCULAR PROCEDURES, W PUMP	26.07	3.88	7.0712	5.9608	2.3563	3.0406	
227	OTHER CARDIOTHORCIC PROCEDURES W/O PUMP	19.66	2.19	5.0581	4.0890	2.4525	1.5246	
228	MAJOR RECONSTRUCT VASCULAR PROC W/O PUMP W MAJOR CC	59.13	6.88	6.6260	6.0976	1.1901	2.4605	
229	MAJOR RECONSTRUCT VASCULAR PROC W/O PUMP W NON-MAJOR CC	29.24	4.84	4.3169	4.3419	1.1516	2.2334	
230	MAJOR RECONSTRUCT VASCULAR PROC W/O PUMP W/O CC	31.35	4.10	2.7061	3.1471	1.0334	2.0166	
231	VASCULAR PROCEDURES EXCEPT MAJOR RECONSTRUCTION W/O PUMP W CC	33.29	3.63	4.0942	3.0195	1.4836	0.9323	
232	VASCULAR PROCEDURES EXCEPT MAJOR RECONSTRUCTION W/O PUMP W/O CC	11.80	1.38	2.0724	1.8377	2.0157	0.8416	
233	AMPUTATION FOR CIC SYSTEM DISORDERS EXCEPT UPPER LIMB & TOE	46.89	6.67	7.9437	7.4312	0.8909	1.3119	
234	UPPER LIMB & TOE AMPUTATION FOR CIC SYSTEM DISORDERS	52.21	6.25	3.5397	3.3187	0.7631	0.8716	
235	PERM CARDIAC PACEMAKER IMP W AMI, HEART FAILURE OR SHOCK	39.61	5.39	5.7248	5.1324	1.9416	2.2559	
236	PERM CARDIAC PACEMAKER IMP W/O AMI, HEART FAILURE OR SHOCK	16.93	2.08	3.7543	3.5947	3.2286	2.3778	
237	CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT	11.98	1.50	2.1130	1.7376	1.8327	1.1155	
238	CARDIAC PACEMAKER DEVICE REPLACEMENT	18.74	2.15	4.1351	4.1278	2.1841	2.9263	
239	VEIN LIGATION & STRIPPING	13.52	-	0.7781	0.8001	0.9175	1.0691	
240	OTHER CIRCULATORY SYSTEM O.R. PROCEDURES	51.87	3.60	4.9357	4.3816	0.9738	1.3202	
241	IMPLANTATION OR REPLACEMENT OF AICD, TOTAL SYSTEM	-	-	9.3562	9.2842	2.4425	5.4116	
242	AICD COMPONENT IMPLANTATION/REPLACEMENT	3.91	-	3.9322	3.9249	3.7645	1.9450	
245	CIRC DISORD W AMI W INVASIVE CARDIAC INVESTIGATION PROC W CC	26.62	4.47	3.3064	3.2097	1.4431	0.0000	
246	CIRC DISORD W AMI W INVASIVE CARDIAC INVESTIGATION PROC W/O CC	18.57	3.04	2.2625	2.1807	1.4659	0.0000	
247	CIRC DISORD W AMI W/O INVASIVE CARDIAC INVESTIGATION PROC, DIED	18.33	1.82	1.5611	1.2476	1.4677	0.0000	
248	CIRC DISORD W AMI W/O INVASIVE CARDIAC INVESTIGATION PROC W CC	24.54	3.60	2.4819	2.3885	1.0542	0.0000	
249	CIRC DISORD W AMI W/O INVASIVE CARDIAC INVESTIGATION PROC W/O CC	16.60	2.78	1.5315	1.4578	1.0357	0.0000	
250	CIRC DISORDER EXCEPT AMI, W INVASIVE CARDIAC INVESTIGATION PROC	11.49	-	0.9057	1.3397	1.7379	0.0000	
251	INFECTIVE ENDOCARDITIS	37.33	5.09	5.6789	3.1746	0.9287	0.0000	
252	HEART FAILURE & SHOCK	29.82	2.87	1.3338	1.3944	0.7984	0.0000	
253	DEEP VEIN THROMBOSIS	21.91	2.77	1.1066	1.1213	0.7282	0.0000	
254	PERIPHERAL VASCULAR DISORDERS	45.09	2.41	1.5504	0.8816	0.9007	0.0000	
255	ATHEROSCLEROSIS W CC	21.15	2.19	1.4640	1.2624	0.9175	0.0000	
256	ATHEROSCLEROSIS W/O CC	12.52	1.50	0.8788	0.7640	0.9129	0.0000	
257	HYPERTENSION W CC	17.70	2.34	0.8479	0.8479	0.7144	0.0000	
258	HYPERTENSION W/O CC	29.60	1.84	0.4840	0.7487	0.6653	0.0000	
259	SYNCOPE & COLLAPSE W CC	18.67	1.89	0.8058	0.7798	0.7773	0.0000	
260	SYNCOPE & COLLAPSE W/O CC	10.46	-	0.4160	0.4495	0.8285	0.0000	
261	CHEST PAIN	31.10	-	0.3769	0.4494	1.0725	0.0000	
262	OTHER CIRCULATORY SYSTEM DIAGNOSES W CC	19.66	2.13	1.8291	2.6575	1.0758	0.0000	
263	OTHER CIRCULATORY SYSTEM DIAGNOSES W/O CC	86.32	3.06	1.0623	3.9600	1.0823	0.0000	
264	CONGENITAL HEART DISEASE AGE >9	12.42	1.44	1.2007	0.8398	1.0316	0.0000	
265	CONGENITAL HEART DISEASE AGE <10	10.14	1.33	1.5478	1.6087	1.4888	0.0000	
266	MAJOR ARRHYTHMIA & CARDIAC ARREST W CC	21.02	2.01	1.5718	1.4128	1.2777	0.0000	
267	MAJOR ARRHYTHMIA & CARDIAC ARREST W/O CC	16.51	1.61	0.6988	0.9969	1.1829	0.0000	
268	NON-MAJOR ARRHYTHMIA & CONDUCTION DISORDERS W CC	21.14	1.95	1.0660	1.0743	0.9276	0.0000	
269	NON-MAJOR ARRHYTHMIA & CONDUCTION DISORDERS W/O CC	7.76	-	0.5224	0.4599	1.0436	0.0000	
270	UNSTABLE ANGINA	11.42	1.35	0.8970	0.8183	0.9856	0.0000	
271	VALVULAR DISORDERS W CC	17.05	1.99	1.1742	0.9681	0.9231	0.0000	
272	VALVULAR DISORDERS W/O CC	6.90	-	0.4694	0.4640	0.9198	0.0000	
300	RECTAL RESECTION W CC	42.09	6.10	4.2287	4.1773	1.0270	1.9038	
301	RECTAL RESECTION W/O CC	23.79	4.08	2.6656	3.0713	0.9382	1.8403	
302	MAJOR SMALL & LARGE BOWEL PROCEDURES W CC	52.59	6.01	4.2312	4.7749	1.1104	1.6685	
303	MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC	20.46	3.52	2.4669	3.1840	0.8875	1.4780	
304	PERITONEAL ADHESIOLYSIS W CC	42.94	5.33	3.2964	3.1375	1.0109	1.1910	
305	PERITONEAL ADHESIOLYSIS W/O CC	17.87	2.05	1.7016	3.2895	0.8617	1.1434	
306	MINOR SMALL & LARGE BOWEL PROCEDURES W CC	18.49	3.55	2.4726	2.2097	0.9100	1.2387	
307	MINOR SMALL & LARGE BOWEL PROCEDURES W/O CC	11.02	2.39	1.4130	1.6972	0.8149	1.0746	
308	STOMACH, OESOPHAGEAL & DUODENAL PROCEDURES AGE >9 W MAJOR CC	47.42	6.02	5.8985	5.2414	1.3403	2.0032	
309	STOMACH, OESOPHAGEAL & DUODENAL PROCEDURES AGE >9 W NON-MAJOR CC	36.08	5.24	4.2279	3.6151	1.1557	1.6533	
310	STOMACH, OESOPHAGEAL & DUODENAL PROCEDURES AGE >9 W/O CC	18.59	2.71	1.8282	1.9824	0.9462	1.1507	
311	STOMACH, OESOPHAGEAL & DUODENAL PROCEDURES AGE < 10	28.49	2.86	1.8350	1.8250	1.3194	0.9209	
312	ANAL & STOMAL PROCEDURES	10.68	-	0.6723	0.7219	0.8784	0.5835	
313	HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL AGE >9	17.81	1.76	0.9690	0.7512	0.8788	0.8128	
314	INGUINAL & FEMORAL HERNIA PROCEDURES AGE >9	9.75	-	0.7850	0.7017	0.8692	0.8333	
315	HERNIA PROCEDURES AGE <10	3.29	-	0.5170	0.5146	1.3644	0.7201	
316	APPENDICECTOMY W COMPLICATED PRINCIPAL DIAG	13.00	2.09	1.2899	1.7132	0.9379	0.8264	
317	APPENDICECTOMY W/O COMPLICATED PRINCIPAL DIAG	8.08	-	0.8323	0.9907	0.9406	0.7643	
318	OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W CC	42.71	4.74	3.5133	4.5107	1.0446	1.1140	
319	OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W/O CC	31.23	1.82	1.2361	1.2429	1.1108	1.0435	
320	DIGESTIVE MALIGNANCY	28.76	3.03	1.3634	1.0804	0.8438	0.0000	
321	G.I. HAEMORRHAGE W CC	29.40	2.25	1.3329	1.5917	0.9307	0.0000	
322	G.I. HAEMORRHAGE W/O CC	17.36	1.43	0.5261	1.2550	0.8974	0.0000	
323	COMPLICATED PEPTIC ULCER W CC	16.49	2.19	1.5625	1.0835	0.9879	0.0000	
324	COMPLICATED PEPTIC ULCER W/O CC	122.53	4.98	0.3595	1.3818	1.1912	0.0000	
325	UNCOMPLICATED PEPTIC ULCER	57.07	2.52	0.5818	0.4271	0.9441	0.0000	
326	INFLAMMATORY BOWEL DISEASE W CC	28.84	3.02	1.6126	1.7080	0.8502	0.0000	
327	INFLAMMATORY BOWEL DISEASE W/O CC	17.99	2.05	0.6936	1.8030	0.9346	0.0000	
328	G.I. OBSTRUCTION	15.30	1.68	0.8432	1.0253	0.8183	0.0000	
329	OESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE >9 W CC	17.05	1.78	0.9609	1.4248	0.8640	0.0000	
330	OESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS AGE >9 W/O CC	9.56	-	0.3409	0.4035	0.9629	0.0000	
331	OESOPHAGITIS, & MISC DIGEST DISORDERS AGE <10	8.08	-	0.4748	0.4680	1.1939	0.0000	
332	OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >9 W CC	18.54	1.95	1.2949	1.3775	1.0467	0.0000	
333	OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >9 W/O CC	8.23	-	0.2917	0.3834	0.9874	0.0000	
334	OTHER DIGESTIVE SYSTEM DIAGNOSES AGE <10	7.63	-	0.3416	0.3287	1.0643	0.0000	
335	GASTROENTERITIS AGE <10	6.05	-	0.4986	0.4970	1.0510	0.0000	
360	PANCREAS, LIVER & SHUNT PROCEDURES W CC	61.54	7.15	6.4130	6.0684	1.2051	1.6646	
361	PANCREAS, LIVER & SHUNT PROCEDURES W/O CC	33.95	3.83	2.7047	2.4121	0.9910	1.4664	
362	BILIARY TRACT PROC EXC ONLY CHOLECYST W OR W/O C.D.E. W MAJOR CC	49.41	7.58	5.3339	4.9355	1.1318	1.7126	
363	BILIARY TRACT PROC EXC ONLY CHOLECYST W OR W/O C.D.E. W NON-MAJOR CC	23.35	3.57	3.7825	11.6461	1.0227	1.7478	
364	BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W/O CC	19.00	3.42	2.5160	2.3013	0.8986	1.4113	
365	CHOLECYSTECTOMY W C.D.E. W CC	76.49	11.33	4.1969	3.8760	1.0165	1.5377	
366	CHOLECYSTECTOMY W C.D.E. W/O CC	13.45	2.46	2.3352	2.1910	0.8366	1.2140	
367	CHOLECYSTECTOMY W/O C.D.E.	13.48	1.58	1.2362	1.4946	0.9952	1.0779	
368	HEPATOBILIARY DIAGNOSTIC PROCEDURE FOR MALIGNANCY	32.50	5.19	2.7674	2.8636	1.0764	1.1437	
369	HEPATOBILIARY DIAGNOSTIC PROCEDURE FOR NON-MALIGNANCY	42.24	4.27	2.7066	2.2598	1.2444	0.9085	
370	OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES	38.62	4.97	8.0406	2.2056	1.3318	1.1389	
371	CIRRHOSIS & ALCOHOLIC HEPATITIS W CC	29.38	3.26	2.0701	1.3024	0.8851	0.0000	
372	CIRRHOSIS & ALCOHOLIC HEPATITIS W/O CC	14.42	1.83	1.1205	0.6094	0.7560	0.0000	
373	MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS	28.86	3.16	1.8303	1.1052	0.9972	0.0000	
374	DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC	23.46	2.44	1.5113	1.5835	0.8424	0.0000	
375	DISORDERS OF PANCREAS EXCEPT MALIGNANCY W/O CC	13.92	1.71	0.7775	1.3725	0.7470	0.0000	
376	DISORDERS OF LIVER EXCEPT MALIG, CIRR, ALC HEPA W CC	25.53	2.77	1.5398	3.5302	0.9265	0.0000	
377	DISORDERS OF LIVER EXCEPT MALIG, CIRR, ALC HEPA W/O CC	13.51	1.42	0.7091	0.8283	1.3414	0.0000	
378	DISORDERS OF THE BILIARY TRACT W CC	15.97	1.90	1.2305	0.7802	0.8761	0.0000	
379	DISORDERS OF THE BILIARY TRACT W/O CC	43.60	1.40	0.5790	1.1232	0.8409	0.0000	
400	BILATERAL OF MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY	57.34	10.24	7.7607	7.7660	0.8107	4.7275	
401	OTHER MAJOR JOINT & LIMB REATTACHMENT PROCEDURES W CC	23.14	4.01	4.3357	4.2938	1.1861	2.2449	
402	OTHER MAJOR JOINT & LIMB REATTACHMENT PROCEDURES W/O CC	22.69	3.78	3.4733	3.5157	1.1196	2.2522	
403	HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >9 W CC	25.96	3.70	3.8033	4.0241	0.8596	1.2058	
404	HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >9 W/O CC	18.44	2.62	2.3373	2.4567	0.8347	1.1414	
405	HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE <10	32.75	3.23	2.4659	2.4871	1.1278	1.0992	
406	AMPUTATION FOR MUSCULOSKELET SYSTEM & CONN TISSUE DISORDERS	55.00	7.04	4.3866	2.7928	0.8565	0.9208	
407	BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE	32.03	2.83	2.3541	1.9468	0.9947	0.7025	
408	WND DEBRID & SKIN GRAFT EXC HAND, MS & CONN TISS DIS W CC	64.62	7.34	7.4915	4.1582	0.9024	1.9938	
409	WND DEBRID & SKIN GRAFT EXC HAND, MS & CONN TISS DIS W/O CC	23.63	2.47	2.3689	3.9799	0.8120	1.0962	
411	LOWER EXTREM & HUMER PROC EXC HIP, FOOT, FEMUR AGE >9 W CC	32.94	3.71	3.0958	3.5489	0.8338	1.2175	
412	LOWER EXTREM & HUMER PROC EXC HIP, FOOT, FEMUR AGE < 10	5.75	-	0.9138	0.9216	1.2025	0.8881	
413	KNEE PROCEDURES	10.18	-	0.7980	1.0777	1.2242	0.7989	
414	MAJOR SHOULDER/ELBOW PROC	8.67	-	0.9271	1.1626	0.8834	0.9711	
415	SHOULDER, ELBOW OR FOREARM PROCEDURE, EXC MAJOR JOINT PROCEDURE	7.71	-	0.8896	0.8999	0.9946	1.0169	
416	FOOT PROCEDURES	47.96	1.81	1.0833	1.3458	0.9311	0.9988	
417	SOFT TISSUE PROCEDURES	10.25	-	0.7992	0.9529	0.9569	0.8208	
418	MAJOR THUMB OR JOINT PROC	8.37	-	0.9310	1.0976	0.9914	0.8420	
419	HAND OR WRIST PROC, EXCEPT MAJOR JOINT PROCEDURE	6.43	-	0.5703	0.7332	1.1438	0.7736	
420	LOCAL EXCISION & REMOVAL OF INT FIX DEVICES OF HIP & FEMUR	9.07	-	0.9668	0.9992	0.9330	0.8260	
421	LOCAL EXCISION & REMOVAL OF INT FIX DEVICES EXC HIP & FEMUR	14.07	-	0.7133	0.9874	1.2839	0.8312	
422	ARTHROSCOPY	17.28	-	0.5880	0.7199	1.2117	0.8211	
423	OTHER MUSCULOSKELETAL SYSTEM & CONN TISS O.R. PROC W CC	12.48	1.97	4.0419	4.9883	0.9019	0.9469	
424	OTHER MUSCULOSKELETAL SYSTEM & CONN TISS O.R. PROC W/O CC	10.85	1.40	1.3091	1.9045	0.9821	0.9828	
425	FRACTURES OF FEMUR	34.34	3.72	3.6428	3.5124	0.6891	0.0000	
426	FRACTURES OF HIP & PELVIS	28.81	3.04	1.8719	4.7317	0.6932	0.0000	
427	SPRAINS, STRAINS & DISLOCATIONS OF HIP, PELVIS AND THIGH	9.60	-	0.8067	0.6946	0.6215	0.0000	
428	OSTEOMYELITIS	17.12	2.27	2.6765	1.8280	0.9101	0.0000	
429	PATHOLOGICAL FRACTURES & MUSCULOSKELETAL & CONN TISSUE MALIG	39.92	3.79	2.2069	3.2000	0.8477	0.0000	
430	CONNECTIVE TISSUE DISORDERS	31.59	2.90	1.8254	2.6695	0.8267	0.0000	
431	SEPTIC ARTHRITIS	15.87	2.11	1.5452	1.9764	0.8851	0.0000	
432	MEDICAL BACK PROBLEMS	20.91	2.02	1.0405	1.3232	0.7789	0.0000	
433	BONE DISEASES & SPECIFIC ARTHROPATHIES W CC	24.05	3.02	1.3290	1.2468	0.6721	0.0000	
434	BONE DISEASES & SPECIFIC ARTHROPATHIES W/O CC	20.51	2.07	0.8780	1.1754	0.6284	0.0000	
435	NON-SPECIFIC ARTHROPATHIES	13.54	1.68	0.7893	0.9995	0.6603	0.0000	
436	SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE	13.37	-	0.6237	0.5960	0.9012	0.0000	
437	TENDONITIS, MYOSITIS & BURSITIS	19.63	1.67	0.6957	1.9802	0.8620	0.0000	
438	AFTERCARE, MUSCOSKELETAL SYSTEM & CONNECTIVE TISSUE	46.64	2.61	1.1995	2.2883	0.7292	0.0000	
439	FX, SPRAIN, STRAIN & DISL OF FOREARM, HAND, FOOT AGE > 9 W CC	17.51	1.86	1.2582	0.8455	0.9148	0.0000	
440	FX, SPRAIN, STRAIN & DISL OF FOREARM, HAND, FOOT AGE < 10	2.75	-	0.2871	0.2816	1.4122	0.0000	
441	FX, SPRAIN, STRAIN & DISL OF UPPERARM, LOWER LEG EXC FOOT AGE > 9 W CC	29.45	2.88	1.9676	1.2050	0.6895	0.0000	
442	FX, SPRAIN, STRAIN & DISL OF UPPERARM, LOWER LEG EXC FOOT AGE > 9 W/O CC	19.93	1.41	0.6224	1.5358	0.7418	0.0000	
443	FX, SPRAIN, STRAIN & DISL OF UPPERARM, LOWER LEG EXC FOOT AGE < 10	3.68	-	0.4056	0.4042	1.1695	0.0000	
444	MAJOR CRANIO-MAXILLO FACIAL SURGERY	23.38	3.56	2.8731	3.3428	1.1253	2.1652	
445	MINOR CRANIO-MAXILLO FACIAL SURGERY	11.92	2.00	1.6018	1.6144	1.3993	1.2234	
446	OTHER MUSCULOSKELETAL SYSTEM & CONN TISS DIAG AGE >9	18.93	1.79	0.6573	0.5064	0.8301	0.0000	
447	BACK & NECK PROCEDURES W SPINAL FUSION	36.39	3.75	3.1681	3.5156	1.0504	1.4508	
448	BACK & NECK PROCEDURES W/O SPINAL FUSION	22.87	3.08	1.8000	1.9179	0.8141	1.1296	
449	HIP REPLACEMENT W CC	37.89	4.59	5.0113	4.8699	1.1043	3.1763	
450	HIP REPLACEMENT W/O CC	24.45	3.52	3.5515	3.5051	1.0486	2.9683	
451	LOWER EXTREM & HUMER PROC EXC HIP, FOOT, FEMUR AGE > 9 W/O CC	15.47	1.84	1.4612	2.0157	0.9201	1.0745	
452	INFECT/INFLAM OF BONE & JOINT W MISC MS & CONN TISS PROC AGE <10	136.91	8.52	2.2282	2.6566	1.1039	0.6425	
453	FX, SPRAIN, STRAIN & DISL OF FOREARM, HAND, FOOT AGE > 9 W/O CC	6.61	-	0.3469	0.3673	1.1447	0.0000	
454	OTHER MUSCULOSKELETAL SYSTEM & CONN TISS DIAG AGE <10	43.39	2.02	3.4728	2.2122	0.9282	0.0000	
480	SKIN GRAFT &/OR DEBRID FOR SKIN ULCER, CELLULITIS	81.44	8.77	5.0728	5.6380	0.8257	1.1058	
481	SKIN GRAFT &/OR DEBRID EXC FOR SKIN ULCER, CELLULITIS	22.34	2.20	1.3314	3.6473	0.8593	0.8229	
482	PERIANAL & PILONIDAL PROCEDURES	6.54	-	0.6058	0.5374	0.8521	0.5558	
483	SKIN, SUBCUTANEOUS TISSUE & BREAST PLASTIC PROCEDURES	12.53	-	0.6128	1.7413	0.9035	0.6645	
484	OTHER SKIN, SUBCUTANEOUS TISSUE & BREAST PROCEDURES	13.61	-	0.5352	0.5640	1.2314	0.5185	
485	SKIN ULCERS	62.33	6.19	1.7689	1.9826	0.7330	0.0000	
486	MAJOR SKIN DISORDERS	25.11	3.21	1.5208	1.5987	0.8380	0.0000	
487	MALIGNANT BREAST DISORDERS	43.23	4.16	1.3582	1.2520	1.2154	0.0000	
488	NON-MALIGNANT BREAST DISORDERS	5.92	-	0.3803	0.3885	0.9673	0.0000	
489	CELLULITIS AGE >9 W CC	27.36	2.77	1.4803	3.8128	0.8246	0.0000	
490	CELLULITIS AGE >9 W/O CC	12.39	1.50	0.6980	0.6227	0.7627	0.0000	
491	CELLULITIS AGE <10	7.78	-	0.6602	0.6649	1.0255	0.0000	
492	TRAUMA TO THE SKIN, SUBCUT TISSUE & BREAST AGE >9 W CC	19.35	1.96	0.9731	0.9945	0.8422	0.0000	
493	TRAUMA TO THE SKIN, SUBCUT TISSUE & BREAST AGE >9 W/O CC	12.73	-	0.3374	0.3439	0.8785	0.0000	
494	TRAUMA TO THE SKIN, SUBCUT TISSUE & BREAST AGE <10	3.53	-	0.2935	0.2937	1.1609	0.0000	
495	MAJOR PROCEDURES FOR MALIGNANT BREAST CONDITIONS	26.09	2.81	1.4339	1.4765	0.7605	1.0144	
496	MINOR PROCEDURES FOR MALIGNANT BREAST CONDITIONS	8.22	-	0.7472	0.7512	0.9485	0.8117	
497	MAJOR PROCEDURES FOR NON-MALIGNANT BREAST CONDITIONS	12.84	1.63	1.0489	1.0781	0.8635	0.9887	
498	MINOR PROCEDURES FOR NON-MALIGNANT BREAST CONDITIONS	5.96	-	0.5695	0.5400	1.2324	0.7934	
499	MINOR SKIN DISORDERS	11.51	1.37	0.7327	0.8704	0.9121	0.0000	
520	AMPUTAT OF LOW LIMB FOR ENDOCRINE, NUTRIT, & METABOL DISORDERS	79.76	9.00	6.2723	5.3825	0.8451	1.0138	
521	ADRENAL PROCEDURES	23.15	3.83	3.2981	3.3160	1.1238	1.5940	
522	PITUITARY PROCEDURES	37.01	4.36	2.9049	2.7644	1.0959	1.8268	
523	SKIN GRAFT & WOUND DEBRID FOR ENDOC, NUTRIT AND METABOL DISORDERS	62.53	8.48	3.3710	3.1623	0.7517	0.7613	
524	O.R. PROCEDURES FOR OBESITY	19.92	2.64	1.0190	1.0631	0.9376	0.8523	
525	PARATHYROID PROCEDURES	39.07	3.39	1.5877	1.6343	0.9423	1.1802	
526	THYROID PROCEDURES	12.79	1.98	1.1196	1.2910	0.9176	1.1063	
527	THYROGLOSSAL PROCEDURES	11.21	1.38	0.6610	1.3051	1.1318	0.7635	
528	OTHER ENDOCRINE NUTRIT & METAB O.R. PROC	24.16	2.48	3.4694	2.1882	1.2903	0.9015	
529	DIABETES AGE >35	48.52	2.99	1.1794	1.1529	0.8144	0.0000	
530	DIABETES AGE <36	14.78	1.66	0.9302	1.0086	0.9889	0.0000	
531	NUTRITIONAL & MISC METABOLIC DISORDERS AGE >9 W CC	19.72	2.27	1.5275	0.9466	0.8602	0.0000	
532	NUTRITIONAL & MISC METABOLIC DISORDERS AGE >9 W/O CC	11.99	1.35	0.6519	1.2924	0.7402	0.0000	
533	NUTRITIONAL & MISC METABOLIC DISORDERS AGE <10	10.71	-	0.8283	0.8177	0.9371	0.0000	
534	INBORN ERRORS OF METABOLISM	15.45	1.44	0.4336	0.7251	1.3070	0.0000	
535	ENDOCRINE DISORDERS	21.54	2.30	1.4628	2.8974	1.0829	0.0000	
536	COMPULSIVE NUTRITION DISORDER REHABILITATION	87.22	9.24	4.1926	10.9787	0.7901	0.0000	
550	KIDNEY TRANSPLANT	46.34	5.98	7.3212	7.4306	2.2333	3.0467	
551	KIDNEY, URETER & MAJOR BLADDER PROC FOR NEOPLASM W CC	58.95	7.35	3.9763	4.3029	1.0651	1.9650	
552	KIDNEY, URETER & MAJOR BLADDER PROC FOR NEOPLASM W/O CC	21.49	3.61	2.4685	3.3055	0.9556	1.7972	
553	KIDNEY, URETER & MAJOR BLADDER PROC FOR NON-NEOPLASM	22.65	2.92	2.6313	2.7371	1.0886	1.3291	
554	PROSTATECTOMY W CC	21.18	3.24	2.5167	2.1165	0.6897	0.9570	
555	PROSTATECTOMY W/O CC	30.67	2.95	1.0190	1.0996	0.7676	0.7964	
556	MINOR BLADDER PROCEDURES	16.15	1.88	1.6649	3.5016	0.9652	1.0662	
557	TRANSURETHRAL PROCEDURES W MAJOR CC	17.75	2.25	2.1187	1.8235	0.8774	0.9267	
558	TRANSURETHRAL PROCEDURES W/O CC	8.29	-	0.6720	0.7024	1.0661	0.8185	
559	URETHRAL PROCEDURES AGE >9 W CC	22.25	2.69	1.8223	1.5734	0.8214	0.9426	
560	URETHRAL PROCEDURES AGE >9 W/O CC	8.10	-	0.7253	0.5950	0.8148	0.8198	
561	URETHRAL PROCEDURES AGE <10	7.38	-	0.8656	0.8632	1.1805	0.8982	
562	OTHER KIDNEY & URINARY TRACT O.R. PROCEDURES	33.02	3.50	3.8739	2.8727	1.2483	1.1075	
563	RENAL FAILURE W CC	26.52	2.73	2.1822	1.1066	1.1015	0.0000	
564	RENAL FAILURE W/O CC	30.72	2.85	0.8488	3.8479	0.7108	0.0000	
565	ADMIT FOR RENAL DIALYSIS	4.78	-	0.2218	0.2687	1.1616	0.0000	
566	KIDNEY & URINARY TRACT NEOPLASMS W CC	29.93	3.14	1.5950	1.1617	0.8438	0.0000	
567	KIDNEY & URINARY TRACT NEOPLASMS W/O CC	11.59	-	0.3974	0.5132	0.9755	0.0000	
568	KIDNEY & URINARY TRACT INFECTIONS AGE >9 W CC	20.54	2.37	1.3629	0.6301	0.8466	0.0000	
569	KIDNEY & URINARY TRACT INFECTIONS AGE >9 W/O CC	11.88	1.39	0.6902	1.1302	0.8011	0.0000	
570	KIDNEY & URINARY TRACT INFECTIONS AGE <10	7.04	-	0.6063	0.6053	1.0639	0.0000	
571	URINARY STONES W ESW LITHOTRIPSY	2.17	-	0.4910	0.4915	1.5959	0.0000	
572	URINARY STONES W/O ESW LITHOTRIPSY	12.28	-	0.3903	0.4827	0.8883	0.0000	
573	KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE >9 W CC	18.30	1.79	0.7957	0.7665	0.8000	0.0000	
574	KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE <10	2.37	-	0.4053	0.4057	1.0575	0.0000	
575	URETHRAL STRICTURE W CC	18.39	1.65	0.7872	0.5135	0.9292	0.0000	
576	URETHRAL STRICTURE W/O CC	6.88	-	0.2597	0.2538	0.9398	0.0000	
578	OTHER KIDNEY & URINARY TRACT DIAGNOSES W MAJOR CC	57.84	4.30	2.6255	2.0132	1.1407	0.0000	
579	OTHER KIDNEY & URINARY TRACT DIAGNOSES W NON-MAJOR CC	15.41	1.44	1.2216	1.8202	0.9388	0.0000	
580	OTHER KIDNEY & URINARY TRACT DIAGNOSES W/O CC	9.82	-	0.4748	0.8364	1.0676	0.0000	
581	KIDNEY & URINARY TRACT SIGNS & SYMPTOMS AGE >9 W/O CC	22.14	1.35	0.3724	0.3924	0.9490	0.0000	
582	TRANSURETHRAL PROCEDURES W NON-MAJOR CC	16.09	1.51	1.0755	0.5315	0.8626	0.8777	
600	MAJOR MALE PELVIC PROCEDURES	24.38	4.20	2.4970	2.5610	0.8904	1.5821	
601	TRANSURETHRAL PROSTATECTOMY W MAJOR CC	28.22	4.13	2.4736	2.5042	0.7685	1.2100	
602	TRANSURETHRAL PROSTATECTOMY W NON-MAJOR CC	19.16	2.74	1.6172	1.6500	0.7468	1.0152	
603	TRANSURETHRAL PROSTATECTOMY W/O CC	10.97	1.75	1.0401	1.0492	0.7593	0.8901	
604	TESTES PROCEDURES, FOR MALIGNANCY W MAJOR CC	25.13	3.33	2.2025	2.2067	1.0184	0.8952	
605	TESTES PROCEDURES, FOR MALIGNANCY W NON-MAJOR CC	24.31	2.46	1.5302	1.3242	0.8047	0.8746	
606	TESTES PROCEDURES, FOR MALIGNANCY W/O CC	7.51	-	0.7482	0.7589	0.8654	0.7593	
607	TESTES PROCEDURES, NON-MALIGNANCY AGE > 9 W CC	23.86	2.45	1.3195	0.8995	0.9572	0.8101	
608	TESTES PROCEDURES, NON-MALIGNANCY AGE< 10	2.86	-	0.4733	0.4749	1.3367	0.7461	
609	PENIS PROCEDURES	18.95	1.95	1.4554	2.2853	1.3446	1.1975	
610	CIRCUMCISION AGE >9	10.43	-	0.5959	0.6848	1.2955	0.5818	
611	CIRCUMCISION AGE <10	2.15	-	0.3632	0.3637	1.1207	0.4894	
612	OTHER MALE REPRODUCTIVE SYST O.R. PROC FOR MALIGNANCY	28.10	2.92	1.3860	1.2639	1.1152	0.8522	
613	OTHER MALE REPRODUCTIVE SYST O.R. PROC EXCEPT FOR MALIGNANCY	14.21	2.00	0.8598	2.1151	0.9369	0.7930	
614	MALIGNANCY, MALE REPRODUCTIVE SYSTEM	47.49	4.50	1.5091	0.9504	0.7588	0.0000	
615	BENIGN PROSTATIC HYPERTROPHY W MAJOR CC	25.10	3.33	2.0393	1.5863	0.8942	0.0000	
616	BENIGN PROSTATIC HYPERTROPHY W NON-MAJOR CC	8.19	-	0.8370	0.8394	0.8459	0.0000	
617	BENIGN PROSTATIC HYPERTROPHY W/O CC	7.55	-	0.3507	0.3627	0.9325	0.0000	
618	INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM	14.92	1.50	0.6178	2.7157	0.9047	0.0000	
619	STERILISATION, MALE	2.20	-	0.3795	0.3800	2.0687	0.0000	
620	OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES	9.45	-	0.4426	0.4603	1.1816	0.0000	
621	TESTES PROCEDURES, NON-MALIGNANCY AGE >9 W/O CC	18.79	-	0.5453	0.5765	1.0948	0.7481	
640	PELVIC EVISCERATION & RADICAL VULVECTOMY	38.02	5.61	3.2174	3.2231	0.8855	1.6332	
641	UTERINE ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIGNANCY W CC	35.38	5.27	2.2876	2.3094	0.8078	1.2611	
642	UTERINE ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIGNANCY W/O CC	15.02	2.89	1.3865	1.4201	0.6813	1.2767	
643	FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES	14.02	2.38	1.2185	1.0743	0.7418	0.9881	
644	UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY	31.04	4.49	2.3013	2.3621	0.9499	1.1683	
645	UTERINE & ADNEXA PROC FOR NON-MALIGNANCY	27.32	2.14	1.1617	1.2218	0.8524	0.9717	
646	CONISATION, VAGINA, CERVIX & VULVA PROCEDURES	11.38	-	0.5326	0.7525	1.2852	0.7811	
647	LAPAROSCOPY & INCISIONAL TUBAL INTERRUPTION	6.90	-	0.5313	0.5401	1.3253	0.7512	
648	ENDOSCOPIC TUBAL INTERRUPTION	3.70	-	0.4619	0.4652	1.3849	0.6835	
649	OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES	15.00	2.32	1.3008	1.1525	1.0328	0.6931	
650	MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM	40.56	3.48	1.2010	0.9849	0.8907	0.0000	
651	INFECTIONS, FEMALE REPRODUCTIVE SYSTEM	12.33	-	0.4820	0.5871	0.8211	0.0000	
652	MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS	8.71	-	0.3140	0.3884	0.9252	0.0000	
653	D & C WITHOUT OTHER O.R. PROCEDURES	7.14	-	0.3757	0.3832	1.1196	0.4878	
670	CAESAREAN DELIVERY W/O COMPLICATION DIAGNOSIS	10.89	2.18	1.4898	1.4870	1.0211	1.0951	
671	CAESAREAN DELIVERY WITH MODERATE COMPLICATING DIAGNOSIS	16.72	2.61	1.7122	1.7110	1.0509	1.0370	
672	CAESAREAN DELIVERY WITH SEVERE COMPLICATING DIAGNOSIS	27.34	3.46	2.1585	2.1833	0.9656	1.1137	
674	VAGINAL DELIVERY W/O COMPLICATING DIAGNOSIS	8.54	1.43	0.7876	0.7532	1.0352	0.0000	
675	VAGINAL DELIVERY WITH COMPLICATING DIAGNOSIS	9.21	1.54	0.9934	0.9241	1.0222	0.0000	
676	VAGINAL DELIVERY WITH SEVERE COMPLICATING DIAGNOSIS	17.07	2.04	1.1907	1.1019	0.9965	0.0000	
677	VAGINAL DELIVERY WITH O.R. PROCEDURE	24.27	2.42	1.3494	1.4082	1.1886	0.7026	
678	POSTPARUM & POST ABORTION DIAGNOSES W/O O.R. PROCEDURE	34.56	1.60	0.6851	0.7231	0.9021	0.0000	
679	POSTPARUM & POST ABORTION DIAGNOSES W O.R. PROCEDURE	6.28	-	0.5654	0.5823	1.4020	0.5211	
680	ECTOPIC PREGNANCY	8.09	-	0.6783	0.6853	1.0600	0.0000	
681	THREATENED ABORTION	11.49	-	0.4233	0.4503	1.0332	0.0000	
682	ABORTION W/O D & C	5.69	-	0.3712	0.3815	1.2837	0.0000	
683	ABORTION W D&C ASPIRATION CURETTAGE OR HYSTEROTOMY	3.90	-	0.4262	0.4288	1.4398	0.4544	
684	PRETERM LABOUR	3.68	-	0.4065	0.4123	1.7345	0.0000	
685	OTHER ANTEPARTUM DIAGNOSES W COMPLICATING PRINCIPAL DIAGNOSIS	8.66	-	0.4859	0.4997	0.9839	0.0000	
686	OTHER ANTEPARTUM DIAGNOSES W/O COMPLICATING PRINCIPAL DIAGNOSIS	12.24	-	0.4531	0.4747	0.9872	0.0000	
701	NEONATE, DIED/TRANS <5 DAYS OF ADM W/O SIG O.R. PROC, BORN HERE	3.51	-	0.3230	0.3238	0.8686	0.0000	
702	NEONATE, DIED/TRANS <5 DAYS OF ADMISSION W SIG O.R. PROC	3.30	-	1.2289	1.2242	2.7474	0.4565	
703	NEONATE, DIED/TRANS <5 DAYS OF ADM W/O SIG O.R. PROC, NOT BORN HERE	3.99	-	0.6694	0.6699	1.8600	0.0000	
704	DIED >4 DAYS OF ADMISSION	44.84	8.56	7.7563	7.7627	1.7878	0.0000	
705	NEONATE ADMISSION WT <750G	95.90	7.51	62.2563	27.6457	1.5714	0.0000	
706	NEONATE, ADMISSION WT 750-999G	144.04	27.89	20.1678	19.3164	1.4555	0.0000	
707	NEONATE, ADMISSION WT 1000-1499G, W SIGNIF O.R. PROCEDURE	104.90	24.06	14.9463	14.9618	1.3731	0.6749	
708	NEONATE, ADMISSION WT 1000-1499G, W/O SIGNIF O.R. PROCEDURE	79.09	13.40	9.3539	8.6940	1.2014	0.0000	
709	NEONATE ADM WT 1500-1999G, W SIGNIF O.R. PROC, MULT MAJOR PROB	73.37	14.42	12.2401	10.9045	1.5641	0.8948	
710	NEONATE ADM WT 1500-1999G, W SIGNIF O.R. PROC, W/O MULT MAJOR PROB	55.81	8.89	5.3309	5.3353	0.8999	0.5274	
711	NEONATE ADM WT 1500-1999G, W/O SIGNIF O.R. PROC, W MULT MAJOR PROB	66.93	12.24	7.1867	6.8882	1.1765	0.0000	
712	NEONATE ADM WT 1500-1999G, W/O SIGNIF O.R. PROC W MAJOR PROB	47.22	8.16	5.1359	4.7305	1.0743	0.0000	
713	NEONATE ADM WT 1500-1999G, W/O SIGNIF O.R. PROC W OTHER MAJOR PROB	52.37	8.05	4.5565	3.9227	0.9458	0.0000	
714	NEONATE ADM WT 1500-1999G, W/O SIGNIF O.R. PROC, W/O PROBLEM	38.45	5.50	3.6608	3.2311	1.0455	0.0000	
715	NEONATE ADM WT 2000-2499G, W SIGNIF O.R. PROC, W MULT MAJOR PROB	44.46	13.67	9.5701	9.5781	1.4331	1.4053	
716	NEONATE ADM WT 2000-2499G, W SIGNIF O.R. PROC, W/O MULT MAJOR PROB	24.49	5.33	4.6179	4.6217	1.3253	0.4545	
717	NEONATE ADM WT 2000-2499G, W/O SIGNIF O.R. PROC, W MULT MAJOR PROB	46.96	6.73	4.4149	4.0546	1.2452	0.0000	
718	NEONATE ADM WT 2000-2499G, W/O SIGNIF O.R. PROC, W MAJOR PROBLEM	42.74	5.65	3.0684	2.7757	1.0861	0.0000	
719	NEONATE ADM WT 2000-2499G, W/O SIGNIF O.R. PROC, W OTHER PROBLEM	33.35	4.24	2.6739	0.9746	0.9238	0.0000	
720	NEONATE ADM WT 2000-2499G, W/O SIGNIF O.R. PROC, W/O PROBLEM	18.99	2.13	1.8877	1.2530	0.8015	0.0000	
721	NEONATE ADM WT >2499G, W SIGNIF O.R. PROC, W MULT MAJOR PROBLEM	67.84	7.83	9.4349	8.9857	1.7467	1.2000	
722	NEONATE ADM WT >2499G,W SIGNIF O.R. PROC, W/O MULT MAJOR PROBLEM	20.20	2.49	4.1787	3.7115	1.4973	0.6226	
723	NEONATE ADM WT >2499G, W MINOR ABDOMINAL PROCEDURE	4.81	-	1.0436	1.0445	1.1419	0.8307	
724	NEONATE ADM WT >2499G, W/O SIGNIF O.R. PROC, W MULT MAJOR PROBLEM	21.91	2.83	2.6992	2.4487	1.4297	0.0000	
725	NEONATE ADM WT >2499G, W/O SIGNIF O.R. PROC, W MAJOR PROBLEM	18.04	1.87	1.4897	1.9979	1.1310	0.0000	
726	NEONATE ADM WT >2499G, W/O SIGNIF O.R. PROC, W OTHER PROBLEM	46.83	1.74	0.9685	0.8394	0.9573	0.0000	
727	NEONATE ADM WT >2499G, W/O SIGNIF O.R. PROC, W/O PROBLEM	8.76	-	0.5009	0.4888	0.7303	0.0000	
750	SPLENECTOMY	26.30	3.79	2.3668	2.7496	1.0754	1.1765	
752	OTHER O.R. PROCEDURES OF BLOOD & BLOOD FORMING ORGANS	17.30	1.66	0.9805	4.1185	1.1197	0.8251	
753	RED BLOOD CELL DISORDERS AGE >9	17.00	1.56	1.0231	2.2650	0.9076	0.0000	
754	RED BLOOD CELL DISORDERS AGE <10	13.48	1.81	1.2442	3.3187	1.2091	0.0000	
755	COAGULATION DISORDERS	16.30	1.54	1.9185	1.4362	1.1844	0.0000	
756	RETICULOENDOTHELIAL & IMMUNITY DISORDERS W MAJOR CC	29.16	3.49	2.2500	3.8814	1.4102	0.0000	
757	RETICULOENDOTHELIAL & IMMUNITY DISORDERS W NON-MAJOR CC	20.60	2.39	1.4229	1.1560	1.1573	0.0000	
758	RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC	12.63	1.42	0.9865	1.5535	0.9628	0.0000	
770	LYMPHOMA & LEUKAEMIA W MAJOR O.R. PROCEDURE W CC	56.95	7.04	6.8320	6.3300	1.3864	1.8412	
771	LYMPHOMA & NON-ACUTE LEUKAEMIA W OTHER O.R. PROC AGE >9 W CC	54.79	5.08	3.9821	3.0175	1.0726	0.9351	
772	LYMPHOMA & NON-ACUTE LEUKAEMIA W OTHER O.R. PROC AGE >9 W/O CC	16.59	1.78	1.2268	1.0362	0.9927	0.8605	
773	LYMPHOMA & NON-ACUTE LEUKAEMIA W OTHER O.R. PROC AGE <10	-	-	5.1153	5.1195	1.2774	0.4990	
774	LYMPHOMA & NON-ACUTE LEUKAEMIA	28.84	2.71	2.2176	5.6759	1.1880	0.0000	
775	ACUTE LEUKAEMIA W/O MAJOR O.R. PROCEDURE	39.88	3.90	7.0785	7.4158	2.5409	0.0000	
776	MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W CC	51.05	7.67	4.2391	3.6486	1.1302	1.3067	
777	MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W/O CC	14.47	2.43	2.1803	2.2366	1.0369	1.1338	
778	MYELOPROLIF DISORD OR POORLY DIFF NEOPL W OTHER O.R. PROC	28.68	2.45	1.9150	1.3316	1.1879	1.0248	
779	RADIOTHERAPY	30.52	3.25	2.3314	1.5677	1.3368	0.0000	
780	CHEMOTHERAPY	36.17	1.35	0.8255	0.7229	1.6935	0.0000	
783	OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W CC	31.10	3.02	2.6121	1.4719	0.7542	0.0000	
784	OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W/O CC	133.94	5.11	0.9558	0.5969	0.9078	0.0000	
785	LYMPHOMA & LEUKAEMIA W MAJOR O.R. PROCEDURE W/O CC	42.57	4.57	2.2813	2.1038	0.9833	1.3043	
800	HIV W SPECIFIED RELATED CONDITION, AGE <10	-	-	1.1263	1.1272	3.2431	0.0000	
801	HIV RELATED CNS DISEASE, AGE > 9	40.71	5.26	6.8272	4.9129	1.3840	0.0000	
802	HIV RELATED MALIGNANCY, AGE > 9	14.21	2.14	2.5491	2.2242	2.1554	0.0000	
803	HIV RELATED INFECTION, AGE > 9	22.98	2.91	2.7848	1.7758	2.8012	0.0000	
804	HIV W OTHER RELATED CONDITION, AGE > 9	11.67	1.76	1.5007	1.1070	1.9451	0.0000	
805	HIV W/O SPECIFIED RELATED CONDITION, AGE < 10	-	-	0.6800	0.6806	1.8894	0.0000	
806	HIV W/O SPECIFIED RELATED CONDITION, AGE > 9	1.00	-	0.6918	0.6865	1.2257	0.0000	
807	O.R. PROCEDURE FOR INFECTIOUS & PARASITIC DISEASES	42.64	4.39	4.5071	5.0382	1.0458	0.9977	
808	SEPTICAEMIA AGE >9	28.57	3.30	2.0872	1.7756	0.9992	0.0000	
809	SEPTICAEMIA AGE <10	24.13	2.33	1.0003	0.8172	1.2035	0.0000	
810	POSTOPERATIVE & POST-TRAUMATIC INFECTIONS	22.30	2.11	1.1734	2.2736	0.8347	0.0000	
811	FEVER OF UNKNOWN ORIGIN AGE >9 W CC	18.07	2.17	1.4799	1.1603	0.8367	0.0000	
812	FEVER OF UNKNOWN ORIGIN AGE >9 W/O CC	8.92	-	0.6988	0.5290	0.8580	0.0000	
813	FEVER OF UNKNOWN ORIGIN AGE <10	5.09	-	0.3371	0.3374	0.9579	0.0000	
814	VIRAL ILLNESS AGE >9	8.49	-	0.5918	0.5866	0.9489	0.0000	
815	VIRAL ILLNESS AGE <10	5.99	-	0.4049	0.4020	1.1057	0.0000	
816	OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES W CC	22.21	2.92	2.2901	1.8098	1.2678	0.0000	
817	OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES W/O CC	10.76	1.40	1.0981	1.3012	1.1315	0.0000	
830	O.R. PROCEDURE W PRINCIPAL DIAGNOSES OF MENTAL ILLNESS	123.40	8.60	6.4393	5.6672	0.7329	1.0514	
831	ACUTE ADJUST REACT & DISTURBANCE OF PSYCHOSOCIAL DYSFUNCTION	16.99	1.70	0.8020	1.3467	0.7796	0.0000	
832	DEPRESSIVE NEUROSES	30.72	2.66	0.7595	1.4677	0.6134	0.0000	
833	NEUROSES EXCEPT DEPRESSIVE	22.28	2.26	0.9651	2.3189	0.6783	0.0000	
834	DISORDERS OF PERSONALITY & IMPULSE CONTROL	112.79	5.02	1.6125	0.5122	0.7136	0.0000	
835	ORGANIC DISTURBANCES & MENTAL RETARDATION	65.34	5.32	2.8970	4.1525	0.5033	0.0000	
836	PSYCHOSES	52.82	4.90	3.6802	2.5694	0.6492	0.0000	
837	CHILDHOOD MENTAL DISORDERS	17.68	2.04	1.4576	1.4264	0.6801	0.0000	
838	OTHER MENTAL DISORDER DIAGNOSES	9.89	-	0.8248	0.9344	0.9586	0.0000	
850	OPIOID ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE	8.42	-	0.4777	0.4859	0.8353	0.0000	
851	OPIOID ABUSE OR DEPENDENCE	16.31	1.59	0.5776	0.4858	0.5847	0.0000	
852	COCAINE OR OTHER DRUG ABUSE OR DEPENDENCE, LEFT AMA	12.29	-	0.4122	0.4177	1.0542	0.0000	
853	COCAINE OR OTHER DRUG ABUSE OR DEPENDENCE	25.53	2.12	1.1087	0.9881	0.8279	0.0000	
854	ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE	6.05	-	0.4309	0.4429	0.9682	0.0000	
855	ALCOHOL ABUSE OR DEPENDENCE	13.28	1.38	0.7862	1.2445	0.7488	0.0000	
870	TRACHEOSTOMY FOR MULTIPLE SIGNIFICANT TRAUMA AGE >15	88.37	13.92	21.4604	18.9133	2.3385	5.4400	
871	TRACHEOSTOMY FOR MULTIPLE SIGNIFICANT TRAUMA AGE <16	20.54	2.58	21.4193	21.5234	2.7151	1.9158	
872	CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA	49.00	16.33	10.7034	10.7303	1.9110	3.0931	
873	HIP, FEMUR & LIMB REATTACHMENT PROC FOR MULTIPLE SIGNIFICANT TRAUMA	52.88	7.02	5.8964	6.4815	1.1713	3.0274	
874	OTHER O.R. PROCEDURE FOR MULTIPLE SIGNIFICANT TRAUMA	51.77	6.02	6.3654	5.5272	1.3038	1.9269	
875	HEAD, CHEST & LOWER LIMB DIAGNOSES OF MULTIPLE SIGNIFICANT TRAUMA	36.74	4.44	2.2354	2.7664	1.2093	0.0000	
876	OTHER DIAGNOSES OF MULTIPLE SIGNIFICANT TRAUMA	9.73	-	2.1003	1.3352	1.1205	0.0000	
877	SKIN GRAFTS FOR INJURIES	55.22	4.41	2.6721	2.8656	0.7536	1.1355	
878	WOUND DEBRIDEMENTS FOR INJURIES	30.51	2.15	2.0530	1.5496	1.0986	1.0190	
879	HAND PROCEDURES FOR INJURIES	8.30	-	0.7925	1.2541	1.0871	1.0049	
880	OTHER O.R. PROCEDURES FOR INJURIES W CC	41.62	4.14	5.4284	4.4225	1.0829	1.2509	
881	OTHER O.R. PROCEDURES FOR INJURIES W/O CC	10.85	-	1.1311	1.0875	1.0117	0.7992	
882	INJURIES TO UNSPECIFIED OR MULTIPLE SITES AGE >9 W MAJOR CC	37.04	3.53	1.3418	1.1109	0.7695	0.0000	
883	INJURIES TO UNSPECIFIED OR MULTIPLE SITES AGE >9 W NON-MAJOR CC	18.89	1.77	0.8762	0.8417	0.7234	0.0000	
884	INJURIES TO UNSPECIFIED OR MULTIPLE SITES AGE >9 W/O CC	14.24	-	0.3627	0.3718	0.8430	0.0000	
885	INJURIES TO UNSPECIFIED OR MULTIPLE SITES AGE <10	4.43	-	0.3741	0.3719	1.0478	0.0000	
886	ALLERGIC REACTIONS AGE >9	6.33	-	0.3740	0.3545	0.9755	0.0000	
887	ALLERGIC REACTIONS AGE <10	3.95	-	0.3353	0.3356	1.4009	0.0000	
888	POISONING & TOXIC EFFECTS OF DRUGS AGE >9 W CC	17.66	-	0.8868	0.9423	1.0674	0.0000	
889	POISONING & TOXIC EFFECTS OF DRUGS AGE >9 W/O CC	34.76	-	0.4330	0.7187	1.1263	0.0000	
890	POISONING & TOXIC EFFECTS OF DRUGS AGE <10	2.71	-	0.2306	0.2244	1.1339	0.0000	
891	COMPLICATIONS OF TREATMENT	16.11	1.42	0.8172	1.5157	0.8966	0.0000	
892	OTHER INJURY, POISONING & TOXIC EFFECT DIAGNOSIS W CC	33.56	3.24	1.6954	1.1016	0.9048	0.0000	
893	OTHER INJURY, POISONING & TOXIC EFFECT DIAGNOSIS W/O CC	9.78	-	0.4509	0.3715	1.2844	0.0000	
894	LEAD POISONING	5.00	1.67	0.6953	0.8548	0.8848	0.0000	
910	BURNS, TRANSFERRED TO ANOTHER ACUTE CARE FACILITY	38.81	2.33	3.2527	2.8629	1.7130	0.0000	
911	EXTENSIVE BURNS W O.R. PROCEDURE	113.30	10.25	36.7432	19.7895	2.5160	6.0308	
912	EXTENSIVE BURNS W/O O.R. PROCEDURE	14.66	3.00	1.7660	1.7714	2.0238	0.0000	
913	NON-EXTENSIVE BURNS W SKIN GRAFT	31.19	4.07	5.6443	8.6476	1.2346	1.4171	
914	NON-EXTENSIVE BURNS W WOUND DEBRIDEMENT OR OTHER O.R. PROC	14.24	1.67	5.5235	6.5365	0.9750	0.8093	
915	NON-EXTENSIVE BURNS W/O O.R. PROCEDURE	12.11	-	0.8189	0.9158	0.9193	0.0000	
930	O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES	37.51	1.96	2.8025	2.8692	1.2124	0.8009	
931	REHABILITATION	97.72	10.19	2.8463	4.5614	0.9412	0.0000	
932	SIGNS & SYMPTOMS	22.27	2.26	0.9471	0.8575	0.8469	0.0000	
933	AFTERCARE WITHOUT SDX OF HISTORY OF MALIGNANCY	22.88	2.21	0.6199	2.4217	0.9812	0.0000	
934	OTHER FACTORS INFLUENCING HEALTH STATUS	40.53	3.65	0.7551	2.4373	0.6333	0.0000	
935	MULTIPLE, OTHER & UNSPECIFIED CONGENITAL ANOMALIES	1.00	-	0.6618	0.4837	1.1266	0.0000	
936	AFTERCARE WITH SDX OF HISTORY OF MALIGNANCY WITH ENDOSCOPY	24.63	-	0.2089	0.2388	1.2166	0.0000	
937	AFTERCARE WITH SDX OF HISTORY OF MALIGNANCY W/O ENDOSCOPY	18.82	2.07	0.7570	0.4367	1.0242	0.0000	
950	EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS	37.43	3.37	3.1122	6.3501	1.1149	1.4283	
951	UNACCEPTABLE AS OBSTETRIC PRINCIPAL DIAGNOSIS	9.28	-	0.7497	0.7503	1.2819	0.0000	
952	UNGROUPABLE	23.11	2.02	0.0000	0.0000	0.0000	0.0000	
953	PROSTATIC O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS	47.77	7.38	3.9440	3.8646	0.7867	0.7741	
954	NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS	52.51	3.49	1.5640	2.3067	0.9172	0.6486	
955	NEONATAL DIAGNOSIS NOT CONSISTENT WITH AGE (>28 DAYS)	26.29	3.77	2.3452	2.1898	0.7370	0.0000	
956	UNACCEPTABLE PRINCIPAL DIAGNOSIS	1.00	-	0.5123	0.6233	1.2550	0.0000	
In this table:
W & CH, ACH means the Adelaide Children's Hospital campus of the Women's and Children's Hospital;
-, in relation to an upper or lower trim point, means 0 (zero).								

Part C—Recognised hospitals: fees for non-admitted patients
1—Interpretation
In this Part, unless the contrary intention appears—
occasion of service, in relation to a service specified in this Part provided by a recognised hospital, means—
	(a)	each occasion on which that service is provided to a patient in a functional unit of the recognised hospital; or
	(b)	in the case of diagnostic tests, each diagnostic test, or simultaneous set of diagnostic tests, for a given patient.
2—Fees for non-admitted public patients in metropolitan hospitals
Fee to be charged by a metropolitan hospital (other than Noarlunga Health Services Incorporated and Gawler Health Services Incorporated) for services to a non-admitted public patient, for each occasion of service:

	(a)	accident and emergency service	$169	
	(b)	service provided by a medical practitioner	$100	
	(c)	service provided by a surgeon	$ 52	
	(d)	service provided by an obstetrician or gynaecologist	$ 64	
	(e)	service provided by a dentist	$ 79	
	(f)	service provided by a paediatrician	$ 71	
	(g)	service provided by a psychiatrist	$ 93	
	(h)	service provided by a radiologist/radiographer other than Magnetic Resonance Imaging	$ 91	
	(i)	Magnetic Resonance Imaging (maximum fee, per scan)	$454	
	(j)	service provided by a radiotherapist	$134	
	(k)	service provided by a person who is not a medical practitioner other than a radiologist/radiotherapist	$ 62	
	(l)	supply of a prescription item (per item)	$ 13.	
3—Fees for non-admitted patients in country (etc) hospitals
Fee to be charged by a country hospital, the Noarlunga Health Services Incorporated and the Gawler Health Services Incorporated for services to a non-admitted patient, for each occasion of service:

	(a)	service provided to a non-admitted public patient by a person other than a medical practitioner—		
	(i)	country regional hospital, country sub-regional hospital, Noarlunga Health Services Incorporated, Gawler Health Services Incorporated	$ 45	
	(ii)	country hospital other than country regional or country sub-regional hospital	$ 26;	
	(b)	nursing service provided to a non-admitted private patient during attendance by medical practitioner—		
	(i)	country regional hospital, country sub-regional hospital, Noarlunga Health Services Incorporated, Gawler Health Services Incorporated	$ 45	
	(ii)	country hospital other than country regional or country sub-regional hospital	$ 26.	
4—Transportation fee
Where, in addition to providing a service referred to in this Part, a recognised hospital transports, or arranges for the transportation of, a non-admitted patient to or from (or between different campuses of) the hospital, the hospital may charge an additional fee equal to the cost to the hospital of providing, or arranging for the provision of, that transportation.
Part D—Recognised hospitals and incorporated health centres: accommodation, rehabilitation and domiciliary care fees

1	South Australian Mental Health Service:		
	fee for inpatient accommodation	$ 284 per day.	
2	Hampstead Centre Nursing Home:		
	fee for inpatient accommodation	$ 246 per day.	
3	Intellectually Disabled Services Council Inc.:		
		(a)	Strathmont Centre—		
	fee for inpatient accommodation	$ 171 per day	
		(b)	Other—		
	fee for inpatient or resident accommodation	$ 246 per day.	
4	Julia Farr Services:		
		(a)	Head Injury Service—		
		(i)	Inpatient—		
		(A)	Rotary Ward A accommodation fee	$ 246 per day	
		(B)	Rotary Ward B accommodation fee	$ 311 per day	
		(C)	professional service fee (not payable by private patient)	$ 80 per day	
		(ii)	Rehabilitation service for non-admitted patients—		
		(A)	assessment or treatment provided by a medical practitioner, per hour of attendance by the patient (maximum fee)	$ 116	
		(B)	individual assessment or treatment provided by a person who is not a medical practitioner, per hour of attendance by the patient (maximum fee)	$ 89	
		(C)	treatment as one of a group of patients provided by a person who is not a medical practitioner, per hour of attendance by the patient (maximum fee)	$ 37	
		(b)	Other Service—		
	Inpatient accommodation fee	$ 246 per day.	
5	All Recognised Hospitals and Incorporated Health Centres:		
	Domiciliary maintenance and care visit—		
		(a)	attendance involving a service provided by a medical practitioner, registered nurse or other health professional (other than a paramedical aide)—per visit	$ 59	
		(b)	any other attendance—per visit	$ 26.	
Part E—Recognised hospitals: classification of recognised hospitals
1—Metropolitan Hospitals
	(a)	Metropolitan Teaching Hospitals
Flinders Medical Centre
Repatriation General Hospital Incorporated
Royal Adelaide Hospital
The Queen Elizabeth Hospital
Women's and Children's Hospital
	(b)	Other Metropolitan Hospitals
Modbury Hospital
Lyell McEwin Health Service
Gawler Health Service Incorporated
Noarlunga Health Services Incorporated
St Margaret's Hospital Inc.
2—Country Hospitals
	(a)	Country Regional Hospitals
Mount Gambier Regional Health Service Incorporated
Port Pirie Regional Health Service Incorporated
Port Augusta Hospital Incorporated
The Whyalla Hospital and Regional Health Services Incorporated
	(b)	Country Sub-Regional Hospitals
Angaston and District Hospital Incorporated
Clare District Hospital Incorporated
Millicent and District Hospital and Health Services Incorporated
Mount Barker District Soldiers' Memorial Hospital Incorporated
The Murray Bridge Soldiers' Memorial Hospital Incorporated
Naracoorte Health Service Incorporated
Northern Yorke Peninsula Regional Health Service Incorporated
Port Lincoln Health and Hospital Services Incorporated
Riverland Regional Health Service Incorporated
South Coast District Hospital Incorporated
	(c)	Other Country Hospitals
Andamooka Outpost Hospital
Australian Inland Mission Hospital (Oodnadatta)
The Balaklava Soldiers' Memorial District Hospital Incorporated
Barmera District Health Services Incorporated
Bishop Kirkby Memorial Hospital
Booleroo Centre District Hospital Inc.
Bordertown Memorial Hospital Incorporated
Burra Burra Hospital Incorporated
Ceduna Hospital Incorporated
Central Eyre Peninsula Hospital Incorporated
Cleve District Hospital Incorporated
Coober Pedy Hospital Incorporated
Cowell District Hospital Inc.
Cummins and District Memorial Hospital Incorporated
Crystal Brook District Hospital Incorporated
Elliston Hospital Incorporated
Eudunda Hospital Incorporated
Great Northern War Memorial Hospital Incorporated
Gumeracha District Soldiers' Memorial Hospital Incorporated
The Jamestown Hospital and Health Service Incorporated
Kangaroo Island General Hospital Incorporated
Kapunda Hospital Incorporated
Karoonda and District Soldiers' Memorial Hospital Incorporated
Kimba District Hospital Incorporated
Kingston Soldiers' Memorial Hospital Incorporated
Lameroo District Hospital Incorporated
Laura and Districts Hospital Incorporated
Leigh Creek Hospital Incorporated
Lower Murray District Hospital Incorporated
Loxton Hospital Complex Incorporated
Maitland Hospital Incorporated
Mannum District Hospital Incorporated
Meningie and Districts Memorial Hospital Incorporated
Mount Pleasant District Hospital Incorporated
Orroroo and District Health Service Incorporated
Penola War Memorial Hospital Incorporated
Peterborough Soldiers' Memorial Hospital Inc.
Pinnaroo Soldiers' Memorial Hospital Incorporated
Port Broughton District Hospital and Health Services Incorporated
Quorn and District Memorial Hospital Incorporated
Renmark and Paringa District Hospital Incorporated
Riverton District Soldiers' Memorial Hospital Incorporated
Royal District Nursing Society Hospital (Marree)
Snowtown Memorial Hospital Inc.
Southern Yorke Peninsula Health Service Incorporated
Strathalbyn and District Soldiers' Memorial Hospital and Health Services
Streaky Bay Hospital Incorporated
Tanunda War Memorial Hospital Inc.
Tarcoola Hospital
Tumby Bay Hospital Inc.
Waikerie Hospital and Health Services Incorporated

Schedule 4—Scales of charges—speech pathologists

Item No	Service Description	Charge	
	INITIAL CONSULTATION		
E0149	INITIAL CONSULTATION	$115.35	
	Note 1:	Consultation means exclusive contact time by a Speech Pathologist with a patient.		
	Note 2:	An initial consultation would commonly contain the following elements:
	-	the taking of a detailed case history;
	-	counselling according to the patient's emotional needs;
	-	determination of options for ongoing management, possibly following an assessment to formulate a diagnosis/prognosis;
	-	consideration and possible implementation of appropriate treatment.		
	ASSESSMENTS		
E0199	ASSESSMENT	$100.15	
	Note 1:	The assessment must be administered by the Speech Pathologist to the exclusion of all other tasks not associated with the patient.		
	Note 2:	To fully evaluate the extent of a communication disorder an assessment will include:
	-	administration of a standardised clinical assessment
and/or
	-	an empirical clinical assessment.
A communication assessment at the worksite may also be required.		
	Note 3:	Assessment results together with information from the initial consultation form the basis of the diagnosis and assist in prognostic indications and treatment planning.		
	TREATMENT		
E0249	TREATMENT	$78.25	
	Note 1:	The focus is treatment and intervention designed to restore function to optimal levels for the patient and may include:
	-	tasks specifically related to skill development;
	-	counselling to facilitate adjustment and transfer of restored skill to everyday communicative situations.		
	REPORTS		
E0810	The comprehensive medical report is chargeable by the page as follows:		
		-	first page	$73.60	
		-	second and subsequent pages	$36.80	
	COMPREHENSIVE MEDICAL REPORT is defined as follows:		
		1.	Own patient, being where a comprehensive report is specifically requested by the claims administrator for the WorkCover Claims Agent, Self-Managed Employer, or Exempt Employer, or where re-assessment of the patient is a prerequisite in the judgement of the Speech Pathologist
(Refer to Standard Report item E0820 where re-assessment of the patient is not required).		
	OR		
		2.	Independent/Second Opinion, being where an assessment and report are requested by the claims administrator for the WorkCover Claims Agent, Self-Managed Employer, or Exempt Employer.		
	A consultation which is a prerequisite for the preparation of a report under this item should be charged in accordance with one of the items E0149 or E0199.		
E0820	The standard medical report is chargeable by the page as follows:		
		-	first page	$55.20	
		-	second and subsequent pages	$27.60	
	STANDARD MEDICAL REPORT		
	A standard report—		
		(a)	is a report that is specifically requested by the claims administrator for the WorkCover Claims Agent, Self-Managed Employer, or Exempt Employer; or		
		(b)	is a report where a reassessment of the patient is not required; or		
		(c)	is a report involving the transcription of existing case notes.		
	GENERAL NOTES FOR REPORTS		
	Note 1:	Pages will be paid in accordance with the following rules:
	-	25% of page - 25% of fee
	-	50% of page - 50% of fee
	-	75% of page - 75% of fee		
	Note 2:	Page set up standards must comply with the following conventions:
	1.	A4 paper
	2.	Top margin no more than 2.5cms
	3.	Bottom margin no more than 2.5cms
	4.	Side margins, left and right no more than 2.5cms
	5.	Line spacing no more than 1.5cms
	6.	Preferred font style - Times New Roman (or equivalent)
	7.	Font size - no more than 12.		
	Note 3:	No other set up standards are acceptable. Reports which do not meet this standard will be returned for reformatting.		
	Note 4:	Reports will not be paid for in advance.		
	TELEPHONE CALLS		
E0850	Telephone call, of five minutes or more, to or from a treating Speech Pathologist in relation to $1.55 per min the management of a worker's injury (telephone calls of a duration of less than 5 minutes are not chargeable).		
	Note 1:	Item E0850 Telephone Calls refer to calls of a case specific nature, made to or received from the:
	-	Claims administrator for the WorkCover Claims Agent; Self-Managed Employer or Exempt Employer;
	-	The employer
in connection with:
	-	a medical report;
	-	patient status (in relation to capacity to work);
	-	initiating a service;
	-	authorising a service.
Telephone calls to or from other treating/referring medical experts which form part of the management of a case are not chargeable.
Telephone calls of an administrative nature other than those outlined above are not chargeable.		
	Note 2:	Parties referred to in Note 1 who are making calls, should telephone the rooms in advance to ascertain the most convenient time to speak to the Speech Pathologist and to allow the patient's notes to be available.		
	Note 3:	Invoices for telephone calls in accordance with this item must record the duration of the conversation in minutes and the name of the other party.		
	CASE CONFERENCE		
E0870	CASE CONFERENCE, for the purpose of determining:	$92.00 per hour	
		-	details of limitations/recommendations facilitating a return to work;		
		-	options for management of a worker's recovery;		
		-	other related information.		
	Note 1:	A case conference may be requested by:
	-	a contracted rehabilitation and return to work provider;
	-	a treating medical expert;
	-	an employer;
	-	a worker advocate;
	-	a claims administrator for a WorkCover Claims Agent, Self-Managed Employer or Exempt Employer.		
	Note 2:	A case conference must be authorised by either:
	-	the claims administrator for the WorkCover Claims Agent, Self-Managed Employer, or Exempt Employer; or
	-	an Exempt Employer rehabilitation coordinator.		
	Note 3:	The composition of the conference will be determined by either:
	-	the claims administrator for the WorkCover Claims Agent, Self-Managed Employer, or Exempt Employer; or
	-	an Exempt Employer rehabilitation coordinator.		
	Note 4:	Charges applicable to the provision of this service will be calculated at an hourly rate which will exclude travelling time from rooms or other appropriate departure point to the venue and return. Travel time must be charged separately in accordance with the appropriate item and itemised on the invoice for the service.		
	TRAVEL		
E0910	TRAVEL TIME of not more than 15 minutes duration	$23.00	
E0920	TRAVEL TIME of more than 15 minutes duration but not more than 30 minutes duration	$34.50	
E0930	TRAVEL TIME of more than 30 minutes duration but not more than 45 minutes duration	$57.50	
E0935	TRAVEL TIME of more than 45 minutes duration but not more than 60 minutes duration	$80.50	
E0940	TRAVEL TIME of more than 60 minutes duration	$92.00 per hour	
	Note 1:	All travel items refer to a return trip, eg. from rooms to worksite and return.		
	Note 2:	Travel time is only charged when a patient is unable to attend at the professional rooms or where attendance by a Speech Pathologist other than at professional rooms is appropriate.		
	Note 3:	Travel time from one clinic or rooms to another clinic or rooms is not chargeable.		
	Note 4:	Travel time is not included in any of the items in this Schedule and should be itemised separately on accounts for associated services.		
	Note 5:	Should delivery of any of the services in this Schedule require travel time in excess of a 3 hour return trip:
	-	the Speech Pathologist should seek prior approval from the claims administrator for the WorkCover Claims Agent, Self-Managed Employer, or Exempt Employer; and
	-	the claims administrator should communicate the decision by fax or phone.
The claims administrator may choose to contain costs by ordering the service from an appropriate Speech Pathologist based in the worker's locality.		
	NON SCHEDULED SERVICES		
E0999	NON SCHEDULED SERVICES		
	Used when services not listed on the fee schedule are required to be provided.	$92.00 per hour	
	Note 1:	Services which are considered inappropriate or unnecessary will be challenged.		
	Note 2:	Charges for non scheduled services must be reasonable.		
	Note 3:	Non scheduled services must be invoiced using the item number E0999, and include a detailed service description and the time taken (in minutes) for the service.		
	ACCOUNTS/RECEIPT PREPARATION STANDARDS		
	Accounts for services rendered in accordance with this Schedule, or receipts issued to injured workers who have paid the accounts themselves, must conform to WorkCover standards and display the information set out below:		
		-	worker's family name and given name(s);		
		-	worker's address;		
		-	claim number (related to the injury being treated);		
		-	brief description of the injury to which the services relate;		
		-	employer name (at the time of injury);		
		-	name of the Speech Pathologist who provided the service;		
		-	provider number and clinic details of the Speech Pathologist who provided the service.		
		-	separate itemisation of each service for which payment is sought;		
		-	date of consultation/attendance/service;		
		-	item number in accordance with this Schedule;		
		-	meaningful service description in accordance with this Schedule (where possible);		
		-	duration of service in hours/minutes where required by the service described in this Schedule;		
		-	charge for the service in accordance with this Schedule;		
		-	total charge for invoiced items.		
	Note 1:	Where the Speech Pathologist is unable to obtain details e.g. the relevant claim number, he or she should telephone WorkCover's Records Management Unit on (08) 8233 2918 for assistance in obtaining these details.		
	Note 2:	WorkCover will not pay "accounts rendered" statements. Payment will only be made on an original account or receipt, or a duplicate of the original.		
	Note 3:	WorkCover is unable to pay accounts or receipts for services rendered until a claim is determined as compensable. The only exception is where the service was ordered by the claims administrator for the WorkCover Claims Agent, Self-Managed Employer, or Exempt Employer.		
	Note 4:	Accounts or receipts which do not meet these standards may be returned to the Speech Pathologist for amendment.		

Schedule 5—Scales of charges—Registered occupational therapists

Item No	Service Description	Charge	
	OCCUPATIONAL THERAPY CORE SCHEDULE SERVICES		
	Refer to the Occupational Therapy Fee Schedule Guidelines for requirements regarding the delivery of core schedule services.		
	INITIAL AND SUBSEQUENT CONSULTATIONS (INDIVIDUAL CLIENT)		
	The following services may be delivered as a component of an initial and subsequent consultation:
	•	clinical assessment
	•	clinical treatment
	•	graded activity/exercise
	•	pain management
	•	stress management
	•	relaxation training
	•	biomechanical education
	•	independent living skills training.
Refer to section 1 of the Occupational Therapy Fee Schedule Guidelines for further details regarding the provision of the initial and subsequent consultations.		
	Initial consultation (individual client)		
OT 105	Initial consultation, history, examination and treatment	$105.60 per hour	
	Subsequent consultations (individual client)		
OT 205	Subsequent consultations and treatment	$105.60 per hour	
	CORRECTIVE/SERIAL SPLINTING		
	Refer to section 2 of the Occupational Therapy Fee Schedule Guidelines for the types of splints available to the occupational therapist and the conditions associated with the provision of these splints.		
OT 300	Fabrication/fitting/adjustment of splint	$105.60 per hour	
OT 390	Materials used to construct or modify a splint	derived fee	
	TREATMENT REVIEW		
OT 780	Independent clinical assessment (ICA)	$107.80 per hour	
	Includes a review of medical history, functional capacity and a clinical examination to provide a differential diagnosis and/or make recommendations regarding ongoing treatment goals, return to work and/or any other criteria as appropriate.		
	The report must be requested in writing and may be requested by:
	•	a claims agent or self-insured employer; or
	•	a worker or worker’s representative.		
	This service is NOT to be performed by the treating occupational therapist.		
	Refer to section 3 of the Occupational Therapy Fee Schedule Guidelines for service standards and indicators for use regarding independent clinical assessment.		
OT 785	Occupational therapy functional estimation form (FEF)	$15.00 per form	
	The Functional Estimation Form (FEF) will be initiated by the treating occupational therapist when information is identified from a clinical consultation which impacts upon the worker’s capacity to return to work. This form must be forwarded directly to the certifying medical practitioner. 		
	This form must only be completed when it complies with the criteria specified within the Occupational Therapy Fee Schedule Guidelines, Section 4. 		
	PAIN MANAGEMENT (GROUP PROGRAM)		
	Pain management, group program, minimum of 2 clients, maximum of 5 clients.		
OT 602	Pain management, group program, per client	$30.00 per hour	
	Refer to section 5 of the Occupational Therapy Fee Schedule Guidelines for further details regarding the delivery of pain management services.		
	ACTIVITIES OF DAILY LIVING ASSESSMENT		
OT 760	Activities of daily living assessment (ADL)	$107.80 per hour	
	An activities of daily living assessment is an assessment of the worker’s level of functioning in regard to personal care, household tasks, and recreational and social activities. Generally conducted in the worker’s home environment, an activities of daily living assessment is utilised to reduce the impact of the injury, and facilitate early return to normal activity. Assessed levels of performance in daily activities can be used as an indicator of functional tolerances for determining work capacity.		
	Refer to section 6 of the Occupational Therapy Fee Schedule Guidelines for further details regarding the provision of an activities of daily living assessment.		
	REPORTS		
OT 810	Comprehensive report	$103.40 per hour	
	A claims agent, self‑insured employer or worker’s representative may request a comprehensive report. A report will be taken to be comprehensive when re‑examination of the patient is a pre‑requisite for the preparation of the report.		
	All reports referred to under this item are chargeable on an hourly basis with a maximum time chargeable of 1.5 hours.		
	Refer to section 7 of the Occupational Therapy Fee Schedule Guidelines for further detail regarding comprehensive reports.		
OT 820	Standard report	$103.40 per hour	
	A claims agent, self-insured employer or worker’s representative may request a standard report. A report will be taken to be standard when re-examination of the worker is not required and the report is based on a transcription of existing clinical records.		
	All reports referred to under this item are chargeable on an hourly basis with a maximum time chargeable of 1 hour.		
	Refer to section 8 of the Occupational Therapy Fee Schedule Guidelines for further detail regarding standards required for report writing. 		
	TELEPHONE CALLS		
OT 552	Telephone call	$15.00 each	
	Calls of a case specific nature made to or received from the worker’s referring/treating medical expert, rehabilitation provider, claims agent or self‑insured employer, WorkCover provider consultant or worker’s representative.		
	Excludes calls made during consultation and calls to or from the worker.		
	Telephone calls of a duration of 3 minutes or less are not chargeable.		
	Refer to section 9 of the Occupational Therapy Fee Schedule Guidelines for further details regarding telephone calls.		
	TRAVEL		
	All travel items refer to an approved return trip from the treating occupational therapist’s rooms for the purpose of a home, hospital or worksite visit or case conference.		
OT 905	Travel in area 100km or less from Adelaide GPO	$90.00 per hour	
OT 900	Travel in area more than 100km from Adelaide GPO	$100.00 per hour	
	Refer to section 10 of the Occupational Therapy Fee Schedule Guidelines for further details regarding travel.		
CURAP	Therapeutic aids and appliances	derived fee	
	Includes an appliance or aid for reducing the extent of a compensable disability or enabling a patient to overcome in whole or in part the effects of a compensable disability.		
	Refer to section 11 of the Occupational Therapy Fee Schedule Guidelines for details regarding therapeutic appliances.		
			
	OCCUPATIONAL THERAPY SUPPLEMENTARY SCHEDULE SERVICES		
	REHABILITATION AND RETURN TO WORK SERVICES		
	Refer to section 12 of the Occupational Therapy Fee Schedule Guidelines for service requirements and indicators for use of each rehabilitation and return to work service listed within the supplementary schedule.		
	WORK SIMULATION - OFF SITE (GROUP PROGRAM)		
	A graduated program of supervised activities used to simulate work conditions and the physical demands of duties. It is highly structured, goal-orientated and individualised and is designed to maximise the worker’s ability to return to work. The program is usually contracted with the worker so that attendance patterns and work behaviours are normalised.		
	Work simulation, at rooms, group program, minimum of 2 clients, maximum of 5 clients.		
OT 502	Work simulation, group program, per client	$30.00 per hour	
OT 519	Work simulation, materials	derived fee	
OT 700	FUNCTIONAL CAPACITY EVALUATION (FCE)	$107.80 per hour	
	Maximum time – 7 hours including report preparation with an executive summary form outlining the major components of the service and relevant findings.		
	Functional capacity evaluation is an assessment of the worker’s physical capabilities. The evaluation consists of a series of standardised tests focussed on selected work tolerances. Work tolerances are the observed and measured physical capabilities that affect the individual’s ability to perform the physical demands of specified work tasks. They are assessed as the ability to sustain a given work effort, i.e. work capacity at a prescribed frequency over a given period of time, and ability to maintain a specified rate of production at a pace compatible with the specified job. Work capacity is inferred based upon the work tolerance data gathered.		
OT 730	WORKSITE ASSESSMENT (WSA)	$107.80 per hour	
	A visit to the workplace to determine the availability of duties for an injured worker and/or comment on the suitability of the workplace for that worker.		
OT 740	JOB ANALYSIS (JA)	$107.80 per hour	
	The service includes the preparation of a report with an executive summary form outlining the major components of the service and relevant findings.		
	A job analysis involves analysis of the critical physical demands of a task, tasks or occupations to ascertain if they are within the worker’s capacity. The job analysis is undertaken based on available medical guidelines or given the medical expert’s knowledge of the worker’s diagnosis, pathology and prognosis.		
	The occupational therapist will also provide recommendations regarding modifications to elements of the job to enable the worker to safely and effectively perform the task, the provision of aids or equipment which will assist the worker to perform the task and work practice guidelines to ensure that appropriate body mechanics are utilised by the worker in the performance of the task.		
OT 750	WORK HARDENING ON SITE	$107.80 per hour	
	Work hardening (on-site) is the process of increasing on a graduated basis the physical tolerances of a worker through the use of actual and productive work duties. This process is essential in assisting the worker to maintain his/her employment through the period of rehabilitation, by ensuring that identified duties are within the worker’s capacity and guidelines relevant to the nature of the injury.		
OT 870	CASE CONFERENCE	$103.40 per hour	
	This service must be authorised by the claims manager or self-insured employer.		
	Case conferences are used for the purpose of determining:
	•	details of limitations/recommendations relating to a sustainable return to work
	•	options for management of a worker’s recovery
	•	other related information		
	A case conference may be requested by:
	•	a treating medical expert
	•	an employer
	•	a worker or worker’s representative
	•	a claims agent or self-insured employer
	•	a rehabilitation provider contracted by WorkCover.		
	Refer to section 13 of the Occupational Therapy Fee Schedule Guidelines for further details regarding case conferences.		
			
	NON SCHEDULED ITEMS		
OT 999	NON SCHEDULED SERVICES	$103.40 per hour	
	The use of this item number requires the approval of the claims agent or self‑insured employer prior to the delivery of the service.		
	This item is used when the provision of services not listed on the Core or Supplementary Fee Schedule is necessary, appropriate and reasonably required.		
	Refer to section 14 of the Occupational Therapy Fee Schedule Guidelines for further details regarding non scheduled services.		
INTERPRETATION			
In this Schedule—
derived fee means that each claim under that item will be considered on its merits.			

Legislative history
Notes
	•	Variations of this version that are uncommenced are not incorporated into the text.
	•	Please note—References in the legislation to other legislation or instruments or to titles of bodies or offices are not automatically updated as part of the program for the revision and publication of legislation and therefore may be obsolete.
	•	Earlier versions of these regulations (historical versions) are listed at the end of the legislative history.
	•	For further information relating to the Act and subordinate legislation made under the Act see the Index of South Australian Statutes.
Principal regulations and variations
New entries appear in bold.
Year	No	Reference	Commencement	
1995	206	Gazette 16.11.1995 p1370	16.11.1995: r 2	
1995	226	Gazette 14.12.1995 p1687	14.12.1995: r 2	
1996	247	Gazette 28.11.1996 p1777	28.11.1996: r 2	
1997	48	Gazette 24.4.1997 p1645	24.4.1997: r 2	
1997	133	Gazette 15.5.1997 p2293	15.5.1997: r 2	
1997	230	Gazette 27.11.1997 p1456	29.11.1997: r 2	
1999	9	Gazette 4.2.1999 p855	4.2.1999: r 2	
1999	269	Gazette 23.12.1999 p3835	23.12.1999: r 2	
2000	4	Gazette 20.1.2000 p458	7.2.2000: r 2	
2000	25	Gazette 30.3.2000 p1933	31.3.2000: r 2	
2000	141	Gazette 22.6.2000 p3370	22.6.2000: r 2	
2002	184	Gazette 26.9.2002 p3540	1.10.2002: r 2	
2004	32	Gazette 20.5.2004 p1331	20.6.2004: r 2 	
2004	237	Gazette 11.11.2004 p4312	11.11.2004: r 2 	
2005	276	Gazette 15.12.2005 p4347	16.1.2006: r 2	
2006	2	Gazette 12.1.2006 p57	23.1.2006: r 2	
Provisions varied
New entries appear in bold.
Entries that relate to provisions that have been deleted appear in italics.
Provision	How varied	Commencement	
r 2	omitted under the Legislation Revision and Publication Act 2002	20.6.2004	
r 3			
r 3(1)	r 3 redesignated as r 3(1) by 237/2004 r 4	11.11.2004	
GST	inserted by 141/2000 r 3	22.6.2000	
GST law	inserted by 141/2000 r 3	22.6.2000	
r 3(2)	inserted by 237/2004 r 4	11.11.2004	
r 4			
r 4(1)	r 4 amended and redesignated as r 4(1) by 247/1996 r 3	28.11.1996	
	varied by 141/2000 r 4(a)	22.6.2000	
r 4(2)	inserted by 247/1996 r 3(b)	28.11.1996	
	varied by 141/2000 r 4(b)	22.6.2000	
r 5	varied by 141/2000 r 5	22.6.2000	
r 6	inserted by 226/1995 r 3	14.12.1995	
	varied by 141/2000 r 6	22.6.2000	
r 7	inserted by 133/1997 r 3	15.5.1997	
	varied by 141/2000 r 7	22.6.2000	
r 8	inserted by 25/2000 r 3	31.3.2000	
	varied by 141/2000 r 8	22.6.2000	
r 9	inserted by 141/2000 r 9	22.6.2000	
r 10	inserted by 237/2004 r 5	11.11.2004	
Sch 1	substituted by 247/1996 r 4	28.11.1996	
	substituted by 230/1997 r 3	29.11.1997	
	substituted by 9/1999 r 3	4.2.1999	
	substituted by 269/1999 r 3	23.12.1999	
	substituted by 184/2002 r 3	1.10.2002	
Sch 1A	inserted by 247/1996 r 4	28.11.1996	
	varied by 48/1997 r 3	24.4.1997	
	substituted by 230/1997 r 3	29.11.1997	
	substituted by 9/1999 r 3	4.2.1999	
	substituted by 269/1999 r 3	23.12.1999	
	substituted by 184/2002 r 3	1.10.2002	
Sch 2	substituted by 4/2000 r 3	7.2.2000	
	substituted by 32/2004 r 4 (Sch 1)	20.6.2004	
Sch 3	inserted by 226/1995 r 4	14.12.1995	
Sch 4	inserted by 133/1997 r 4	15.5.1997	
Sch 5	inserted by 25/2000 r 4	31.3.2000	
	substituted by 237/2004 r 6	11.11.2004	
Historical versions
Reprint No 1—14.12.1995		
Reprint No 2—28.11.1996		
Reprint No 3—24.4.1997		
Reprint No 4—15.5.1997		
Reprint No 5—29.11.1997		
Reprint No 6—4.2.1999		
Reprint No 7—23.12.1999		
Reprint No 8—7.2.2000		
Reprint No 9—30.3.2000		
Reprint No 10—22.6.2000		
Reprint No 11—1.10.2002		
20.6.2004