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296 <br /> <br /> UPON MOTION of Commissioner Hamby, seconded by Commissioner Carpenter with <br />Commissioners Hamby and Carpenter and Vice-Chairman Barnhart voting for, the <br />Board adopted the following fees for Health Department Physician Provided <br />Services to Health Department Patients to be effective January 1, 1991. <br /> <br /> CABARRUS COUNTY HEALTH DEPARTMENT <br />Fees for Health Department Physician Provided Services <br />to Health Department Patients <br /> <br />CPT CODE* <br /> <br />Fee <br /> <br />To Be Effective 1-1-91 <br /> Procedure <br /> <br />54150 <br />54160 <br />5640O <br />56420 <br />57452 <br />57454 <br />57520 <br />57700 <br />59320 <br />58600 <br />58605 <br /> <br />120 00 <br />250 00 <br />50 00 <br />60 00 <br />150 00 <br />150 00 <br />250 00 <br />500 00 <br />500 00 <br />850 O0 <br />600 00 <br /> <br />58611 1,200.00 <br />58982 500.00 <br /> <br />58983 500.00 <br /> <br />59000 150.00 <br />59025 60.00 <br />59160 250.00 <br />58120 250.00 <br /> <br />59410 800.00 <br />59515 1,000.00 <br />59812 200.00 <br /> <br />59820 250.00 <br /> <br />59821 250.00 <br /> <br />76805 90.00 <br /> <br />76815 90.00 <br /> <br />76816 50.00 <br />76818 100.00 <br />90782 35.00 <br /> <br />Circumcision, using clamp, newborn <br />Circumcision, surgical, other than clamp, newborn <br />I & D Vulva Abscess <br />I & D Bartholin Abscess <br />Colposcopy (vaginoscopy) <br />Colposcopy with biopsy of the cervix <br />Cervical biopsy, with or without fulguration <br />Cerclage of uterine cervix, non-obstetrical <br />Cerclage of cervix during pregnancy <br />Tubal Ligation/Operattve <br />Postpartum bilateral tubal ligatton, during same <br />hospitalization <br />C-Section Bilateral tubal ligation <br />Tubal ligation, Laparoscopy, with ful§uration of <br />oviducts <br />Tubal li§ation, Laparoscopy, with occlusion of <br />oviducts by device <br />Amniocentesis <br />Fetal non-stress test <br />D & C postpartum & hemorrhage <br />D & C diagnostic and/or therapeutic, non- <br />obstetrical <br />Vaginal delivery with postpartum care <br />Cesarean delivery with postpartum care <br />Treatment of spontaneous abortion, any trimester, <br />completed surgically <br />Treatment of missed abortion, any trimester; <br />completed surgically, 1st trimester <br />Treatment of missed abortion, any trimester; <br />completed surgically, 2nd trimester <br />OB Ultrasound, 1st, complete maternal & fetal <br />eval. <br />OB Ultrasound, 1st, limited (gestattonal age, <br />fetal position, heart beat, placental location, <br />etc.) <br />OB Ultrasound, follow-up or repeat <br />Fetal biophysical profile <br />Therapeutic/diagnostic injection (subcu or IM), <br />(specify injection, e.g. Rho§am) <br /> <br />Daily In-Patient Hospital Care (non post-partum) New Patient <br />90200 85.00 Brief (See definitions for levels of service) <br />90215 115.00 Intermediate <br />90220 195.00 Comprehensive <br /> <br />Daily In-Patient Hospital Care (non post-partum) Established Patient <br />90240 45.00 Brief (See definitions for levels of service) <br />90250 55.00 Limited <br />90260 62.00 Intermediate <br />90270 96.00 Extended <br />90280 105.O0 Comprehensive <br /> <br />Emergency Room Visit - New Patient <br />90505 25.00 Brief (See definitions for levels of service) <br />90510 40.00 Limited <br />90515 55.00 Intermediate <br />90517 75.00 Extended <br />90520 100.00 Comprehensive <br /> <br /> <br />