Elective care type code N

Guide for use:

Elective surgery comprises elective care where the procedures required by patients are listed in the surgical operations section of the Medicare benefits schedule, with the exclusion of specific procedures frequently done by non-surgical clinicians.

Elective care is care that, in the opinion of the treating clinician, is necessary and admission for which can be delayed for at least twenty-four hours.

CODE 1 Elective surgery

All elective surgery, that is excluding procedures listed in exclusion list for Code 2, should be included in this code.

CODE 2 Other

Patients awaiting the following procedures should be classified as Code 2 - other:

• biopsy of:
  • kidney (needle only)
  • lung (needle only)
  • liver and gall bladder (needle only)
• bronchoscopy (including fibre-optic bronchoscopy) organ or tissue transplant procedures
• colonoscopy
• cosmetic surgery, i.e. when the procedure will not attract a Medicare rebate
• dental procedures not attracting a Medicare rebate
• endoscopic retrograde cholangio-pancreatography (ERCP)
• endoscopy of:
  • biliary tract and pancreas
  • oesophagus
  • small intestine
  • stomach
• endovascular interventional procedures
• gastroscopy
• haemodialysis
• in vitro fertilisation
• miscellaneous cardiac procedures
• miscellaneous lower urinary tract procedures
• oesophagoscopy
• organ or tissue transplant
• procedures associated with obstetrics (e.g. elective caesarean section, cervical suture)
• panendoscopy (except when involving the bladder)
• peritoneal and renal dialysis;
• proctosigmoidoscopy (including sigmoidoscopy, anoscopy)
• other diagnostic and non-surgical procedures.

These procedure terms are also defined by the Australian Classification of Health Interventions (ACHI) codes which are listed under Comments below. This coded list is the recommended, but optional, method for determining whether a patient is classified as requiring elective surgery or other care.

Comments:

The table of Australian Classification of Health Interventions (ACHI) (7th edition) procedure codes was prepared by the National Centre for Classification in Health. Some codes were excluded from the list on the basis that they are usually performed by non-surgeon clinicians. A more extensive and detailed listing of procedure descriptors is under development. This will replace the list in the Guide for use to facilitate more readily the identification of the exclusions when the list of codes is not used.

ACHI CODES FOR THE EXCLUDED PROCEDURES:

Biopsy (needle) of:
• kidney: 36561-00 [1047]
• lung: 38812-00 [550]
• liver and gall bladder: 30409-00 [953] 30412-00 [953] 90319-01 [951] 30094-04 [964]

Bronchoscopy:
41889-00 [543] 41892-00 [544] 41904-00 [546] 41764-02 [416] 41895-00 [544] 41764-04 [532] 41892-01 [545] 41901-00 [545] 41898-00 [543] 41898-01 [544] 41889-01 [543] 41849-00 [520] 41764-03 [520] 41855-00 [520]

Dental:
Blocks [450] to [490] 97022-00 [451] 97025-00 [451] 97113-00 [453] 97121-01 [454] 97123-01 [454] 97165-01 [455] 97221-00 [456]
97222-00 [456] 97231-00 [456] 97232-00 [456] 97233-00 [456] 97234-00 [456] 97384-00 [461] 97386-01 [461] 97415-00 [462] 97417-00 [462] 97431-00 [463] 97433-00 [463] 97434-00 [463] 97437-00 [463] 97445-00 [464] 97455-00 [464] 97511-01 [465] 97512-01 [465] 97513-01 [465] 97514-02 [465] 97515-02 [465] 97541-01 [465] 97542-01 [465] 97543-01 [465] 97544-00 [465] 97545-00 [465] 97521-01 [466] 97522-01 [466] 97523-01 [466] 97524-00 [466] 97525-00 [466] 97531-00 [466] 97532-00 [466] 97533-00 [466] 97534-00 [466] 97535-00 [466] 97551-01 [466] 97552-01 [466] 97553-01 [466] 97554-01 [466] 97555-01 [466] 97572-01 [469] 97574-01 [469] 97575-00 [469] 97578-00 [469] 97582-01 [469] 97583-01 [469] 97631-00 [470] 97632-00 [471] 97649-00 [471] 97671-00 [473] 97672-00 [473] 97673-00 [473] 97732-00 [474] 97733-00 [474] 97739-00 [474] 97741-00 [475] 97762-00 [476] 97765-00 [476] 97768-00 [476] 97825-00 [479]

Endoscopy of biliary tract and pancreas:
30484-00 [957] 30484-01 [957] 30484-02 [974] 30494-00 [971] 30452-00 [971] 30491-00 [958] 30491-02 [975] 30485-00 [963] 30485-01 [963] 30452-01 [958] 30450-00 [959] 30452-02 [959] 90349-00 [975]

Endoscopy of oesophagus:
30473-03 [850] 30473-04 [861] 41822-00 [861] 30478-11 [856] 41819-00 [862] 30478-10 [852] 30478-13 [861] 41816-00 [850] 41822-00 [861] 41825-00 [852] 30478-12 [856] 41831-00 [862] 30478-12 [856] 30490-00 [853] 30479-00 [856]

Endoscopy of large intestine, rectum and anus:
32075-00 [904] 32090-00 [905] 32084-00 [905] 30479-02 [908] 90308-00 [908] 32075-01 [910] 32078-00 [910] 32081-00 [910] 32090-01 [911] 32093-00 [911] 32084-01 [911] 32087-00 [911] 30479-01 [931] 90315-00 [933]

In vitro fertilisation:
13209-00 [1297] 13206-00 [1297] 13200-00 [1297] 13203-00 [1297] 13212-00 [1297] 13212-01 [1297] 13215-00 [1297] 13215-01 [1297]
13215-02 [1297] 13215-03 [1297]

Endovascular interventional:
38300-01 [670] 38303-00 [670] 38300-00 [670] 38303-01 [670] 38306-00 [671] 38306-01 [671]38306-03 [671] 38306-04 [671] 38306-02 [671] 38306-05 [671] 34524-00 [694] 13303-00 [694]
34521-01 [694] 32500-01 [722] 32500-00 [722] 13300-01 [738] 13300-02 [738] 13319-00 [738]13300-00 [738] 13815-00 [738] 13815-01 [738] 34521-02 [738] 34530-04 [738] 90220-00 [738]

Miscellaneous cardiac:
38603-00 [642] 38600-00 [642] 38256-00 [647] 38256-01 [647] 38256-00 [647] 38350-00 [648] 90202-00 [649] 38470-00 [649] 38473-00 [649] 38353-00 [650] 38358-00 [654] 38358-01 [654] 38368-02 [654] 90203-00 [654] 38350-02 [654] 90219-00 [663] 38353-02 [655] 38212-00 [665] 38209-00 [665] 38200-00 [667] 38203-00 [667] 38206-00 [667] 35324-00 [740] 35315-00 [758] 35315-01 [758] 38368-00 [648] 90202-01 [649] 38358-00 [654] 38358-01 [654] 38358-02 [654]
38654-02 [654] 38456-26 [654] 38456-27 [654] 90203-04 [654] 38456-25 [654] 38353-02 [654] 38287-01 [601] 38287-02 [601] 38213-00 [665]

Miscellaneous lower urinary tract procedure:
36800-00 [1090] 36800-01 [1090] 37011-00 [1093] 37008-01 [1093] 37008-00 [1093] 37315-00 [1112] 37318-01 [1116] 36815-01 [1116] 37854-00 [1116]
35527-00 [1116] 37318-04 [1117] 36800-03 [1090] 37318-02 [1116] 37318-03 [1116]

Organ or tissue transplant:
90172-00 [555] 90172-01 [555] 90204-00 [659] 90204-01 [659] 90205-00 [660] 90205-01 [660] 13700-00 [801] 13706-08 [802] 13706-00 [802] 13706-06 [802] 13706-07 [802] 13706-09 [802] 13706-10 [802] 30375-21 [817] 90317-00 [954] 90324-00 [981] 36503-00 [1058] 36503-01 [1058] 14203-01 [1906]

Panendoscopy:
30476-03 [874] 32095-00 [891] 30568-00 [893] 30569-00 [894] 30473-05 [1005] 30473-00 [1005] 30473-02 [1005] 30478-00 [1006] 30478-14 [1006]
30478-01 [1007] 30478-02 [1007] 30478-03 [1007] 30478-15 [1007] 30478-16 [1007] 30478-17 [1007] 30478-20 [1007] 30478-21 [1007] 30473-01 [1008]
30478-04 [1008] 30473-06 [1008] 30478-18 [1008]

Peritoneal and renal dialysis:
13100-06 [1061] 13100-07 [1061] 13100-08 [1061] 13100-00 [1060]

Procedures associated with obstetrics:
16511-00 [1274]

Obstetric:
Blocks [1330] to [1345] and [1347] 90463-01 [1330] 90488-00 [1330]

Other diagnostic and non-surgical:
90347-01 [983] 30406-00 [983] 90347-02 [983] 30408-00 [983]

Blocks [1820] to [1939], [1940] to [2016]

11003-00 [1825] 11018-00 [1826] 11018-01 [1826] 11614-00 [1851] 11602-00 [1852] 11604-00 [1852] 11605-00 [1852] 11610-00 [1852]
11611-00 [1852] 11612-00 [1852] 11709-00 [1853] 11917-00 [1860] 11919-00 [1860] 96209-00 [1920] 96209-01 [1920] 96209-02 [1920]
96209-03 [1920] 96209-04 [1920] 13706-05 [1893] 96209-06 [1920] 96209-07 [1920] 96209-08 [1920] 96209-09 [1920] 55084-00 [1943]
55600-00 [1943] 60000-01 [1992] 60048-00 [1996] 60060-00 [1997] 60060-01 [1997] 61442-00 [2012] 96196-00 [1920] 96196-01 [1920]
96196-02 [1920] 96196-03 [1920] 96196-04 [1920] 13706-05 [1893] 96196-06 [1920] 96196-07 [1920] 96196-08 [1920] 96196-09 [1920]
96197-00 [1920] 96197-01 [1920] 96197-02 [1920] 96197-03 [1920] 96197-04 [1920] 96197-06 [1920] 96197-07 [1920] 96197-08 [1920]
96197-09 [1920] 96198-00 [1920] 96198-01 [1920] 96198-02 [1920] 96198-03 [1920] 96198-04 [1920] 96198-06 [1920] 96198-07 [1920]
96198-08 [1920] 96198-09 [1920] 96199-00 [1920] 96199-01 [1920] 96199-02 [1920] 96199-03 [1920] 96199-04 [1920] 96199-06 [1920]
96199-07 [1920] 96199-08 [1920] 96199-09 [1920] 96200-00 [1920] 96200-01 [1920] 96200-02 [1920] 96200-03 [1920] 96200-04 [1920]
96200-06 [1920] 96200-07 [1920] 96200-08 [1920] 96200-09 [1920] 96201-00 [1920] 96201-01 [1920] 96201-02 [1920] 96201-03 [1920]
96201-04 [1920] 96201-06 [1920] 96201-07 [1920] 96201-08 [1920] 96201-09 [1920] 96202-00 [1920] 96202-01 [1920] 96202-02 [1920]
96202-03 [1920] 96202-04 [1920] 96202-06 [1920] 96202-07 [1920] 96202-08 [1920] 96202-09 [1920] 96203-00 [1920] 96203-01 [1920]
96203-02 [1920] 96203-03 [1920] 96203-04 [1920] 96203-06 [1920] 96203-07 [1920] 96203-08 [1920] 96203-09 [1920] 96199-00 [1920]
96199-01 [1920] 96199-02 [1920] 96199-03 [1920] 96199-04 [1920] 13706-05 [1893] 96199-06 [1920] 96199-07 [1920] 96199-08 [1920]
96199-09 [1920] 96205-00 [1920] 96205-01 [1920] 96205-02 [1920] 96205-03 [1920] 96205-04 [1920] 96205-06 [1920] 96205-07 [1920]
96205-08 [1920] 96205-09 [1920] 96206-00 [1920] 96206-01 [1920] 96206-02 [1920] 96206-03 [1920] 96206-04 [1920] 96206-06 [1920]
96206-07 [1920] 96206-08 [1920] 96206-09 [1920]