1 Division of Neurosurgery PROF. H B HARTZENBERG Afdeling. Neurochirurgie Room 6041 MB.Ch.,B. (UCT) M.MED. NEUROCHIR.(U. STELL.) Kamer 6041 Faculty of Medicine and Fakulteit van Geneeskunde en Health sciences Gesondheidswetenskappe PO Box 19063 NEUROSURGEON / NEUROCHIRURG Posbus 19063 7505 Tygerberg PR.No. 2400944 7505 Tygerberg Tel. 021- 9389265 Fax: 021-9389456 e-mail [email protected] 14-06-2013 Medshield Medical Aid Client Services TO WHOM IT MAY CONCERN (Motivations) PROPOSED CRANIOFACIAL SURGERY ON: Divan Conradie Medshield 55200311393 The above is the son of Mrs and Mr M Conradie, the former being a member of your medical aid. Divan is 4 months old and born at full term. He was referred by Dr Temlett Hockey (Prctice number 3204294), from Paarl with the problem of sagittal suture synostosis (ICD 10 Q 75.0). The sagittal suture has fused early resulting in a deformity of the skull called scaphocephaly. I evaluated him on 12-03-2013and again on 11-06-2013 and he has slight generalized increase in tone and hyper-reflexia of the lower limbs. In view of the danger of raised intracranial pressure (G93.5) we have proposed a reconstructive procedure to free the cranial vault and expand the cranium to allow adequate brain growth. This condition needs to addressed to prevent the complications of raised intracranial pressure that includes blindness in the long term. This condition has been confirmed on CT scan of the brain. The planned surgery for correction of the synostosis and to expand the cranium will be done by a Craniofacial team of surgeons that includes a Neurosurgeon and a Reconstructive Surgeon. In his case, Neurosurgeon Prof HB Hartzenberg practice number 2400944 and Reconstructive Surgeon Prof BJ Van R Zeeman practice number 3601250, and their assistants will do the surgery. Surgery has been provisionally planned for 31-08- 2013 at the Panorama Medi-clinic. Post-operative care in an ICU is imperative and the stay here is usually about 36 -48 hours. We form part of the post op critical care team that is required to monitor and treat any intracranial complications should they occur. The surgical team fee, which includes the fee for 2 surgeons and 2 assistants and the postoperative care in an Intensive Care Unit for up to 48 hours - is as set out below. Cost breakdown of surgical fee (team fee): 2 Quote of Procedure: Code Fee 2900 7041.80 First craniotomy and shifting the supra-orbital ridge 0005(2900) 5281.35 Second craniotomy (75% of fee) 0005(2900) 3520.90 Third Craniotomy (50% of fee) 0005(2900) 1760.45 Fourth Craniotomy (25% of fee) 0005(2900) 1760.45 Fifth Craniotomy (25% of fee) 2863 2816.70 Cranioplasty 1 0005(2863) 2112.53 Cranioplasty 2 (75%) 0005(2863) 1408.35 Cranioplasty 3 (50%) 0005(2863) 704.18 Cranioplasty 4 (25%) 0005(2863) 704.18 Cranioplasty 5 (25%) Subtotal 27110.89 0008 9036.96 Specialist assistant(1/3 of fee) Total fee 36147.85 ( Total team fee.). ICD 10 Q75.0 Craniosynostosis G93.5 Brain compression and raised intracranial pressure We request authorization for this procedure please and an indication as to whether the medical aid society will pay the costs involved. Kind regards. PROF HB HARTZENBERG Head of Neurosurgery University of Stellenbosch/ Tygerberg Academic Hospital
Posted on: Fri, 28 Jun 2013 07:25:21 +0000
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