BAD MEDICAL AID

Good day

Please advise on the below and please inform your members about the ******** manner their medical aid is applying rule Stating below that the codes are no longer in use for a cardiologist when clearly they are still active with SAMA and all other medical aids are paying for these services except medihelp

Medihelp is always applying their own rules and not following SAMA billing rules.

Medihelp members should be aware that if they see a cardiologist and needs to have a procedure done that their claims will not get paid in full.

Aw always an excuse not to pay

Regards Juan

No longer allowed for the use by Cardiologists 3557 Catheterisation aorta or vena cava, any level, any route, with aortogram/cavogram 3558 Translumbar aortic puncture, with full study 3559 Selective first order catheterisation, arterial or venous, with angiogram/venogram 3560 Selective second order catheterisation, arterial or venous, with angiogram/ venogram 3562 Selective third order catheterisation, arterial or venous, with angiogram/venogram 3564 Direct femoral arterial or venous or jugular venous puncture 3566 Guiding catheter placement, any site arterial or venous, for any intracranial procedure or anteriovenous malformation (AVM) 3569 Intravascular pressure studies, arterial or venous, once off per case 3570 Microcatheter insertion, any cranial vessel and/or pulmonary vessel, arterial or venous (including guiding catheter placement) 3572 Transcatheter selective blood sampling, arterial or venous 3574 Spinal angiogram (global fee) including all selective catheterisations 3563 Direct intravenous for limb 3575 Cut-downs for venography: ADD