Injury Prevention, Rehabilitation, and Compensation (Liability to Pay or Contribute to Cost of Treatment) Amendment Regulations 2012

2012/11

Coat of Arms of New Zealand

Injury Prevention, Rehabilitation, and Compensation (Liability to Pay or Contribute to Cost of Treatment) Amendment Regulations 2012

Jerry Mateparae, Governor-General

Order in Council

At Wellington this 20th day of February 2012

Present:
His Excellency the Governor-General in Council

Pursuant to section 324 of the Accident Compensation Act 2001, His Excellency the Governor-General, acting on the advice and with the consent of the Executive Council and on the recommendation of the Minister for ACC, makes the following regulations.

Regulations

1  Title
  • These regulations are the Injury Prevention, Rehabilitation, and Compensation (Liability to Pay or Contribute to Cost of Treatment) Amendment Regulations 2012.

2  Commencement
3  Principal regulations

Part 1
Amendments that come into force on 1 April 2012

4  Regulation 13 amended (Medical practitioners' costs)
5  Regulation 14 amended (Nurses' costs)
6  Regulation 15 amended (Medical practitioners' and nurses' costs for combined treatment)
7  New regulation 15A inserted (Nurse practitioners' costs)
  • After regulation 15, insert the following regulation:

    15A Nurse practitioners' costs
    • (1) This regulation applies if—

      • (a) a claimant visits or is visited by a nurse practitioner; and

      • (b) any treatment received by the claimant during the visit is specified in the Schedule under the heading Medical practitioners', nurses', and nurse practitioners' costs.

      (2) For each visit the Corporation is liable to pay—

      • (a) $29.34; plus

      • (b) the amount specified for any treatment the claimant receives.

      (3) If the claimant receives 2 or more treatments at the same visit, for different injuries, the Corporation is liable to pay—

      • (a) the amount specified for the most expensive treatment the claimant receives; plus

      • (b) 50% of the amount specified for each other treatment the claimant receives.

      (4) However, if at the same visit the claimant receives a treatment and a more comprehensive treatment for the same injury, the Corporation is liable to pay only the amount specified for the more comprehensive treatment.

      (5) The amount that the Corporation is liable to pay for the treatment under this regulation includes a contribution to the cost of the nurse practitioner using the most effective treatment materials available to the nurse practitioner having regard to the nature of the claimant's personal injury.

8  Schedule amended

Part 2
Amendments that come into force on 1 July 2012

9  Regulation 9 amended (Counsellors' costs)
10  Regulation 11 amended (Hyperbaric oxygen treatment costs)
11  Regulation 13 amended (Medical practitioners' costs)
12  Regulation 14 amended (Nurses' costs)
13  Regulation 15 amended (Medical practitioners' and nurses' costs for combined treatment)
14  Regulation 15A amended (Nurse practitioners' costs)
  • In regulation 15A(2)(a), replace $29.34 with $25.51.

15  Regulation 16 amended (Specialists' costs)
16  Regulation 17 amended (Specified treatment providers' costs)
17  Regulation 19 amended (GST included)
  • (1) In the heading to regulation 19, replace included with excluded.

    (2) In regulation 19, replace inclusive with exclusive.

18  Schedule replaced

Schedule 1
Amendments to Schedule

r 8

Insert the following item after item DR8:

  $
DR9

Complex reconstruction in complex resin, direct

178.89

Omit item DC12.

Replace the heading Medical practitioners' and nurses' costs with Medical practitioners', nurses', and nurse practitioners' costs.

In item RD14, replace 788.54 with 785.54.

Insert after the heading Specified treatment providers' costs:

 $
POD3

Abscess or haematoma: drainage with incision (with or without local anaesthetic agent)

30.88
POD4

Nail, simple removal of

24.73
POD5

Nail, wedge resection/removal of—requiring the use of digital anaesthesia

102.91

Schedule 2
Schedule replaced

r 18

Schedule
Costs of treatment

rr 6, 7, 9–17

  $
Dentists' costs 
 Examination 
DE1Dental consultation, including examination55.58
DE2Periodic oral examination/review28.36
DE3Extended initial examination (complex cases relating to dental implants, orthodontics, and advanced restorative work)—including study models and photographs115.56
 Radiological examination and interpretation 
DX1Periapical or bitewing film (each)10.67
DX2Occlusal (each)28.36
DX3Panorex31.11
DX4Other extra film (each)28.36
DX5Tomography131.82
DX6Lateral or antero-posterior head films59.56
DX7Sedation (age appropriate)80.00
 Emergency temporary cover 
DT1Emergency temporary cover28.36
 General oral surgery 
 Extractions 
DG1Extraction of permanent or deciduous tooth per first tooth93.33
DG2Surgical removal of tooth or tooth fragment (root fracture)141.69
DG3Removal of unerupted tooth or teeth in fracture line247.91
DG4Extraction of subsequent permanent or deciduous tooth in same quadrant as for DG166.67
 Surgery 
DG5Management of minor (less than 1 cm) or moderate (1 to 2 cm) lacerations by suturing per operative site141.69
DG6Management of serious (over 2 cm) lacerations by suturing site244.44
DG7Incision and drainage abscess cellulitis191.29
DG8Excision of traumatic mucous cyst232.89
DG9Removal of root from maxillary sinus262.13
DG10Splint application or removal (per tooth)59.29
DG11Cleaning of wound and removal of debris59.29
DG14Reduction of fractured alveolar process88.89
DG15Repositioning of displaced tooth (per tooth)44.44
DG16Replacing avulsed tooth44.44
DG17Occlusal adjustment (simple)29.60
DG18Removal of plates, wires, and screws370.40
DG19Jaw fractures non-surgical management127.47
DG20Jaw fractures simple and moderate (simple methods of fixation)290.49
DG21TMJ disorder conservative management127.47
DG22Minor surgical operations not otherwise covered by this schedule127.47
DG23Provision of bite splints213.33
 Restorative 
DR1Amalgam 1 surface filling (including 2 fillings on the one surface)62.22
DR2Amalgam 2 surface filling (approximo-occlusal)80.00
DR3Amalgam 3 surface filling (mesio-occlusal-distal)88.89
DR4Amalgam restoration (including 1 or more cusps)115.56
DR5Complex coronal reconstruction in amalgam128.89
DR6Non-metallic simple fillings55.29
DR7Non-metallic filling (more than 1 surface per tooth)109.33
DR8Rebonding tooth fragment83.64
DR9Complex reconstruction in composite resin, direct 155.56
 Prosthodontics 
DP1Partial denture (1 tooth)351.11
DP2Each additional tooth (all dentures)18.49
DP3Each clasp11.38
DP4Lingual bar19.82
DP5Metal framed partial denture (1 tooth)836.44
DP6Plastic flexible denture, eg, Valplast (1 tooth)433.33
DP7Transitional denture replacing missing tooth351.11
DP8Full upper or lower denture566.67
DP9Full upper and lower denture991.73
DP10Rebasing full upper or lower denture226.67
DP11Reline full denture155.56
DP12Reline partial denture155.56
DP13Repair (all types)51.02
 Crown and bridge 
 Temporary structure 
DC1Temporary crown80.00
DC2Temporary bridge (per unit)80.00
 Inlay/onlay 
DC3Indirect gold inlay/onlay265.60
DC4Indirect resin inlay/onlay199.20
DC5Indirect porcelain inlay/onlay265.16
 Veneers 
DC6Porcelain veneer600.71
DC7Composite resin veneer155.56
DC8Post (wrought or pre-formed)82.13
DC9Composite or glass ionomer core55.29
DC10Amalgam core55.29
DC11Cast post and core (metal or ceramic)177.78
 Crowns 
DC13Stainless steel crown70.84
DC14Acrylic jacket crown340.00
DC15All ceramic crown711.11
DC16Porcelain fused to metal crown685.69
DC17Cast gold crown (full and three-quarters)648.89
 Bridges 
DC18Indirect composite bridge (per unit)209.69
DC19Maryland bridge (per unit)262.13
DC20Direct composite bridge (per unit)231.02
DC21All ceramic bridge (per unit)566.67
DC22Porcelain fused to metal bridge (per unit)566.67
DC23Gold bridge (per unit)566.67
 Miscellaneous 
DC24Stress breaker/precision attachment in bridge28.36
DC25Recementing crown/bridge/veneer/inlay28.36
 Endodontics 
DN1Pulpotomy85.07
DN2Irrigation and dressing of root canal system85.07
DN3Complete preparation and obturation of root canal (per canal)—open or closed apex284.44
DN5Apicectomy and retrograde filling (per canal)266.67
DN6Removal of root filling (per canal)213.96
DN7Removal of post or post crown213.96
DN8Bleaching, 1 non-vital tooth (per treatment)133.33
DN9Pulp capping35.56
DN10Removal of a fractured post or instrument213.96
DN11Internal repair of perforation213.96
DN12Surgical repair of perforation213.96
DN13Negotiation of a calcified canal (can be used with item DN3)213.96
 Periodontics 
DD1Gingivectomy (per tooth)131.82
DD2Surgical crown lengthening (per tooth)311.11
DD3Pericision (per tooth)85.07
DD4Surgical subgingival curettage (per tooth)85.07
DD5Frenectomy222.22
DD6Vestibuloplasty222.22
DD7Site preparation for dental implant311.11
DD8Placement of membrane333.33
DD9Substitute bone material133.33
 Dental implants 
DM1Resilient linings (tooth or teeth)64.00
DM2Fixture head impressions and copings (per fixture)342.22
DM3Dental implant crown (per single unit)1,066.67
DM4Dental stent and guide (per fixture)115.56
DM5Definitive abutment (per fixture)342.22
DM6Temporary abutment (per fixture)42.67
DM7Repairs to abutments (per fixture)74.04
 Claimants under 18 years old 
DY1Dental consultation, including examination57.40
DY2Periodic oral examination/review40.00
DY3Periapical or bitewing film (each)10.67
DY4Panorex31.11
DY5Sedation (age appropriate), covers IV and IM (not oral sedation)80.00
DY6Emergency temporary cover31.11
DY7Extraction permanent tooth or deciduous tooth (per tooth)93.33
DY8Surgical removal of tooth or root177.78
DY9Repositioning of displaced tooth (per tooth)53.33
DY10Replacing avulsed tooth53.33
DY11Non-metallic filling109.56
DY12Rebonding tooth fragment97.78
DY13Partial denture (1 tooth)351.11
DY14Temporary crown106.67
DY15Temporary bridge (per unit)106.67
DY16Complex reconstruction in composite resin, direct155.56
DY17Complete preparation and obturation of root canal per canal closed apex (either item DY17 or DY18 but not both)284.44
DY18Complete preparation and obturation of open apexed tooth per tooth (either item DY18 or DY17 but not both)320.00
DY19Bleaching, 1 non-vital tooth (per treatment)160.00
DY20Pulp capping35.56
DY21Surgical decoronation373.33
Hyperbaric oxygen treatment costs 
H1Neurological assay before recompression85.02
H2Neurological assay after recompression76.49
H3In-chamber treatment supervision, per hour88.88
H4Out-of-chamber treatment supervision, per hour43.56
Medical practitioners', nurses', and nurse practitioners’ costs 
 Burn/abrasion 
MB1Treatment of burn less than 4 cm²29.76
MB2Treatment of burn at a single site greater than 4 cm²58.60
MB3Treatment of significant abrasions less than 4 cm² at a single site29.77
MB4Treatment of significant abrasions greater than 4 cm² at a single site58.60
MB5Significant burns or abrasions (not including fractures) at multiple sites (greater than 4 cm²): necessary wound cleaning, preparation, and dressing85.37
 Dislocation 
MD1Dislocation of finger/toe with splint/strapping34.48
MD2Dislocation of thumb: closed reduction and immobilisation96.62
MD3Dislocation of elbow with radiological confirmation: closed reduction and immobilisation89.49
MD4Dislocation of shoulder: closed reduction and collar and cuff immobilisation64.45
MD5Dislocation of patella: closed reduction and cast immobilisation153.36
 Fracture 
MF1Fractured finger or toe (proximal, middle, or distal phalanx): closed reduction and immobilisation34.48
MF2Fractured finger or toe (proximal, middle, or distal phalanx): requiring local anaesthetic47.67
MF3Fractured metatarsal: closed reduction (not requiring cast): closed reduction, immobilisation by strapping34.48
MF4Fractured metacarpal(s) hand: with or without local anaesthetic: immobilisation by strapping47.67
MF5Fractured carpal bone, including scaphoid: treatment by cast immobilisation, not requiring reduction107.38
MF6Fractured tarsal or metatarsal bones (excluding calcaneum or talus): treatment by cast immobilisation153.36
MF7Fractured calcaneum or talus: treatment by cast immobilisation153.36
MF8Fractured clavicle64.45
MF9Fractured distal radius and ulna: cast immobilisation not requiring reduction107.38
MF10Fractured distal radius and ulna requiring closed reduction, involving regional or other form of anaesthesia128.39
MF11Fractured shaft radius and ulna: treatment by cast immobilisation107.38
MF12Fractured distal humerus (supracondylar or condylar): by cast immobilisation107.38
MF13Fractured proximal or shaft humerus: immobilisation by collar and cuff or U-slab65.12
MF14Fractured shaft tibia and/or fibula: treatment by cast immobilisation with reduction153.36
MF15Fractured distal tibia and/or fibula: treatment by cast immobilisation with reduction153.36
MF16Fractured fibula (without tibial fracture): immobilisation with soft tissue strapping65.12
 Miscellaneous 
MM1Abscess or haematoma: drainage with incision (with or without local anaesthetic agent)26.85
MM2Insertion of IV line for administration of IV medications or electrolytes or transfusion (if provided under local or national guideline approved by the Corporation)53.71
MM3Nail, simple removal of21.50
MM4Nail, removal of or wedge resection: requiring the use of digital anaesthesia89.49
MM5Removal of embedded or impacted foreign body from cornea or conjunctiva (with use of topical anaesthetic), or from auditory canal or nasal passages, or from skin or subcutaneous tissue with incision, or from rectum or vagina28.92
MM6Pinch skin graft67.14
MM7Dental anaesthetic25.08
MM8Epistaxis: arrest during episode by nasal cavity packing with or without cautery39.65
 Open wound 
MW1Closure of open wounds less than 2 cm: any necessary care and treatment, including cleaning and debriding, exploration, administration of anaesthetic, and dressing31.63
MW2Closure of open wound (or wounds) of skin and subcutaneous tissue or mucous membrane 2 cm to 7 cm long: any necessary care and treatment, including cleaning and debriding, exploration, administration of anaesthetic, and dressing60.34
MW3Closure of open wound (or wounds) of skin and subcutaneous tissue or mucous membrane greater than 7 cm long: any necessary care and treatment, including cleaning and debriding, exploration, administration of anaesthetic, and dressing79.84
MW4Amputation of digit, including use of anaesthetic, debridement of bone and soft tissue, and closure of wound89.49
 Soft tissue injury 
MT1Simple soft tissue injuries: management of simple sprain of wrist/ankle/knee/elbow or other soft tissue injury requiring crepe bandage or similar immobilisation not requiring formal strapping14.04
MT2Soft tissue injury (other than splinting of dislocated or fractured digit), unless specified elsewhere: application of plaster or padded splint or specific strapping within agreed guidelines (includes splinting of Achilles tendon injury and serious ankle sprains)65.12
MT3Aspiration of inflamed joint, tendon, bursa, or other subcutaneous tissue or space (with or without injection)31.60
MT4Extensor tendon, primary repair161.08
MT5Ruptured Achilles tendon: management by plaster immobilisation157.90
Radiologists' costs 
 Extremities 
RA01Sternum55.93
RA02Sterno-clavicular joints63.91
RA03Clavicle47.94
RA04Acromio-clavicular joints47.94
RA05Scapula47.94
RA06Shoulder51.93
RA07Humerus51.93
RA08Elbow joint43.94
RA09Forearm43.94
RA10Hand and/or wrist joint43.94
RA11Wrist/hand for bone age43.94
RA15Upper limb (infant)51.93
RA21Sacro-iliac joints51.93
RA22Pelvis or both hips (1 projection)51.93
RA25Hip joint (more than 1 projection)55.93
RA26Femur51.93
RA27Knee joint47.94
RA28Knee joint (and intercondylar/axial)55.93
RA29Tibia and fibula47.94
RA30Ankle joint51.93
RA32Foot47.94
RA35Long legs (hips to ankles—including measurement)59.92
RA40Lower limb (infant)55.93
 Head, neck, and spine 
RB01Cervical spine59.92
RB02Thoracic spine55.93
RB03Lumbar spine including lumbosacral joint55.93
RB04Sacro-coccygeal spine51.93
RB08Spine (scoliosis views)59.92
RB10Skull55.93
RB12Nasal bones47.94
RB13Facial bones51.93
RB14Optic foramina43.94
RB16Auditory canals (plain films only)55.93
RB21Nasal sinuses43.94
RB22Nasopharynx51.93
RB23Mastoids (bilateral)55.93
RB24Larynx and/or trachea47.94
RB31Upper teeth43.94
RB32Lower teeth43.94
RB33Mandible or OPG or lateral ceph59.92
RB34Temporo-mandibular joints59.92
RB35Salivary gland51.93
RB37Pharynx51.93
 Chest, including breast 
RC05Thoracic inlet51.93
RC06Chest (1 view)51.93
RC07Chest (more than 1 view)51.93
RC08Chest and thoracic cage63.91
RC09Chest and both oblique views63.91
 Mammography 
RC31Screening mammogram87.88
RC32Recall mammogram119.84
RC35Problem mammogram bilateral175.77
RC36Problem mammogram unilateral115.85
RC40Needle localisation235.69
RC41Galactogram235.69
RC45Breast aspiration biopsy235.69
RC46Breast biopsy with stereotaxis235.69
 GI, GU, and obstetrics—no contrast modifiers permitted 
 Radiology 
RD01Abdomen (1 projection)51.93
RD02Abdomen (more than 1 projection)51.93
RD07Pelvimetry (1 view)51.93
RD08Pelvimetry (2 or more views)51.93
 Screening 
RD10Contrast swallow (oesophagus only)407.46
RD11Contrast study upper GI tract407.46
RD13Small bowel meal407.46
RD14Small bowel enema (enteroclysis)683.08
RD15Contrast enema407.46
RD20Dynamic proctogram407.46
RD30ERCP407.46
RD40IVP including plain film and tomos235.69
RD44Cystogram retrograde or antegrade407.46
RD45Urethrogram407.46
RD46Micturating cysto-urethrogram407.46
RD47Ascending urethrogram407.46
 Special procedures 
RS42Tube injection235.69
RS43Dacrocystogram235.69
RS44Sialogram235.69
RS46Hysterosalpingogram407.46
RS61Myelogram cervical407.46
RS62Myelogram lumbar407.46
RS63Myelogram multilevel407.46
RS70Arthrogram235.69
RS71Arthrogram—upper limb235.69
RS73Arthrogram—lower limb235.69
 Ultrasound 
 Abdomen and pelvis 
RU01US abdomen123.83
RU02US abdomen and pelvis155.80
RU03US renal tracts115.85
RU04US abdominal aorta (without Doppler)115.85
RU06US pelvis (trans-abdominal only)115.85
 Infants 
RU10US infant head115.85
RU11US infant pylorus115.85
RU12US infant heart219.71
RU13US infant hips115.85
RU19US infant miscellaneous115.85
 Various 
RU20US thyroid/neck115.85
RU21US scrotum and testis115.85
RU22US breast115.85
RU23US veins163.78
RU24US eye115.85
RU25US chest115.85
RU27US injection/aspiration231.69
RU28US additional region83.88
RU29US miscellaneous115.85
 Skeletal 
RU30US shoulder163.78
RU31US musculoskeletal123.83
RU32US foreign body localisation91.88
RU39US skeletal miscellaneous123.83
 Intracavitary 
RU40US prostate143.80
RU41US anus/rectum143.80
RU42US female pelvis (includes trans-vaginal and trans-abdominal, or trans-vaginal only)143.80
RU43US trans-oesophageal243.67
RU44US intraoperative243.67
RU49US intracavitary miscellaneous143.80
 Vascular 
RU51Duplex/Doppler of chest195.74
RU56Duplex/Doppler: additional limb (arterial or venous)155.80
 Pregnancy 
RU60US routine pregnancy less than 28 weeks123.83
RU61US problem pregnancy155.80
RU62US pregnancy greater than 28 weeks155.80
RU64US with amniocentesis231.69
RU68US pregnancy—per extra foetus greater than 159.92
 Additional 
RX24X-ray additional region43.94
RX25Domiciliary X-ray (in addition)83.88
Specialists' costs 
 Repair recent wound 
SR1Not exceeding 7 cm, superficial127.51
SR2Not exceeding 7 cm, deeper tissue170.00
SR3Exceeding 7 cm, superficial212.53
SR4Exceeding 7 cm, deeper tissue255.02
 Fractures (closed reduction) 
SF1Phalanges85.02
SF2Metacarpals, excluding Bennetts153.02
SF3Metatarsals119.02
SF4Bennetts221.02
SF5Carpal bones110.49
SF6Colles204.00
SF7Radius and ulna—shafts246.49
SF8Radius—head and neck221.02
SF9Humerus246.49
SF10Talus—neck229.51
SF11Calcaneus229.51
SF12Other tarsals144.53
SF13Ankle—fracture dislocation, Potts357.02
SF14Tibia and fibula—shaft408.00
SF15Tibia and fibula—upper end357.02
SF16Tibia and fibula—involving joint traction416.49
SF17Femur, any site, with/without traction629.02
 Haematoma, abscess, or other infection 
SH1Small—aspiration21.29
SH2Large—incision and drainage (local anaesthetic)101.47
SH3Large—incision and drainage (general anaesthetic)110.49
 Foreign body, removal of 
SB1Under local anaesthetic80.80
SB2Under general anaesthetic178.49
SB3From cornea or sclera55.29
SB4From ear, other than by simple syringing85.02
SB5From muscle, tendon, or other deep tissue255.02
SB6From nose, other than by simple probing102.00
SB7From throat, additional fee85.02
 Dislocations (closed reduction) 
SD1Elbow, wrist, thumb, and fingers with strapping/splint170.00
SD2Shoulder102.00
SD3Patella144.53
SD4Hip204.00
 Plaster 
SP1Upper limb—above elbow127.51
SP2Upper limb—below elbow110.49
SP3Lower limb—above knee153.02
SP4Lower limb—below knee127.51
 Other 
SM1Aspiration of joint21.29
SM2Amputation of all or part of 1 digit187.02
SM3Extensor tendon, primary repair297.51
SM4Nail, simple removal of85.02
Specified treatment providers' costs 
TMTAll treatment21.76
POD 3Abcess or haematoma: drainage with incision (with or without local anaesthetic agent)26.85
POD 4Nail, simple removal of21.50
POD 5Nail, wedge resection/removal of: requiring the use of digital anaesthesia89.49
X-RAYX-ray services provided by chiropractor (maximum of 2 films per claimant per personal injury)13.60

Michael Webster,
for Clerk of the Executive Council.


Explanatory note

This note is not part of the regulations, but is intended to indicate their general effect.

These regulations amend the Injury Prevention, Rehabilitation, and Compensation (Liability to Pay or Contribute to Cost of Treatment) Regulations 2003. Part 1 and Schedule 1 of the regulations come into force on 1 April 2012. Part 2 and Schedule 2 of the regulations come into force on 1 July 2012.

The amendments made by Part 1 and Schedule 1

  • increase the amounts specified for non-specialist treatment by medical practitioners and nurses; and

  • insert a new regulation providing for nurse practitioners' costs; and

  • specify costs of treatment for 3 new treatments by podiatrists; and

  • make a number of technical amendments.

The amendments made by Part 2 and Schedule 2

  • provide that the amounts specified for the costs of treatment are GST exclusive; and

  • adjust the amounts accordingly; and

  • replace the Schedule of the costs of treatment with a new Schedule.


Issued under the authority of the Acts and Regulations Publication Act 1989.

Date of notification in Gazette: 23 February 2012.

These regulations are administered by the Department of Labour.