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Dear Colleagues,
Some of you may have seen that Monitor have published draft documentation for consultation on
relative tariffs for 16/17. The ‘relative’ means that these are not the final tariffs but that they show
the relationship of one to another. There are likely to be further changes between now and April.
However at present there are 2 pieces of good news. Firstly, Outpatient Paediatric EEG, EMG and
NCS will now attract a tariff. This is proposed to be £333 but may change. Those of you performing
paediatric investigations may wish to bring this to the attention of your business managers prior to
the next financial year.
The second piece of good news is that the HRGs have finally been redesigned successfully to allow a
reasonable and equivalent tariff for telemetry regardless of whether it is performed for epilepsy,
NEAD or sleep disorders. Previously sleep disorders attracted a much lower tariff because
respiratory medicine were using neurophysiology codes for their out patient polysomnographies
thus lowering the reference costs. The tariff will be independent of the presence or absence of comorbidities and in the draft document is set at £2341.
To get this tariff:
DO CODE
 Primary procedure as U221 (EEG telemetry)
 Primary diagnosis as any neurological/psychiatric/sleep disorder
DO NOT CODE
 Primary procedure as A847 (Sleep studies)
 Primary Diagnosis as Sleep Apnoea
The HRG you should get is AA40Z which is labelled Complex Long Term EEG Monitoring. Ignore
AA39Z, AA41Z, AA42Z which are where any respiratory patients coded with EEG codes for their OP
polysomnograms will map.
There is less good news on the adult OP tariff for EEG/EMG/NCS which has been reduced in the draft
document by 19% to £154 from £191. This has been highlighted to Monitor as a potential cause of
destabilising departments so I hope they will adjust the final tariff accordingly.
The HRG design to allow higher tariffs for surgical procedures performed with IOM and also awake
craniotomies is complete and should be included in the 17/18 tariff. This has been an incredibly long
haul – about 7 years – but hopefully it will work out this time.
This is the link to the draft documents: https://www.gov.uk/government/collections/201617national-tariff-proposals
With kind regards
Ros
Ros Kandler
Chair, Expert Working Group Neurosciences Chapter
National Casemix Office
Health & Social Care Information Centre