Description
Description
Medical Doctors’ Coding Manual 2026 (MCDM 2026)
The SAMA Medical Doctors’ Coding Manual (MDCM) book, previously known as the Doctors’ Billing Manual (DBM) is back by popular demand. The book, which has been in use as a reference guide for allocating procedure codes and generating claims data, is updated and maintained by the Medical Coding Division of the South African Medical Association in cooperation with the different medical doctor disciplines/groups.
The 2026 edition contains updated information regarding changes made to the following disciplines:
2 new additions to ENT procedures for resection for Thyroid Malignancy (codes 2986 & 2988), as well as 2 new codes for Eustachian Tube Dilatation (codes 5205 & 5206). The Relative Value Units (RVU’s) of certain existing codes in ENT were brought in line with CPT RVU’s.
There are 2 minor changes from Ophthalmology; a description amendment of code 3020, to include Glaucoma, and the reallocation of codes 3631 and 3632, from Radiology: Section 19.11 to Ophthalmology: Section 16.15.
Dermatology has introduced new equipment: Automated Total Body Mapping (ATBM) device, a high-tech dermatology process using specialized cameras and AI to create a complete, detailed digital map of a person’s skin, capturing moles and spots to track changes over time for early skin cancer detection (code 0249). There is also a minor change in the description of codes 0287, and 0241 – 0243.
There is the introduction of the Rezum procedure from Urology, this procedure is for Transurethral destruction of prostate tissue using radiofrequency-generated water vapour thermotherapy for the treatment of benign prostatic hyperplasia (BPH), including an intra-operative nerve block and contains detailed coding guidelines (code 2267)
Ampath has added a code to make provision for the Multiplex Allergy (IgE) ImmunoAssay , this code will be used to cover the testing of 17 allergens (code 4590).
The General Practitioners Private Practice Committee (GPPPC) has introduced the following changes:
A new code for Pap Smear, with or without pelvic examination, has been added to Section 12.3 “Cervix Uteri”, (code 2398), this is an add on code, that is to be added to consultation items 0190 – 0193, it contains detailed coding guidelines.
Modification of ECG interpretation codes to include RVU’s for GPs (codes 1230 & 1231): An amendment to items 1230 & 1231 to make provision for GP’s interpreting ECGs referred to them by other medical doctors.
Revision of item 0132, to limit its use to writing of repeat or alternative prescriptions
In addition, four new modifiers have been introduced by SAMA:
An Information Modifier for Bilateral Procedures (Modifier 00BL)
Two information modifiers for Left and Right Sided procedures (Modifiers 00RT & 00LT)
An Information Modifier to distinguish procedures / services that are not typically reported together but are warranted under the circumstances (Modifier 0022).
International coding standards dictate the necessity of coding for laterality. It is important for procedural and diagnostic coding to correspond to provide accurate health records. SAMA must keep up with these standards, and we believe that the introduction of left, right and bilateral modifiers will be a step in the right direction.
The introduction of information modifiers will be beneficial in lessening the burden and cost on medical doctors to motivate / explain the laterality of a procedure.
It is further notable that the full information of changes and additions of coding rules and interpretations are available on the eMDCM and MDCM hard copies. These are obtainable from the SAMA website: https://samedical.org/estore/
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