Is a claim for item 104 subject to any multiple service rules when co-claimed with an imaging service?
14 September 25Is a claim for item 104 subject to any multiple service rules when co-claimed with an imaging service?
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If a specialist refers a patient for a procedure is the specialist blocked from billing consultations during the aftercare period for that procedure?
14 September 25When a specialist refers a patient to another surgeon or an interventional radiologist to perform a procedure, is the original referrer disqualified from claiming further consultations during …
read more >How do we bill item 10983 correctly when there’s a nurse with the patient and a specialist on a video call? Does the specialist supervise the nurse?
7 September 25Our team-based model combines nurses and GP’s in-person at aged care facilities with geriatricians and other specialists via telehealth. We think we can bill item 10983 for the patient-end s…
read more >If a radiologist receives an imaging request and needs to discuss the image with the patient beforehand, can they claim attendance item 104?
7 September 25There is a lot of confusion about when radiologists can claim attendance item 104. If you have an X-ray request in hand, but you need to chat to the patient about the test before you start, wh…
read more >If an intensivist attends a cardiac arrest outside of the ICU are items 160-164 the appropriate items to bill?
31 August 25If an intensivist has to attend to assist with a patient that is not under their care for a life threatening emergency (e.g. cardiac arrest), is item 160-164 the appropriate items to bill (dep…
read more >Can low testosterone be continually monitored through Medicare funded blood tests when it’s not clinically necessary?
31 August 25I understand that if a patient is under the care of an endocrinologist for low testosterone, Tx would qualify the patient for a repeat MBS funded pathology testing as a formal hypogonadism dia…
read more >I saw your LinkedIn post that said the MBS is not the law. So what is it?
24 August 25I was fascinated by your LinkedIn post that said the MBS is not the law. I (and I think the whole nation) always thought it was. How can the MBS and the law be different and what is the MBS th…
read more >What exactly does the term “including all associated intraoperative imaging” refer to with regards item 38376?
24 August 25What is the MBS definition of “intraoperative imaging” and what exactly does the term “including all associated intraoperative imaging” refer to with regards to item 38376. Is this an exclusio…
read more >Do referrals to public hospital outpatient clinics have to be written exclusively by GPs or specialists exercising a ROPP?
18 August 25The CFO of our public hospital gave a talk on Medicare billing recently and told us that any referral written by anyone other than a GP or specialist exercising a ROPP cannot be used to bill M…
read more >How do we know when a patient is admitted? Is there a definition of admission?
18 August 25At what precise moment in time does a non-admitted patient in the emergency department become admitted? Is it when the admitting doctor makes the decision to admit, or is it after the paperwor…
read more >Can GPs bill Medicare for shared medical appointments?
10 August 25We received the following information. The questioner had received conflicting advice from multiple sources.
Shared Medical Appointments (SMA) are a type of group medical appointment that typ…
Is a nurse practitioner a provider of medical services under the Constitution?
10 August 25Having read your PhD thesis, I am curious as to whether section 51(xxiiiA.) of the Australian Constitution applies to services provided by nurse practitioners (NP) because it refers to “medica…
read more >Do I have to bill a 110 before a 116?
4 August 25This question has come from two almost identical experiences shared by physicians. The first was reported in my PhD and the second, which appears to have happened around the same time, was sha…
read more >Services Australia says we must use DB1N or DB1H when bulk billing. Does that apply to ECLIPSE claims?
4 August 25MBS Note AN.0.12 states that “practitioners who accept assigned benefits must claim from Services Australia using either Claim for Assigned Benefits form DB1N or DB1H. Are these forms required…
read more >If a specialist leaves a practice, can that specialist charge a 116 in the new practice without having a 110 on file with the new provider number?
28 July 25If a specialist leaves one practice and joins another new practice, can that specialist charge a 116 in the new practice without having a 110 on file with that new provider number? Medicare wi…
read more >Does Medicare have records of all item numbers billed for private patients in public hospitals? What if the patient was first seen as a public patient?
28 July 25If a patient is admitted to a public hospital but chooses to come in as a private patient, the specialist will submit an invoice to the private fund. Will Medicare have a record of all item nu…
read more >How to navigate your Medicare statement and more informative free resources
How to navigate your Medicare statement and more informative free resources
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