Why are my item 35615 claims being rejected? I do the biopsy. What am I doing wrong?
13 October 25I am an Obstetrician and Gynaecologist and am finding that many of my item 35615 claims are being rejected. I am definitely performing the vulval biopsies. Is there a trick to getting these pa…
read more >Should I use MBS item 35630 or 35633 for a hysteroscopy, D&C and Mirena insertion?
6 October 25I am an Obstetrician and Gynaecologist and am worried about the MBS items our practice manager is billing for some of my procedures. She is billing MBS code 35633 instead of code 35630 for hys…
read more >As a physio, if I bulk bill a consultation under a care plan, can I charge separately for the splint I provide to the patient?
6 October 25I know you can’t charge separate gaps when you bulk bill but I thought you could charge separately for consumables such as a splint that I might provide to the patient. Is that right?
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read more >When you can you bill a new patient item (e.g.110) when a patient is privately admitted to a public hospital but is already known in some way in outpatients to your clinical team?
28 September 25When can you bill a new patient item (e.g. 110) when a patient is privately admitted to a public hospital but is already known in some way in outpatients to your clinical team?
E.g. When a pa…
If I do a telehealth consult on an admitted Bupa ADF patient in another state, can I bill Bupa ADF or charge for it in any way?
21 September 25I did a telehealth consult on an admitted Bupa ADF patient in another state. The referral came from the Bupa ADF doctor who was with the patient (by his bedside) during my telehealth consult. …
read more >Can item 57341 be billed twice on the same day for interventional injections in both the right and left knees?
21 September 25We would like clarification on whether billing item no. 57341 can be used on the same day for interventional injections in both the right and left knees to treat osteoarthritis. We received a …
read more >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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read more >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…
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