Margaret Faux, Author at AIMAC

If 92210 is the telehealth equivalent of item 599, does this mean the doctor has to visit the patient, or open the consulting rooms?

10 February 25

If 92210 is the telehealth equivalent of item 599, does this mean the doctor would also have to visit the patient, or open the consulting rooms? I am very confused by this.
I asked AskMBS and…

Can intensivists rostered in an ICU claim additional attendance items during the evening shift if the daily global ICU items have already been claimed?

10 February 25

I work in an ICU with separately rostered day and evening / night shift intensivists who are in person and conduct an evening ward round. Can the evening intensivist bill a 110 or 116 item num…

Can hospital administrators type change a patient from a valid private election back to being public without the patient’s consent?

3 February 25

What happens to billing of a private patient in a public hospital who undergoes solid organ (other than kidney) transplantation? There is no MBS item billable for this so it can’t be billed to…

Do you need a separate provider number for a satellite clinic across the road from a hospital where you already have one?

3 February 25

How site specific are provider numbers? e.g. do you need a different provider number for a satellite clinic directly across the road from the main hospital which you already have a provider nu…

If I do a revision of a breast scar after cosmetic breast implant surgery can I claim the scar revision surgery to Medicare?

27 January 25

The questioner had received this advice which was wrong.
“Thank you for your enquiry regarding the revised item descriptor for item 45518, that will come into effect from 1 July 2023.The rati…

Can a unit trust charge a user fee to patients, along with the doctor’s fees, if not bulk billing?

27 January 25

Can a medical practice registered as a Unit Trust charge a user fee to patients along with the doctors’ fees, if the doctor does not bulk bill that visit.
e.g. For an initial visit with an Ob…

Do the words “ongoing care” on a GP referral mean the referral is indefinite?

19 January 25

We have been informed that a GP re-referral for “ongoing care” where no duration is specified should be interpreted as an INDEFINITE REFERRAL. We do not think this is sufficient for something …

If we obtain verbal consent from the patient to bulk bill and note it in the patient’s file, is that compliant for bulk billing?

19 January 25

Is a verbal consent noted in the patient’s file enough? If a bulk billed patient has to provide consent by signature for items put through to Medicare this creates additional admin work, in particul…

When a respiratory physician does a bronchial biopsy (item 38417) together with a radiologist doing the fluoroscopy why is one claim rejected?

12 January 25

We have a scenario where Medicare reject claims submitted by the physician for an item 38417 because it states fluoroscopy can only be claimed by one provider once for that occasion of service…

If I have to abandon a pulmonary vein isolation or pacemaker procedure part way through, can I still bill it to Medicare?

12 January 25

I occasionally have patients who come into hospital for a pulmonary vein isolation (item numbers 38290, 38212, 38206, 55118) but at the time of the procedure we find an intracardiac thrombus …

If a practice nurse does dressings and vaccinations and the GP does not physically see the patient, can the practice nurse bill under the GPs name?

6 January 25

We have a Practice Nurse who does vaccinations and wound dressings etc. Does the doctor have to physically see the patient or can the nurse discuss the patient with the doctor, act on his/her …

If a spinal surgeon is doing an anterior fusion and a vascular surgeon provides anterior exposure, do step down rules apply or are these separate services?

6 January 25

If a principal spinal surgeon is performing an anterior spinal fusion and a vascular surgeon is required to provide anterior exposure, are both surgeons eligible to invoice for their separate …

Should ultrasound scans reported by locums be billed under the locum’s provider number or the partner’s provider number?

15 December 24

If we have regular locums in an ultrasound practice, reporting scans, should these be billed under the partner’s provider numbers or the locum’s provider numbers?

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