Margaret Faux, Author at AIMAC

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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Can geriatricians bill items 145, 147 and 128 for phone consultations provided to patients in aged care facilities?

15 December 24

It was my understanding that we can’t bill items 145, 147, 128 over the phone in nursing homes. Is this still correct or do we have numbers equivalent that we can bill for consultations over t…

How do I correctly administer a known-gap claim without breaking the law that applies to illegal split bills?

8 December 24

I’m working as a surgical assistant. I sometimes charge the patient a gap. My registration with each fund is ‘known gap’. As an example – Bupa pays $386 for assisting a 49518. I want to …

Can a specialist use the same referral in different locations?

8 December 24

If you work in multiple outpatient locations, and first see the patient in Location A for an initial consult and bill a 110, can you provide a follow up consult from Location B (which has a di…

Can a psychologist who is overseas conduct an online interview with an Australian consumer in Australia for the purposes of preparing a legal report?

2 December 24

I am an Australian Citizen and psychologist. At times clinics have asked me to write court reports on Australian residents for Legal Aid while I am out of the country. So I interview the clien…

If a pathology company fits a BP monitoring device but a GP does the treatment plan, who can claim the item 11607?

2 December 24

I am a GP. I have come across an issue with item number 11607. Our pathology company is billing 11607. They fit the patient with an ambulatory bp monitor and send a report to me from a cardiol…

Can a psychologist continue billing to Medicare under a Mental Healthcare Plan if the patient is admitted to hospital and becomes an inpatient?

24 November 24

If I have been providing services to a client under Medicare through a Mental Healthcare Plan (MHCP) and they have been admitted to hospital as an inpatient. Is the client able to continue wit…

If patients book a video consult and pay prior to my consultation can they get a Medicare rebate or do they have to pay on the same day as the consult?

24 November 24

If my patients book a video telehealth with me online and pay prior to my consultation (given that they have a GP referral in advance) can they get a medicare rebate? Or does the payment need …

If a referral is addressed to “Dr ABC or Dr XYZ” can both doctors use it when exercising a ROPP?

17 November 24

This question relates to medical specialists exercising rights of private practice in public hospital outpatient departments. The questioner wanted to know if both Dr ABC and XYZ can use the r…

If a nurse practitioner and radiographer perform a PICC line insertion can a radiologist claim for the associated digital subtraction angiography?

13 November 24

A PICC line insertion is performed by a nurse/nurse practitioner and radiographer, including imaging (Fluoroscopy + Digital Subtraction Angiography of thorax). Post examination, a …

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