The context for this question involves co-claiming diagnostic ultrasound and vascular access items. After the last MBS review, vascular access items 13815, 13842 and the newly introduced ECMO item number 13837/13838 and 13834/13835 definitions included a new clause to stipulate that no ultrasound item numbers can be claimed in association with these procedures. Traditionally 55054 was co-claimed when ultrasound was used, however the review taskforce stipulated that this was now standard of care and these procedures should attract no further ultrasound benefit. That is all fine, except the way this was implemented at a processing level, is that the above vascular access item numbers restrict with ALL diagnostic ultrasound item numbers. It is sometimes necessary to provide diagnostic imaging services to ICU patients (either referred or self-deemed). This is most often echocardiography, but it can be general abdominal, soft tissue, etc. These diagnostic imaging item numbers are not related to vascular access, but unfortunately even if it is clearly indicated in the service text that they are unrelated, a large majority of the time they get rejected and require manual processing. Someone suggested we could overcome this by obtaining a separate provider number that would be used for medical imaging services only and then the items would not conflict at processing. For example, the same intensivist would claim all intensive care item numbers including vascular access under their “ICU” provider number and then claim any medical imaging services they provide under a different provider number. I am not sure this...