MBS ANSWERS

Recent

Can a provider holding both a Staff Specialist and a salaried Visiting Medical Practitioner (VMP) position at the same time in one hospital bill separately for each role?

7 November 26

Are there any issues with a provider holding both a Staff Specialist and a salaried Visiting Medical Practitioner (VMP) position at the same time in one hospital and, to keep billing revenue s…

When patients attend our private fracture clinic and we convert the ED’s backslab to a definitive fibreglass cast, can this be billed as the T8 treatment item?

7 November 26

Cast conversion at follow-up: When patients attend our private fracture clinic and we convert the ED’s backslab to a definitive fibreglass cast, can this be billed as the T8 treatment item? Ho…

I know that charging separate fees when bulk billing is fraud but if we charge separate fees like facility fees when we are not bulk billing how can that be fraud?

1 November 26

I know that charging separate fees when bulk billing is fraud but if we charge separate fees like facility fees when we are not bulk billing how can that be fraud?

…

Under the diagnostic imaging remote area exemption, can an off-site radiologist claim MBS items 55850 and 55848 when an accredited sonographer provides real-time ultrasound guidance/diagnostic images, a GP administers the injection, and the radiologist subsequently reviews the images and provides a diagnostic report?

23 October 26

Under the diagnostic imaging remote area exemption, can an off-site Radiologist claim MBS items 55850 and 55848 when an accredited sonographer provides real-time ultrasound guidance/diagnostic…

Can item 38248 (selective coronary angiography) be performed to exclude serious pathology for a patient who recently attended ED with tachycardia, has a family history of heart attack, has been on statins for a long time and is anxious about their condition?

23 October 26

My 60 year-old patient has been on cholesterol lowering drugs for many years and said they recently had a racing heart and went to a private ED. The ED said there was nothing to worry about an…

Can a patient be charged for a consumable item together with an attendance and be bulk-billed for a procedure that uses the consumable?

17 October 26

Would the following scenario be compliant? The patient is assessed and managed in an outpatient fracture clinic. The practitioner determines that non-operative management is appropriate and ap…

Can radiation oncology procedural items be claimed by a specialist after the referral period has ended?

10 October 26

ASKMBS stated ‘A referral is only required for MBS services that state the requirement in their item descriptor. This is mainly professional attendance items. The radiation oncology treatment …

When one of the T8 fracture items is billed, can the practice separately charge the patient for consumables such as a waterproof cast, crutches, moon boots, or braces?

2 October 26

When one of the T8 fracture items (47387, 47348, 47354, 47561, 47411, 47423, 47444, 47453, 47462, 47543, 47579, 47595 and 47015) is billed, can the practice separately charge the patient for c…

Is a purely non-procedural pathway compliant for a T8 fracture/dislocation item that does not specify a particular procedure?

2 October 26

Where a T8 item descriptor uses the word “treatment” without specifying a procedure (e.g. reduction, cast, splint), can treatment be satisfied by clinical assessment, diagnosis and implementat…

Would information including the MBS item, clinical coding, theatre records, billing and practitioner comparison data ordinarily be available to a private hospital to audit a doctor’s billing?

25 September 26

What MBS item, clinical coding, theatre, billing and practitioner comparison data would ordinarily have been available to a private hospital to audit a doctor’s billing?

…

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Recent

Can a provider holding both a Staff Specialist and a salaried Visiting Medical Practitioner (VMP) position at the same time in one hospital bill separately for each role?

When patients attend our private fracture clinic and we convert the ED’s backslab to a definitive fibreglass cast, can this be billed as the T8 treatment item?

I know that charging separate fees when bulk billing is fraud but if we charge separate fees like facility fees when we are not bulk billing how can that be fraud?

Can item 38248 (selective coronary angiography) be performed to exclude serious pathology for a patient who recently attended ED with tachycardia, has a family history of heart attack, has been on statins for a long time and is anxious about their condition?

Can a patient be charged for a consumable item together with an attendance and be bulk-billed for a procedure that uses the consumable?

Can radiation oncology procedural items be claimed by a specialist after the referral period has ended?

When one of the T8 fracture items is billed, can the practice separately charge the patient for consumables such as a waterproof cast, crutches, moon boots, or braces?

Is a purely non-procedural pathway compliant for a T8 fracture/dislocation item that does not specify a particular procedure?

Would information including the MBS item, clinical coding, theatre records, billing and practitioner comparison data ordinarily be available to a private hospital to audit a doctor’s billing?