MBS ANSWERS

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

Context

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 which means the case has to be abandoned. Is there a way to bill for abandoned pulmonary vein isolations?

The same occasionally happens where a patient comes into hospital for a pacemaker implant (item numbers 38356, 38353, 61109) and I find that the veins are blocked or abnormal and not suitable for passing pacemaker wires into the heart. In these cases I have to abandon the procedure and rebook them for another time after further assessment and discussion with the patient. Is there a way to bill for abandoned pacemaker procedures as well?

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Health Insurance Act – Cases and Commentary by Bruce Topperwien

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