Is it legal for anaesthetists to charge booking or administration fees?
24 March 25Can anaesthetists charge patients a separate administration or booking fee of say $1,000 before they are admitted to hospital for their anaesthetic?
read more >Can anaesthetists charge patients a separate administration or booking fee of say $1,000 before they are admitted to hospital for their anaesthetic?
read more >As an anaesthetist who is not rostered in the intensive care unit (ICU), I am sometimes asked to go to ICU and take a ventilated and sedated patient to radiology for various imaging procedures such as CT scans and MRIs. Can I bill a pre-anaesthetic consultation when I go and see the patient? I don’t talk to them obviously. The initiation item I bill is 21922.
read more >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...
read more >There is nothing in the MBS to preclude multiple transfusions (item 13706) being provided on the same calendar day and the item number covers three different types of regularly provided transfusions (blood, platelets, IVIg). There are ample examples in ICU when a patient legitimately requires multiple appropriate transfusion episodes during a 24 hour period and these are due to changing clinical circumstances, not part of a pre-defined transfusion plan (e.g. blood transfusion at 4am with 2 units of packed cells, subsequent transfusion of platelets and another unit of blood at 2 pm and another transfusion with a unit of blood at 10pm – for ongoing surgical bleeding). In my interpretation these would account for three distinct, time separated transfusion episodes and item 13706 should be claimed three times. However, Medicare seems to reject claims with more than two 13706 items on it. The error message is usually that the service has already been paid or maximum number reached. This is in spite of times and NDS override documented on the submission. Also, how does one reconcile a massive transfusion episode in billing (sometimes dozens of units of blood and platelets are given) – clearly this is a very different level of clinical workload and involvement compared to a single unit transfusion.
read more >The question posed was: If an ECG is performed during a pre-admission consultation (MBS Item 17610 or 17615) and the criteria of item number 11714 is met, is it permissible to claim both?
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