Do you have to withhold billing item 723 until a formal acceptance to participate is received from at least 2 care team members?
26 March 24GP 2024 / 0368 Answer In our opinion, no. Context At our practice we…
read more >Can a cardiologist self-refer to follow up a patient post discharge from hospital?
24 February 21GA 2021/0230 Answer No. Context The question posed was: “Cardiologist, Dr Z, performs a…
read more >Can item 11714 (ECG) be co-claimed with item 17610 or 17615 (pre-anaesthetic consultations) prior to admission?
24 February 21GA 2021/0229 Answer Yes, in our opinion, but not as a modus operandi. Context…
read more >If a public inpatient is discharged and then referred back to the hospital outpatient clinic by the GP (so, no previous Medicare billing), can I bill item 132 if I spend more than an hour with the patient?
28 January 21GA 2021/0127 Answer No. Context A hospital billing manager asked: If we have a…
read more >Can rehabilitation physicians claim items 170-172 for family meetings?
28 January 21RM 2020/0714 Answer No. Context Dr A was a rehabilitation physician who had heard…
read more >Can I take over a named referral in a public hospital outpatient setting if I am of the same specialty?
22 January 21RM 2020/067 Answer Yes. Context Doctor A was a rehabilitation physician working in a…
read more >What constitutes a referral from the Emergency Department to an inpatient medical unit?
20 January 21GA 2021/0231
Answer: An entry in the patient’s hospital record. Context: This is a common question…
read more >Can I bill to Medicare when a patient is in Australia but I am overseas?
8 January 21GA 2020/065 Answer No. Context Doctor A asked what happens when the treating doctor…
read more >How do I bill for a 3 day course of chemotherapy delivered via a pump?
18 December 20OH 2020/063 Answer One service can be billed on day 1, nothing on day…
read more >In a public hospital outpatient clinic does a referral to “Dear Specialist” enable Medicare bulk billing?
21 September 20GA 2020/0924 Answer No. Context Question: If a clinic receives a referral to “Dear…
read more >Do you get one item 132 and two item 133’s every 12 months?
31 August 20GA 2020/0822 Answer No. Context Doctor A worked in a public hospital outpatient department…
read more >Are inpatient and outpatient episodes considered as separate for billing purposes, so that when a patient is discharged a new episode of care automatically commences?
26 August 20GA 2020/0823 Answer No. Context Question: If the same treating rehab physician sees a…
read more >Can a GP with surgical training bill item 41764?
17 August 20GP 2020/0611 Answer Probably not. Context A general practitioner has asked whether he can…
read more >Can oncologists bill item 14206 and does it come under the supervision rules?
17 August 20OH 2020/064 Answer Part one – probably Part two – no Context A practice…
read more >Can I bulk bill a Medicare service and charge for a related non-Medicare service simultaneously?
1 August 20GE 2020/069 Answer In our opinion, no. Context A gastroenterology practice asked whether a…
read more >Can a nephrologist bill item 13103 for supervising dialysis patients when unable to see the patients face to face?
1 August 20NR 2020/0610 Answer In our opinion, yes. Context I am a nephrologist working in…
read more >Can a group of specialists operating under a single brand, but with their own separate practices, agree to charge the same fees?
1 August 20OH 2020/0612 Answer No. Context A group of haematologists in private practice, who operate…
read more >If a patient is having chemotherapy at a hospital and the doctor goes on holiday, can we still bill for treatment under that doctor’s provider number because they created and approved the treatment regime?
1 August 20OH 2020/0718 Answer No. Context Question: Wanting to confirm that if a patient is…
read more >If a specialist sees a non-admitted patient in a private emergency department, can she bill to Medicare and is the patient entitled to a rebate?
10 July 20OH 2020/0719 Answer Yes. Context Billing to Medicare for non-admitted patients in public hospital…
read more >Can we bill to Medicare for public inpatients in public hospitals?
10 July 20GA 2020/0717 Answer No. Context An administrator in a public hospital had been incorrectly…
read more >Can another psychiatrist, who is known to the patient, be the second participating doctor in a case conference?
10 July 20PY 2020/0716 Answer No Context Question: For case conferences involving psychiatrists and allied health…
read more >Can I bill using my provider number when a locum is covering for me?
10 July 20OH 2020/0715 Answer No. Context Doctor A was an oncologist who understood that when…
read more >Can we co-claim a consultation every time we do a bone marrow biopsy?
3 July 20OH 2020/0713 Answer No, not as a modus operandi, though it may be appropriate…
read more >