Sonographers performing medical ultrasound examinations either R or NR type items on behalf of a medical practitioner must be suitably qualified, involved in a relevant and appropriate Continuing Professional Development program and be Registered on the Register of Accredited Sonographers held by the Department of Human Services.
To be eligible for registration on the Register of Accredited Sonographers held by the Department of Human Services, the person must be accredited with the Australian Sonographer Accreditation Registry. For accreditation with the Australian Sonographer Accreditation Registry the person must:. The sonographer's initial and surname is to be written on the report. The name of the sonographer is not required to be included on the copy of the report given to the patient.
For the purpose of this rule, the "name" means the sonographer's initial and surname. As a rule, benefit is payable once only for ultrasonic examination at the one attendance, irrespective of the areas involved. Except as indicated in the succeeding paragraphs, attendance means that there is a clear separation between one service and the next. For example, where there is a short time between one ultrasound and the next, benefits will be payable for one service only.
As a guide, the Department of Human Services will look to a separation of three hours between services and this must be stated on accounts issued for more than one service on the one day.
Where more than one ultrasound service is rendered on the one occasion and the service relates to a non-contiguous body area, and they are "clinically relevant", ie. Accounts should be marked "non-contiguous body areas".
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Benefits for two contiguous areas may be payable where it is generally accepted that there are different preparation requirements for the patient and a clear difference in set-up time and scanning. Accounts should be endorsed "contiguous body area with different set-up requirements".
Similarly, if a complete pelvic, urinary or abdominal ultrasound is billed, it is inappropriate to bill separately for a post-void residual determination, since payment of this has already been included in the payment for the complete scans. In addition, the medical record must contain documentation of the indication for the service and the number of times performed. Transoesophageal echocardiography - Item and consequential amendment to Item The Medical Services Advisory Committee MSAC has reviewed intra-operative transoesophageal echocardiography and recommended that public funding for this procedure be supported on an interim basis and be restricted to assessment of cardiac valve competence following valve replacement or repair.
Item has been developed for these indications in consultation with the Australian Society of Anaesthetists, the Australian Medical Association and the Cardiac Society of Australia and New Zealand. Indications other than those recommended by MSAC will continue to be funded under item Further research will be undertaken to assist MSAC in its future evaluation of the use of intra-operative transoesophageal echocardiography.
A vascular ultrasound study may include one or more items.
Associated Notes
Additionally where a patient is referred for a bilateral study of both arms or both legs eg both arms for item , the account should indicate 'bilateral' or 'left' and 'right' to enable benefit to be paid. Any decision to have a patient return on a different day to complete a multi-area diagnostic imaging service should only be made on the basis of clinical necessity.
Benefits for these items are payable where the service is rendered in the following circumstances:. Items and cover the situation where the service was rendered by a medical practitioner who did not assess the patient, whereas items and cover the situation where the service was rendered by a medical practitioner who did assess the patient.
Medicare benefits are not payable for more than three NR-type ultrasound services in Subgroup 5 of Group I1 ultrasound that are performed on the same patient in any one pregnancy. For items where clinical indications are listed items , , , , and , or where a clinical indication is required items , , and for performance of subsequent scans the referral must identify the relevant clinical indication for the service.
It should be noted that a patient must have previously had either a or ultrasound in the same pregnancy to be eligible to claim for either a or obstetric service. To be eligible to claim for either a or obstetric service, a patient must have previously had either a or ultrasound in the same pregnancy. If the service is self-determined items , , , , , , , , and , the clinical condition or indication must be recorded in the medical practitioner's clinical notes.
Where a nuchal translucency measurement is performed when the pregnancy is dated by a crown rump length of mm in conjunction with items R or NR or R or NR , then items R or NR should be claimed. If nuchal translucency measurement for risk of foetal abnormality is performed in conjunction with any additional condition in items , , or , only one fee is payable. It is anticipated that use of items and will be restricted to credentialed medical practitioners and sonographers in the future. Obstetric ultrasound items to cover scanning of a patient who is experiencing a multiple pregnancy.
The items incorporate a fee adjustment in recognition of the added complexity and costs associated with scanning multiple pregnancies. Based on the recommendations of the profession, the items apply only to patients where a multiple pregnancy has been confirmed by ultrasound. The items include identical restrictions and provisions as the second and third trimester items , and include items for referred and non-referred services. In relation to items , , and , non-metropolitan area includes any location outside of the Sydney, Melbourne, Brisbane, Adelaide, Perth, Greater Hobart, Darwin or Canberra major statistical divisions, as defined in the Australian Standard Geographical Classification published by the Australian Bureau of Statistics publication number These suggestions can help you find the best service for you.
In the meantime, we will continue to update and add content to Pregnancy, Birth and Baby to meet your information needs. This information is for your general information and use only and is not intended to be used as medical advice and should not be used to diagnose, treat, cure or prevent any medical condition, nor should it be used for therapeutic purposes. The information is not a substitute for independent professional advice and should not be used as an alternative to professional health care.
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