Medicare Benefits Schedule - Item 11607

Search Results for Item 11607

View Associated Notes

Category 2 - DIAGNOSTIC PROCEDURES AND INVESTIGATIONS

11607

11607 - Additional Information

Item Start Date:
01-Nov-2021
Description Updated:
01-Nov-2021
Schedule Fee Updated:
01-Nov-2021

Group
D1 - Miscellaneous Diagnostic Procedures And Investigations
Subgroup
5 - Vascular

Continuous ambulatory blood pressure recording for 24 hours or more for a patient if:

(a) the patient has a clinic blood pressure measurement (using a sphygmomanometer or a validated oscillometric blood pressure monitoring device) of either or both of the following measurements:

(i) systolic blood pressure greater than or equal to 140 mmHg and less than or equal to 180 mmHg;

(ii) diastolic blood pressure greater than or equal to 90 mmHg and less than or equal to 110 mmHg; and

(b) the patient has not commenced anti‑hypertensive therapy; and

(c) the recording includes the patient’s resting blood pressure; and

(d) the recording is conducted using microprocessor‑based analysis equipment; and

(e) the recording is interpreted by a medical practitioner and a report is prepared by the same medical practitioner; and

(f) a treatment plan is provided for the patient; and

(g) the service:

(i) is not provided in association with ambulatory electrocardiogram recording, and

(ii) is not associated with a service to which any of the following items apply:

(A) 177;

(B) 224 to 228;

(C) 229 to 244;

(D) 699;

(E) 701 to 707;

(F) 721 to 732;

(G) 735 to 758.

Applicable only once in any 12 month period

 

Fee: $107.20 Benefit: 75% = $80.40 85% = $91.15

(See para DN.1.35 of explanatory notes to this Category)


Associated Notes

Category 2 - DIAGNOSTIC PROCEDURES AND INVESTIGATIONS

DN.1.35

Treatment plan guidelines and additional claiming guidelines for ambulatory blood pressure monitoring

Treatment plan guidelines for ambulatory blood pressure monitoring

To fulfil the treatment plan of item 11607, a comprehensive written plan must be prepared describing:

a.    the patient's diagnosis;

b.    management goals with which the patient agrees;

c.     appropriate interventions including lifestyle modification;

d.    treatment the patient may need; and

f.     arrangements to review the plan by a date specified in the plan.

 

In preparing the plan, the medical practitioner must:

a.     explain to the patient and the patient's carer (if any, and if the medical practitioner considers it appropriate and the patient agrees) the steps involved in preparing the plan; and

b.    record the plan; and

c.     record the patient's agreement to the preparation of the plan; and

d.    offer a copy of the plan to the patient and the patient's carer (if any, and if the medical practitioner considers it appropriate and the patient agrees); and

e.     add a copy of the plan to the patient's medical records.

 

Additional Claiming Guidelines for ambulatory blood pressure monitoring:

Blood pressure monitoring equipment:

Both the in-clinic blood pressure monitor and the ambulatory blood monitoring equipment (cuff and monitor) used for services under item 11607 must be listed on the Australian Register of Therapeutic Goods, with monitoring devices recalibrated at time intervals as per the manufacturer's recommendations.

Claiming separate consultations:

If a consultation is for the purpose of an Ambulatory blood pressure monitoring treatment plan, a separate and additional consultation should not be undertaken in conjunction with the Ambulatory blood pressure monitoring consultation, unless it is clinically indicated that a separate problem must be treated immediately.


Where a separate consultation is undertaken in conjunction with an Ambulatory blood pressure monitoring consultation, the patient's invoice or Medicare voucher (assignment of benefit form) for the separate consultation should be annotated (e.g. separate consultation clinically required/indicated).

Related Items: 11607


Legend

  • Assist - Addition/Deletion of (Assist.)
  • Amend - Amended Description
  • Anaes - Anaesthetic Values Amended
  • Emsn - EMSN Change
  • Fee - Fee Amended
  • Renum - Item Number Change (renumbered)
  • New - New Item
  • NewMin - New Item (previous Ministerial Determination)
  • Qfe - QFE Change