Medicare Benefits Schedule - Item 11723

Search Results for Item 11723

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Category 2 - DIAGNOSTIC PROCEDURES AND INVESTIGATIONS

11723

11723 - Additional Information

Item Start Date:
01-Mar-2021
Description Updated:
01-Mar-2021
Schedule Fee Updated:
01-Nov-2023

Group
D1 - Miscellaneous Diagnostic Procedures And Investigations
Subgroup
6 - Cardiovascular

Note: the service only applies if the patient meets one or more of the following and the requirements in Note: DR.1.1

Ambulatory electrocardiogram monitoring, by a specialist or consultant physician, if the service:

(a) utilises a patient activated, single or multiple event recording, on a memory recording device that:

(i) is connected continuously to the patient for up to 7 days; and

(ii) is capable of recording for at least 20 seconds prior to each activation and for 15 seconds after each activation; and

(b) includes transmission, analysis, interpretation and formal report (including the indication for the investigation); and

(c) is for the investigation of recurrent episodes of:

(i) unexplained syncope; or

(ii) palpitation; or

(iii) other symptoms where a cardiac rhythm disturbance is suspected and where infrequent episodes have occurred; and

(d) is not associated with a service to which item 11716, 11717, 11735, 12203, 12204, 12205, 12207, 12208, 12210, 12213, 12215, 12217 or 12250 applies

Applicable only once in any 3 month period

Note: The service does not apply if the patient is an admitted patient.

Fee: $57.20 Benefit: 85% = $48.65

(See para DN.1.26, DR.1.1 of explanatory notes to this Category)


Associated Notes

Category 2 - DIAGNOSTIC PROCEDURES AND INVESTIGATIONS

DN.1.26

Discussion of results

Discussions of the results, findings or interpretation of a study are reasonably expected to be part of a formal report. Discussion of these findings with a patient does not constitute a consult. Similarly, discussion(s) during the course of a study or to determine the safety or appropriateness of the study is part of the service and should not be claimed as a consult.

 

Related Items: 11717 11723 11735

Category 2 - DIAGNOSTIC PROCEDURES AND INVESTIGATIONS

DR.1.1

AECG requirements for claiming

Items 11716, 11717, 11723 or 11735 do not apply to a service unless:

(i)  the patient is referred to a specialist or consultant physician by a referring practitioner; or
(ii) the service is requested by a requesting practitioner.

Admitted patient

Item 11716, 11717, 11723 or 11735 do not apply to a service if the patient is an admitted patient.

An “admitted patient” includes an episode of hospital treatment and an episode of hospital-substitute treatment where a benefit is paid from a private health insurer.

Referred services

For referred services to which items 11716, 11717, 11723 or 11735 apply, the specialist or consultant physician who renders the service must:

(i)   manage the ongoing care of the patient; or
(ii)  perform an attendance to determine that testing is necessary, where the need for the test has not otherwise been scheduled; or
(iii) perform an attendance immediately after the test has been performed, at which clinical management decisions are discussed with the patient.

A service is taken to be referred if the specialist or consultant physician who renders the service to which items 11716, 11717, 11723 or 11735 applies is the patient’s treating practitioner, determines the need for a cardiac investigation that has not otherwise been scheduled, or performs a scheduled test but also provides an attendance where clinical management decisions are discussed with the patient.  Services in all other circumstances are considered to be requested.

Requested services

(i)   for requested services, items 11716, 11717, 11723 or 11735 do not apply to a service if the rendering specialist or consultant physician has performed a service to which an attendance applies for the same patient on the same day.

(ii)  definition of 'requesting practitioner' when applied to items 11716, 11717, 11723 or 11735 is as follows:

  1. a medical practitioner (other than a specialist or consultant physician) requests that a specialist or consultant physician provide the service.
  2. a specialist or consultant physician requests that a separate specialist or consultant physician provide the service.

Related Items: 11716 11717 11723 11735


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