Medicare Benefits Schedule - Item 12272

Search Results for Item 12272

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Category 2 - DIAGNOSTIC PROCEDURES AND INVESTIGATIONS

12272 New

12272 - Additional Information

Item Start Date:
01-Nov-2018
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Nov-2018

Group
D1 - Miscellaneous Diagnostic Procedures And Investigations
Subgroup
10 - Other Diagnostic Procedures And Investigations

Maintenance of wakefulness test for the assessment of the ability to maintain wakefulness for a patient less than 12 years of age, if:

(a) a qualified sleep medicine practitioner determines that testing to objectively confirm the ability to maintain wakefulness is necessary; and

(b) an overnight diagnostic assessment of sleep, for a period of at least 8 hours duration where there is continuous monitoring of oxygen saturation and breathing using a multi‑channel polygraph, and recordings of the following are made, in accordance with current professional guidelines:

(i) airflow;

(ii) continuous EMG;

(iii) ECG;

(iv) EEG (with a minimum of 4 EEG leads or, in selected investigations, a minimum of 6 EEG leads);

(v) EOG;

(vi) oxygen saturation;

(vii) respiratory movement of rib and abdomen (whether movement of rib is recorded separately from, or together with, movement of abdomen);

(viii) measurement of carbon dioxide (either end‑tidal or transcutaneous); and

(c) immediately following the overnight investigation, a daytime investigation is performed where at least 4 wakefulness trials are conducted, during which there is continuous recording of EEG, EMG, EOG and ECG; and

(d) a sleep technician is in continuous attendance under the supervision of a qualified sleep medicine practitioner; and

(e) polygraphic records are:

(i) analysed (for assessment of sleep stage, arousals, respiratory events, cardiac abnormalities and limb movements) with manual scoring, or manual correction of computerised scoring in epochs of not more than 1 minute; and

(ii) stored for interpretation and preparation of report; and

(f) interpretation and preparation of a permanent report is provided by a qualified sleep medicine practitioner with personal direct review of raw data from the original recording of polygraphic data from the patient; and

(g) the diagnostic assessment is not provided to the patient on the same occasion that a service mentioned in any of items 11003, 12210, 12215 or 12268 is provided to the patient

Applicable only once in a 12 month period

Fee: $1,027.55 Benefit: 75% = $770.70 85% = $944.15

(See para DN.1.23 of explanatory notes to this Category)


Associated Notes

Category 2 - DIAGNOSTIC PROCEDURES AND INVESTIGATIONS

DN.1.23

Multiple sleep latency testing and Maintenance of wakefulness testing

Determination of the need for testing and testing procedures should be performed in accordance with current Australasian Sleep Association guidelines. Not to be used as part of an occupational health service or pre-employment assessment.

The date of service for the purposes of items 12254 to 12272 is deemed to be the day on which the daytime investigation component of the test is completed. Billing for the service must only occur once all of the requirements of the item have been fulfilled.

Related Items: 12254 12258 12261 12265 12268 12272


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