Medicare Benefits Schedule - Item 38270

Search Results for Item 38270

View Associated Notes

Category 3 - THERAPEUTIC PROCEDURES

38270

38270 - Additional Information

Item Start Date:
01-May-1997
Description Updated:
01-Nov-2004
Schedule Fee Updated:
01-Nov-2023

Group
T8 - Surgical Operations
Subgroup
6 - Cardio-Thoracic
Subheading
1 - Cardiology Procedures

BALLOON VALVULOPLASTY OR ISOLATED ATRIAL SEPTOSTOMY, including cardiac catheterisations before and after balloon dilatation

Multiple Operation Rule

(Anaes.) (Assist.)

Fee: $1,004.15 Benefit: 75% = $753.15 85% = $905.45

(See para TN.8.278 of explanatory notes to this Category)


Associated Notes

Category 3 - THERAPEUTIC PROCEDURES

TN.8.278

Balloon valvuloplasty co-claiming restriction with Transcatheter Aortic Valve Implantation (TAVI) items

The services performed under TAVI items (38495, 38514 and 38522) are complete medical services and include balloon valvuloplasty as part of the TAVI procedural service. MBS item 38270 for balloon valvuloplasty cannot be co-claimed with the TAVI items for the same occasion of service.

Accompanying text is required for claims where a TAVI item and item 38270 are performed on the same day at separate occasions. Suitable texts could include "separate attendances" or "10 AM and 3PM".

Providers are legally responsible for services billed under their provider number or their own name. This includes any incorrect billing of services that result in overpayment of Medicare benefits, regardless of who does the billing or receives the benefit.

Related Items: 38270 38495 38514 38522


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