Medicare Benefits Schedule - Item 38272

Search Results for Item 38272

View Associated Notes

Category 3 - THERAPEUTIC PROCEDURES

38272

38272 - Additional Information

Item Start Date:
01-Nov-2005
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Nov-2023

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

Atrial septal defect or patent foramen closure:

(a) for congenital heart disease in a patient with documented evidence of right heart overload or paradoxical embolism; and

(b) using a septal occluder or similar device, by transcatheter approach; and

(c) including right or left heart catheterisation (or both);

other than a service associated with a service to which item 38200, 38203, 38206 or 38254 applies

Multiple Operation Rule

(Anaes.) (Assist.)

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

(See para TN.8.221 of explanatory notes to this Category)


Associated Notes

Category 3 - THERAPEUTIC PROCEDURES

TN.8.221

Paediatric conditions exemption

Claiming Guidance

This item may be claimed without evidence of right heart overload in highly rare paediatric conditions such as abnormal development of the right heart. Additionally, in patients under 16 years old, risk of paradoxical embolism is sufficient.

Related Items: 38272


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