Medicare Benefits Schedule - Item 38286

Search Results for Item 38286

View Associated Notes

Category 3 - THERAPEUTIC PROCEDURES

38286

38286 - Additional Information

Item Start Date:
01-Nov-2004
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2021

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

Removal of implantable ECG loop recorder

Multiple Operation Rule

(Anaes.)

Fee: $144.60 Benefit: 75% = $108.45 85% = $122.95

(See para TN.8.211 of explanatory notes to this Category)


Associated Notes

Category 3 - THERAPEUTIC PROCEDURES

TN.8.211

In and Out of Hospital

Claiming Guidance

  • The service to which item 38285 applies may be claimed for the insertion of an implanted loop recorder (ILR) rendered to a patient as part of an episode of hospital treatment, including services provided in hospital outpatient settings.
  • Private health insurers are required to pay benefits for products listed on the Prostheses List, if the product is rendered to a patient with the appropriate level of cover, as part of an episode of hospital treatment or hospital substitute treatment.
  • When the ILR is inserted in the outpatient setting (the specialist or consultant physicians private rooms/clinic) the private insurer may opt to cover the cost of the device, but is not required to do so.

 

 

Related Items: 38285 38286


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