Medicare Benefits Schedule - Item 51312

Assistance at any interventional obstetric procedure covered by items 16606, 16609, 16612, 16615 and 16627

one fifth of the established fee for the procedure or combination of procedures

(See para TN.4.11, TN.9.1 of explanatory notes to this Category)

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For Items 16600 to 16627, 35518 and 35674 there is no component in the Schedule fee for the associated ultrasound.  Benefits are attracted for the ultrasound under the appropriate items in Group I1 of the Diagnostic Imaging Services Table.  If diagnostic ultrasound is performed on a separate occasion to the procedure, benefits would be payable under the appropriate ultrasound item.

Item 51312 provides a benefit for assistance by a medical practitioner at interventional techniques covered by Items 16606, 16609, 16612, 16615, and 16627. 

Related Items: 16600 16603 16606 16609 16612 16615 16618 16621 16624 16627 35518 35674 51312

Items covering operations which are eligible for benefits for surgical assistance have been identified by the inclusion of the word "Assist." in the item description.  Medicare benefits are not payable for surgical assistance associated with procedures which have not been so identified.

The assistance must be rendered by a medical practitioner other than the surgeon, the anaesthetist or the assistant anaesthetist.

Where more than one practitioner provides assistance to a surgeon no additional benefits are payable.  The assistance benefit payable is the same irrespective of the number of practitioners providing surgical assistance.

NOTE: The Benefit in respect of assistance at an operation is not payable unless the assistance is rendered by a medical practitioner other than the anaesthetist or assistant anaesthetist.  The amount specified is the amount payable whether the assistance is rendered by one or more medical practitioners.

Assistance at Multiple Operations

Where surgical assistance is provided at two or more operations performed on a patient on the one occasion the multiple operation formula is applied to all the operations to determine the surgeon's fee for Medicare benefits purposes.  The multiple-operation formula is then applied to those items at which assistance was rendered and for which Medicare benefits for surgical assistance is payable to determine the abated fee level for assistance.  The abated fee is used to determine the appropriate Schedule item covering the surgical assistance (ie either Item 51300 or 51303). 

The derived fee applicable to Item 51303 is calculated on the basis of one-fifth of the abated Schedule fee for the surgery which attracts an assistance rebate.

Surgeons Operating Independently

Where two surgeons operate independently (ie neither assists the other or administers the anaesthetic) the procedures they perform are considered as two separate operations, and therefore, where a surgical assistant is engaged by each, or one of the surgeons, benefits for surgical assistance are payable in the same manner as if  the surgeons were operating separately.

Related Items: 51300 51303 51306 51309 51312 51315 51318