Medicare Benefits Schedule - Item 11704

Search Results for Item 11704

View Associated Notes

Category 2 - DIAGNOSTIC PROCEDURES AND INVESTIGATIONS

11704

11704 - Additional Information

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

Group
D1 - Miscellaneous Diagnostic Procedures And Investigations
Subgroup
6 - Cardiovascular

Twelve‑lead electrocardiography, trace and formal report, by a specialist or a consultant physician, if the service:

(a) is requested by a requesting practitioner; and

(b) is not associated with a service to which item 12203, 12204, 12205, 12207, 12208, 12210, 12213, 12215, 12217 or 12250 applies.

Note: the following are also requirements of the service:

  1. a formal report is completed; and
  2. a copy of the formal report is provided to the requesting practitioner; and
  3. the service is not provided to the patient as part of an episode of hospital treatment or hospital-substitute treatment; and
  4. is not provided in association with an attendance item (Part 2 of the schedule); and
  5. the specialist or consultant physician who renders the service does not have a financial relationship with the requesting practitioner.

Fee: $34.40 Benefit: 85% = $29.25

(See para DN.1.31, DR.1.4 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $25.80


Associated Notes

Category 2 - DIAGNOSTIC PROCEDURES AND INVESTIGATIONS

DN.1.31

ECG Report (Items 11704 and 11705)

The formal report is separate to any letter and entails interpretation of the trace commenting on the significance of the trace findings and their relationship to clinical decision making for the patient in their clinical context, in addition to any measurements taken or automatically generated.

 

Related Items: 11704 11705

Category 2 - DIAGNOSTIC PROCEDURES AND INVESTIGATIONS

DR.1.4

12-lead electrocardiography requirements for claiming

There are four 12-lead electrocardiography items:

·         Item 11704 for a trace and formal report service performed by a specialist or consultant physician.

·         Item 11705 for a formal report service performed by a specialist or consultant physician, where the specialist reports on a trace.

·         Item 11707 for a trace service performed by a medical practitioner.

·         Item 11714 for trace and clinical note service performed by a specialist or consultant physician.

Admitted patient

Items 11704, 11707 and 11714 do not apply where the patient is an “admitted patient” of a hospital. An “admitted patient” includes an episode of hospital treatment and an episode of hospital-substitute treatment where a benefit is paid from a private health insurer. Item 11705 can be performed out-of-hospital or for admitted hospital patients.

Requested service

a) Items 11704 and 11705 are requested services which require the rendering specialist or consultant physician to produce a written formal report which must be provided to the requesting practitioner. The rendering specialist or consultant physician cannot perform the service unless it has been requested by another medical practitioner.

b) As a requested service, it is generally not expected that items 11704 or 11705 would involve any clinical work beyond performing the formal report (and the trace for item 11704). The MBS Review Taskforce recommended that an attendance should not be co-claimed with a diagnostic cardiac investigation in these circumstances. Item 11704 cannot be claimed if the rendering specialist or consultant physician has performed an attendance on the same patient on the same day.

Generally, it is expected that item 11705 should not be co-claimed with an attendance, but in exceptional clinical circumstances an attendance can be performed i.e. an admitted patient requires a formal report (on a trace) to be provided by a cardiologist and the result of this reporting determines that an urgent attendance (life threatening) is required by the cardiologist to guide immediate treatment (particularly when there is only one cardiologist rostered on the shift).

Financial relationship

The rendering specialist or consultant physician and the requesting practitioner cannot have a financial relationship. Definition of ‘financial relationship’: is where the requesting practitioner is a member of a group of practitioners of which the providing practitioners is a member (both the requestor and provider potentially financially benefit from the MBS service provided). The need for a request should be informed by a clinical decision only.

Item 11707

Item 11707 is a trace only service and can be performed by any medical practitioner.

Item 11714

Item 11714 allows specialist and consultant physicians to perform an electrocardiography trace and interpret the results (in the form of producing a written clinical note) where they consider it necessary for the management or treatment of the patient. No request is required for this service. There is no limitation on the claiming of an attendance with item 11714, as the Taskforce agreed that performance of an electrocardiography was part of routine assessment for patients presenting to specialist and consultant physicians for management of their cardiac condition.

Related Items: 11704 11705 11707 11714


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