Medicare Benefits Schedule - Item 2504

Search Results for Item 2504

View Associated Notes

Level C

Professional attendance by a general practitioner (not being a service to which any other item in this table applies) lasting at least 20 minutes, including any of the following that are clinically relevant:

f)     taking a detailed patient history;

g)     performing a clinical examination;

h)     arranging any necessary investigation;

i)     implementing a management plan;

j)     providing appropriate preventive health care;

in relation to 1 or more health-related issues, with appropriate documentation


and at which a cervical screening test is taken from a person at least 24 years and 9 months of age but is less than 75 years of age, who has not had a cervical screening test in the last 4 years.

Category 1 - PROFESSIONAL ATTENDANCES

2504

2504 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-Dec-2017
Schedule Fee Start Date:
01-Jul-2014

Group
A18 - General Practitioner Attendance Associated With Pip Incentive Payments
Subgroup
1 - Taking Of A Cervical Smear From An Unscreened Or Significantly Underscreened Person
Subheading
3 - Level C

Professional attendance by a general practitioner at consulting rooms, lasting at least 20 minutes and including any of the following that are clinically relevant:

(a) taking a detailed patient history;

(b) performing a clinical examination;

(c) arranging any necessary investigation;

(d) implementing a management plan;

(e) providing appropriate preventive health care;

for one or more health-related issues, with appropriate documentation, and at which a specimen for a cervical screening service is collected from the patient, if the patient is at least 24 years and 9 months of age but is less than 75 years of age and has not been provided with a cervical screening service or a cervical smear service in the last 4 years

Fee: $71.70 Benefit: 100% = $71.70

(See para AN.0.9, AN.0.53 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $215.10


Associated Notes

Category 1 - PROFESSIONAL ATTENDANCES

AN.0.9

Attendances by General Practitioners (Items 3 to 51, 193, 195, 197, 199, 585, 594, 599, 2497-2559 and 5000-5067)

Attendances by General Practitioners (Items 3 to 51, 193, 195, 197, 199, 585, 594, 599, 2497-2559 and 5000-5067)

Items 3 to 51 and 193, 195, 197, 199, 585, 594, 599, 2497-2559 and 5000-5067 relate to attendances rendered by medical practitioners who are:

-          listed on the Vocational Register of General Practitioners maintained by the Department of Human Services; or

-          holders of the Fellowship of the Royal Australian College of General Practitioners (FRACGP) who participate in, and meet the requirements of the RACGP for continuing medical education and quality assurance as defined in the RACGP Quality Assurance and Continuing Medical Education program; or

-          holders of the Fellowship of the Australian College of Rural and Remote Medicine (FACRRM) who participate in, and meet the requirements of the Australian College of Rural and Remote Medicine (ACRRM) for continuing medical education and quality assurance as defined in ACRRM's Professional Development Program; or

-          undertaking an approved placement in general practice as part of a training program for general practice leading to the award of the FRACGP or training recognised by the RACGP as being of an equivalent standard; or

-          undertaking an approved placement in general practice as part of a training program for general practice leading to the award of the FACRRM or training recognised by ACRRM as being of an equivalent standard.

 

To assist general practitioners in selecting the appropriate item number for Medicare benefit purposes the following notes in respect of the various levels are given.

 

LEVEL A

A Level A item will be used for obvious and straightforward cases and this should be reflected in the practitioner's records.  In this context, the practitioner should undertake the necessary examination of the affected part if required, and note the action taken.

 

LEVEL B

A Level B item will be used for a consultation lasting less than 20 minutes for cases that are not obvious or straightforward in relation to one or more health related issues.  The medical practitioner may undertake all or some of the tasks set out in the item descriptor as clinically relevant, and this should be reflected in the practitioner's record.  In the item descriptor singular also means plural and vice versa.

 

LEVEL C

A Level C item will be used for a consultation lasting at least 20 minutes for cases in relation to one or more health related issues.  The medical practitioner may undertake all or some of the tasks set out in the item descriptor as clinically relevant, and this should be reflected in the practitioner's record.  In the item descriptor singular also means plural and vice versa.

 

LEVEL D

A Level D item will be used for a consultation lasting at least 40 minutes for cases in relation to one or more health related issues.  The medical practitioner may undertake all or some of the tasks set out in the item descriptor as clinically relevant, and this should be reflected in the practitioner's record. In the item descriptor singular also means plural and vice versa.

 

Creating and Updating a Personally Controlled Electronic Health Record (PCEHR)

The time spent by a medical practitioner on the following activities may be counted towards the total consultation time:

· Reviewing a patient's clinical history, in the patient's file and/or the PCEHR, and preparing or updating a Shared Health Summary where it involves the exercise of clinical judgement about what aspects of the clinical history are relevant to inform ongoing management of the patient's care by other providers; or

· Preparing an Event Summary for the episode of care.

Preparing or updating a Shared Health Summary and preparing an Event Summary are clinically relevant activities.  When either of these activities are undertaken with any form of patient history taking and/or the other clinically relevant activities that can form part of a consultation, the item that can be billed is the one with the time period that matches the total consultation time.

 

MBS rebates are not available for creating or updating a Shared Health Summary as a stand alone service.

 

Counselling or Advice to Patients or Relatives

For items 23 to 51 and 5020 to 5067 'implementation of a management plan' includes counselling services.

 

Items 3 to 51 and 5000 to 5067 include advice to patients and/or relatives during the course of an attendance. The advising of relatives at a later time does not extend the time of attendance.

 

Recording Clinical Notes

In relation to the time taken in recording appropriate details of the service, only clinical details recorded at the time of the attendance count towards the time of consultation.  It does not include information added at a later time, such as reports of investigations.

 

Other Services at the Time of Attendance

Where, during the course of a single attendance by a general practitioner, both a consultation and another medical service are rendered, Medicare benefits are generally payable for both the consultation and the other service. Exceptions are in respect of medical services which form part of the normal consultative process, or services which include a component for the associated consultation (see the General Explanatory Notes for further information on the interpretation of the Schedule).

 

The Department of Human Services (DHS) has developed an Health Practitioner Guideline for responding to a request to substantiate that a patient attended a service which is located on the DHS website.

 

Related Items: 3 4 20 23 24 35 36 37 43 44 47 51 193 195 197 199 585 594 599 2497 2501 2503 2504 2506 2507 2509 2517 2518 2521 2522 2525 2546 2547 2552 2558 2559 5000 5003 5010 5020 5023 5028 5040 5043 5049 5060 5063 5067

Category 1 - PROFESSIONAL ATTENDANCES

AN.0.53

Taking a Cervical Screen from a Person who is Unscreened or Significantly Under-screened - (Items 2497 - 2509 and 2598 - 2616)

The item numbers 2497, 2501, 2503, 2504, 2506, 2507, 2509, 2598, 2600, 2603, 2606, 2610, 2613 and 2616 should be used in place of the usual attendance item where as part of a consultation, a sample for cervical screening is collected from a person between the ages of 24 years and 9 months and 74 years inclusive who has not had a cervical smear in the last four years. Cervical Screening in accordance with the National Cervical Screening Policy at P.16.11.

 

Self collection of a sample for screening is only available for women between the ages of 30 and 74 years of age who are overdue for screening by two or more years (i.e. being 4 years since their last Pap test).  Self collection should only be offered to an eligible person who refuses to have a sample collected by their requesting practitioner.

 

When providing this service, the doctor must satisfy themselves that the person has not had a cervical screening test in the last four years by:

 

(a) asking the person if they can remember having a cervical screening test in the last four years;

(b) checking their own practice's medical records; and

(c) checking the National Cancer Screening Register.

  

A person from the following groups are more likely than the general population to be unscreened or significantly underscreened - low socioeconomic status, culturally and linguistically diverse backgrounds, Indigenous communities, rural and remote areas and older people.

 

Vault smears are not eligible for items 2497 - 2509 and 2598 - 2616.

 

 In addition to attracting a Medicare rebate, the use of these items will initiate a Cervical Screening SIP through the PIP.

 

 A PIP Cervical Screening SIP is available for taking a cervical screen from a person who has not been screened in the last for four years.  The SIP will be paid to the medical practitioner who provided the service if the service was provided in a general practice participating in the PIP Cervical Screening Incentive. A further PIP Cervical Screening Incentive payment is paid to practices which reach target levels of cervical screening for their patients aged 24 years and 9 months of age to 74 years inclusive. More detailed information on the PIP Cervical Screening Incentive is available from the Department of Human Services PIP enquiry line on 1800 222 032 or from the Department of Human Services website.

 

Related Items: 2497 2501 2503 2504 2506 2507 2509 2598 2600 2603 2606 2610 2613 2616


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