Medicare Benefits Schedule - Note DN.1.19

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Category 2 - DIAGNOSTIC PROCEDURES AND INVESTIGATIONS

DN.1.19

Retinal Photography with a Non-Mydriatic Retinal Camera

This service is separated into two items, MBS item 12325 and MBS item 12326, in line with NHMRC guidelines' recommended frequency of repeat testing in persons of Aboriginal andTorres Strait Islander descent and the general population. 

This item is intended for the provision of retinal photography with a non-mydriatic retinal camera.  Mydriasis is permitted if adequate photographs cannot be obtained through an undiated pupil. 

Presenting distance vision means unaided distance vision or the vision obtained with the current spectacles or contact lenses, if normally worn for distance vision. 

Detection of any diabetic retinopathy should be followed by referral to an optometrist or ophthalmologist in accordance with the NHMRC guidelines. 

Where images are inadequate quality for detection of diabetic retinopathy, referral to an optometrist or ophthalmologist for further assessment is indicated.

Any element(s) of the service may be performed by appropriately trained or qualified personnel under the direction of the medical practitioner co-ordinating the patient’s care, who retains overall responsibility for claiming of the service. 

Related Items: 12325 12326


Related Items

Category 2 - DIAGNOSTIC PROCEDURES AND INVESTIGATIONS

12325

12325 - Additional Information

Item Start Date:
01-Nov-2016
Description Start Date:
01-Nov-2016
Schedule Fee Start Date:
01-Nov-2016

Assessment of visual acuity and bilateral retinal photography with a non mydriatic retinal camera, including analysis and reporting of the images for initial or repeat assessment for presence or absence of diabetic retinopathy, in a patient with medically diagnosed diabetes, if:

(a)    the patient is of Aboriginal and Torres Strait Islander descent; and

(b)    the assessment is performed by the medical practitioner (other than an optometrist or ophthalmologist) providing

    the primary glycaemic management of the patient's diabetes; and

(c)    this item and item 12326 have not applied to the patient in the preceding 12 months; and

(d)    the patient does not have:

    (i)    an existing diagnosis of diabetic retinopathy; or

    (ii)    visual acuity of less than 6/12 in either eye; or

    (iii) a difference of more than 2 lines of vision between the 2 eyes at the time of presentation

Fee: $50.00 Benefit: 75% = $37.50 85% = $42.50

(See para DN.1.19 of explanatory notes to this Category)

Category 2 - DIAGNOSTIC PROCEDURES AND INVESTIGATIONS

12326

12326 - Additional Information

Item Start Date:
01-Nov-2016
Description Start Date:
01-Nov-2016
Schedule Fee Start Date:
01-Nov-2016

Assessment of visual acuity and bilateral retinal photography with a non-mydriatic retinal camera, including analysis and reporting of the images for initial or repeat assessment for presence or absence of diabetic retinopathy, in a patient with medically diagnosed diabetes, if:

(a)    the assessment is performed by the medical practitioner (other than an optometrist or ophthalmologist) providing

    the primary glycaemic management of the patient's diabetes; and

(b)    this item and item 12325 have not applied to the patient in the preceding 24 months; and

(c)    the patient does not have:

    (i)    an existing diagnosis of diabetic retinopathy; or

    (ii)    visual acuity of less than 6/12 in either eye; or

    (iii)    a difference of more than 2 lines of vision between the 2 eyes at the time of presentation

Fee: $50.00 Benefit: 75% = $37.50 85% = $42.50

(See para DN.1.19 of explanatory notes to this Category)


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