Medicare Benefits Schedule - Note IN.0.8

In addition to the normal particulars of the patient, date of service, the services performed and the fees charged, the details which must be entered on accounts or receipts, and Medicare assignment of benefits forms in respect of diagnostic imaging services are as follows: 

-          the LSPN of the diagnostic imaging premises or mobile facility where the diagnostic imaging procedure was undertaken; 

-          if the professional service is provided by a specialist in diagnostic radiology the name and either the address of the place of practice, or the provider number, of that specialist; 

-          if the medical practitioner is not a specialist in diagnostic radiology the name and either the practice address or provider number of the practitioner who is claiming or receiving fees;

-          for R-type (requested) services and services rendered subsequent to lost requests, the account or receipt or the Medicare assignment form must indicate the date of the request and the name and provider number, or the name and address, of the requesting practitioner.

-          services that are self-determined must be endorsed with the letters 'SD' to indicate that the service was self-determined.  Services are classified as self-determined when rendered:

-          by a consultant physician or specialist, in the course of that consultant physician or specialist practicing his or her specialty (other than a specialist in diagnostic radiology), or - to provide additional services to those specified in the original request and the additional services are of the type that would have otherwise required a referral from a specialist or consultant physician in a remote area, or

-          under a pre-existing diagnostic imaging practice exemption.

-          substituted services the account etc. must be endorsed 'SS'.

-          emergencies, the account etc. must be endorsed ‘emergency’.

-          lost requests the account etc. must be endorsed ‘lost request’.

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