Medicare Benefits Schedule - Note IN.1.3

Indications

Examples of other rare but acceptable indications include (but are not limited to): sudden death of an immediate relative, prior to the commencement of specific drugs which require cardiac monitoring, and for patients scheduled for cardiac surgery who have not previously had an echocardiogram.

Providers

Providers of this item number should meet the Level 1 requirements described in the Cardiac Society of Australia & New Zealand Guidelines for Training and Performance in Adult Echocardiography or equivalent. https://www.csanz.edu.au/wp-content/uploads/2015/04/Adult-Echo_2015-February.pdf

Results

Discussions of the results, findings or interpretation of a study are reasonably expected to be part of a formal report. Discussion of these findings with a patient does not constitute a consult. Similarly, discussion(s) during the course of a study or to determine the safety or appropriateness of the study is part of the service and should not be claimed as a consult.

Related Items: 55126

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Bulk bill incentive

Note: the service only applies if the patient meets the requirements of the descriptor and the requirements of Note: IR.1.2

Initial real time transthoracic echocardiographic examination of the heart with real time colour flow mapping from at least 3 acoustic windows, with recordings on digital media, if the service:

(a) is for the investigation of any of the following:

(i) symptoms or signs of cardiac failure;

(ii) suspected or known ventricular hypertrophy or dysfunction;

(iii) pulmonary hypertension;

(iv) valvular, aortic, pericardial, thrombotic or embolic disease;

(v) heart tumour;

(vi) symptoms or signs of congenital heart disease;

(vii) other rare indications; and

(b) is not associated with a service to which:

(i) another item in this Subgroup applies (except items 55137, 55141, 55143, 55145 and 55146); or

(ii) an item in Subgroup 2 applies (except items 55118 and 55130); or

(iii) an item in Subgroup 3 applies

Applicable not more than once in a 24 month period (R)

Fee: $249.95 Benefit: 75% = $187.50 85% = $212.50

(See para IN.0.19, IN.1.3, IN.7.1, IR.1.2, IR.1.3 of explanatory notes to this Category)