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Botulinum Toxin Type A Purified Neurotoxin Complex (Botox), intravesical injection of, with cystoscopy, for the treatment of urinary incontinence, including all such injections on any one day, if:

(a)    the urinary incontinence is due to idiopathic overactive bladder in a patient: and

(b)    the patient is at least 18 years of age; and

(c)    the patient has urinary incontinence that is inadequately controlled by at least 2 alternative anti-

    cholinergic agents, as manifested by having experienced at least 14 episodes of urinary incontinence per week

    before commencement of treatment with botulinum toxin; and

(d)    the patient is willing and able to self-catheterise; and

(e)    treatment is not provided on the same occasion as a service mentioned in item 104, 105, 110, 116, 119, 11900 or     11919

For each patient-applicable not more than once except if the patient achieves at least a 50% reduction in urinary incontinence episodes from baseline at any time during the period of 6 to 12 weeks after first treatment

(H)  

Fee: $253.05 Benefit: 75% = $189.80

(See para TN.11.1 of explanatory notes to this Category)

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Telehealth attendance by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) of at least 45 minutes in duration for an initial assessment of a patient with at least 2 morbidities (which may include complex congenital, developmental and behavioural disorders) following referral of the patient to the consultant physician by a referring practitioner, if:

(a) an assessment is undertaken that covers:

     (i) a comprehensive history, including psychosocial history and medication review; and

     (ii) comprehensive multi or detailed single organ system assessment; and

     (iii) the formulation of differential diagnoses; and

(b) a consultant physician treatment and management plan of significant complexity is prepared and provided to the referring practitioner, which involves:

    (i) an opinion on diagnosis and risk assessment; and

    (ii) treatment options and decisions; and

    (iii) medication recommendations; and

(c) an attendance on the patient to which item 110, 116, 119 of the general medical services table or item 91824, 91825, 91826 or 91836 applies did not take place on the same day by the same consultant physician; and

(d) this item, or item 132 of the general medical services table, has not applied to an attendance on the patient in the preceding 12 months by the same consultant physician

Fee: $294.85 Benefit: 85% = $250.65

(See para AN.0.7, AN.40.1 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $500.00

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• Next - Item 92423

Telehealth attendance by a consultant physician in the practice of the consultant physician’s specialty (other than psychiatry) of at least 20 minutes in duration after the first attendance in a single course of treatment for a review of a patient with at least 2 morbidities (which may include complex congenital, developmental and behavioural disorders) if:

(a) a review is undertaken that covers:

    (i) review of initial presenting problems and results of diagnostic investigations; and

    (ii) review of responses to treatment and medication plans initiated at time of initial consultation; and

    (iii) comprehensive multi or detailed single organ system assessment; and

    (iv) review of original and differential diagnoses; and

(b) the modified consultant physician treatment and management plan is provided to the referring practitioner, which involves, if appropriate:

     (i) a revised opinion on the diagnosis and risk assessment; and

     (ii) treatment options and decisions; and

     (iii) revised medication recommendations; and

(c) an attendance on the patient to which item 110, 116, 119 of the general medical services table or 91824, 91825, 91826 or 91836 applies did not take place on the same day by the same consultant physician; and

(d) item 132 of the general medical services table or item 92422 applied to an attendance claimed in the preceding 12 months; and

(e) the attendance under this item is claimed by the same consultant physician who claimed item 132 of the general medical services table or 92422; and

(f) this item, or item 133 of the general medical services table has not applied more than twice in any 12 month period

Fee: $147.65 Benefit: 85% = $125.55

(See para AN.0.7, AN.40.1 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $442.95

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• Next - Item 92434

Telehealth attendance of more than 60 minutes in duration by a consultant physician or specialist in the practice of the consultant physician’s or specialist’s specialty of geriatric medicine, if:

(a) the patient is at least 65 years old and referred by a medical practitioner practising in general practice (not including a specialist or consultant physician) or a participating nurse practitioner; and

(b) the attendance is initiated by the referring practitioner for the provision of a comprehensive assessment and management plan; and

(c) during the attendance:

    (i) all relevant aspects of the patient’s health are evaluated in detail using appropriately validated assessment tools if indicated (the assessment); and

    (ii) the patient’s various health problems and care needs are identified and prioritised (the formulation); and

    (iii) a detailed management plan is prepared (the management plan) setting out:

        (A) the prioritised list of health problems and care needs; and

        (B) short and longer term management goals; and

        (C) recommended actions or intervention strategies to be undertaken by the patient’s general practitioner or another relevant health care provider that are likely to improve or maintain health status and are readily available and acceptable to the patient and the patient’s family and carers; and

    (iv) the management plan is explained and discussed with the patient and, if appropriate, the patient’s family and any carers; and

    (v) the management plan is communicated in writing to the referring practitioner; and

(d) an attendance to which item 104, 105, 107, 108, 110, 116, 119 of the general medical services table or item, 91822, 91823, 91833, 91824, 91825, 91826 or 91836 applies has not been provided to the patient on the same day by the same practitioner; and

(e) an attendance to which this item or item 145 of the general medical services table applies has not been provided to the patient by the same practitioner in the preceding 12 months

Fee: $505.70 Benefit: 85% = $429.85

Extended Medicare Safety Net Cap: $500.00

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• Next - Item 92624

Telehealth attendance of more than 30 minutes in duration by a consultant physician or specialist in the practice of the consultant physician’s or specialist’s specialty of geriatric medicine to review a management plan previously prepared by that consultant physician or specialist under item 141, 92623 or 145, if:

(a) the review is initiated by the referring medical practitioner practising in general practice or a participating nurse practitioner; and

(b) during the attendance:

     (i) the patient’s health status is reassessed; and

     (ii) a management plan prepared under item 141, 92623 or 145 is reviewed and revised; and

     (iii) the revised management plan is explained to the patient and (if appropriate) the patient’s family and any carers and communicated in writing to the referring practitioner; and

(c) an attendance to which item 104, 105, 107, 108, 110, 116, 119 of the general medical services table or item 91822, 91823, 91833, 91824, 91825, 91826 or 91836 applies was not provided to the patient on the same day by the same practitioner; and

(d) an attendance to which item 141 or 145 of the general medical services table or item 92623 applies has been provided to the patient by the same practitioner in the preceding 12 months; and

(e) an attendance to which this item, or item 147 of the general medical services table applies has not been provided to the patient in the preceding 12 months, unless there has been a significant change in the patient’s clinical condition or care circumstances that requires a further review

Fee: $316.15 Benefit: 85% = $268.75

Extended Medicare Safety Net Cap: $500.00

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• Next - Item 92701