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Results 11 to 18 of 18 matches

Completion Of A Cycle Of Care For Patients With Established Diabetes Mellitus

The minimum requirements of care to complete an annual Diabetes Cycle of Care for patients with established diabetes mellitus must be completed over a period of at least 11 months and up to 13 months, and must include:


-     Assess diabetes control by measuring HbA1c               At least once every  year

-     Ensure that a comprehensive eye examination is carried out*     At least once every two years

-     Measure weight and height and calculate BMI**               At least twice every cycle of care

-     Measure blood pressure                         At least twice every cycle of care

-     Examine feet***                              At least twice every cycle of care

-     Measure total cholesterol, triglycerides and HDL cholesterol     At least once every year

-     Test for microalbuminuria                         At least once  every year

-     Test for estimated Glomerular Filtration Rate (eGFR)                    At least once every year

-     Provide self-care education                         Patient education regarding diabetes management

-     Review diet                              Reinforce information about appropriate dietary                                                             choices

-     Review levels of physical activity                    Reinforce information about appropriate levels of                                                        physical activity

-     Check smoking status                         Encourage cessation of smoking (if relevant)

-     Review of medication                         Medication review


*     Not required if the patient is blind or does not have both eyes.

**     Initial visit: measure height and weight and calculate BMI as part of the initial patient assessment.

    Subsequent visits: measure weight.

***     Not required if the patient does not have both feet.

Level D

Professional attendance by a general practitioner (not being a service to which any other item in this table applies) lasting at least 40 minutes, including any of the following that are clinically relevant:

a)     taking an extensive patient history;

b)     performing a clinical examination;

c)     arranging any necessary investigation;

d)     implementing a management plan;

e)     providing appropriate preventive health care;

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


AND which completes the minimum requirements of a cycle of care for a patient with established diabetes mellitus.

Category 1 - PROFESSIONAL ATTENDANCES

2525

2525 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-May-2010
Schedule Fee Start Date:
01-Jul-2014

Group
A18 - General Practitioner Attendance Associated With Pip Incentive Payments
Subgroup
2 - Completion Of A Cycle Of Care For Patients With Established Diabetes Mellitus
Subheading
3 - Level D

Professional attendance by a general practitioner at consulting rooms, lasting at least 40 minutes and including any of the following that are clinically relevant:

(a) taking an extensive 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 that completes the minimum requirements of a cycle of care for a patient with established diabetes mellitus



Fee: $105.55 Benefit: 100% = $105.55

(See para AN.0.9, AN.0.54 of explanatory notes to this Category)


Extended Medicare Safety Net Cap: $316.65

Category 1 - PROFESSIONAL ATTENDANCES

2526

2526 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Jul-2014

Group
A18 - General Practitioner Attendance Associated With Pip Incentive Payments
Subgroup
2 - Completion Of A Cycle Of Care For Patients With Established Diabetes Mellitus
Subheading
3 - Level D

Professional attendance by a general practitioner at a place other than consulting rooms, lasting at least 40 minutes and including any of the following that are clinically relevant:

(a) taking an extensive 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 that completes the minimum requirements of a cycle of care for a patient with established diabetes mellitus



The fee for item 2525, plus $25.95 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for 2525 plus $2.00 per patient.
Ready Reckoner

(See para AN.0.54 of explanatory notes to this Category)


Extended Medicare Safety Net Cap: 300% of the Derived fee for this item, or $500, whichever is the lesser amount

Completion Of The Asthma Cycle Of Care

Note: Benefits are payable for only one service included in Subgroup 3 or A19, Subgroup 3 in a 12-month period, unless a further Asthma Cycle of Care is clinically indicated.


At a minimum the Asthma Cycle of Care must include:

- at least 2 asthma related consultations within 12 months for a patient with moderate to severe asthma (at least 1 of which (the review consultation) is a consultation that was planned at a previous consultation)

- documented diagnosis and assessment of level of asthma control and severity of asthma

- review of the patient's use of and access to asthma related medication and devices

- provision to the patient of a written asthma action plan (if the patient is unable to use a written asthma action plan – discussion with the patient about an alternative method of providing an asthma action plan, and documentation of the discussion in the patient's medical records)

- provision of asthma self-management education to the patient

- review of the written or documented asthma action plan.

Level B

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

a)     taking a patient history;

b)     performing a clinical examination;

c)     arranging any necessary investigation;

d)     implementing a management plan;

e)     providing appropriate preventive health care;

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


AND which completes the minimum requirements of the Asthma Cycle of Care.

Category 1 - PROFESSIONAL ATTENDANCES

2546

2546 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-May-2010
Schedule Fee Start Date:
01-Jul-2014

Group
A18 - General Practitioner Attendance Associated With Pip Incentive Payments
Subgroup
3 - Completion Of The Asthma Cycle Of Care
Subheading
1 - Level B

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

(a) taking a 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 that completes the minimum requirements of the Asthma Cycle of Care



Fee: $37.05 Benefit: 100% = $37.05

(See para AN.0.9, AN.0.55 of explanatory notes to this Category)


Extended Medicare Safety Net Cap: $111.15

Category 1 - PROFESSIONAL ATTENDANCES

2547

2547 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Jul-2014

Group
A18 - General Practitioner Attendance Associated With Pip Incentive Payments
Subgroup
3 - Completion Of The Asthma Cycle Of Care
Subheading
1 - Level B

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

(a) taking a 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 that completes the minimum requirements of the Asthma Cycle of Care



The fee for item 2546, plus $25.95 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 2546 plus $2.00 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.55 of explanatory notes to this Category)


Extended Medicare Safety Net Cap: 300% of the Derived fee for this item, or $500, whichever is the lesser amount

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:

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;

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


AND which completes the minimum requirements of the Asthma Cycle of Care.

Category 1 - PROFESSIONAL ATTENDANCES

2552

2552 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-May-2010
Schedule Fee Start Date:
01-Jul-2014

Group
A18 - General Practitioner Attendance Associated With Pip Incentive Payments
Subgroup
3 - Completion Of The Asthma Cycle Of Care
Subheading
2 - 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 that completes the minimum requirements of the Asthma Cycle of Care



Fee: $71.70 Benefit: 100% = $71.70

(See para AN.0.9, AN.0.55 of explanatory notes to this Category)


Extended Medicare Safety Net Cap: $215.10

Category 1 - PROFESSIONAL ATTENDANCES

2553

2553 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Jul-2014

Group
A18 - General Practitioner Attendance Associated With Pip Incentive Payments
Subgroup
3 - Completion Of The Asthma Cycle Of Care
Subheading
2 - Level C

Professional attendance by a general practitioner at a place other than 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 that completes the minimum requirements of the Asthma Cycle of Care



The fee for item 2552, plus $25.95 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 2552 plus $2.00 per patient.
Ready Reckoner

(See para AN.0.55 of explanatory notes to this Category)


Extended Medicare Safety Net Cap: 300% of the Derived fee for this item, or $500, whichever is the lesser amount

Level D

Professional attendance by a general practitioner (not being a service to which any other item in this table applies) lasting at least 40 minutes, including any of the following that are clinically relevant:

a)     taking an extensive patient history;

b)     performing a clinical examination;

c)     arranging any necessary investigation;

d)     implementing a management plan;

e)     providing appropriate preventive health care;

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


AND which completes the minimum requirements of the Asthma Cycle of Care.

Category 1 - PROFESSIONAL ATTENDANCES

2558

2558 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-May-2010
Schedule Fee Start Date:
01-Jul-2014

Group
A18 - General Practitioner Attendance Associated With Pip Incentive Payments
Subgroup
3 - Completion Of The Asthma Cycle Of Care
Subheading
3 - Level D

Professional attendance by a general practitioner at consulting rooms, lasting at least 40 minutes and including any of the following that are clinically relevant:

(a) taking an extensive 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 that completes the minimum requirements of the Asthma Cycle of Care



Fee: $105.55 Benefit: 100% = $105.55

(See para AN.0.9, AN.0.55 of explanatory notes to this Category)


Extended Medicare Safety Net Cap: $316.65

Category 1 - PROFESSIONAL ATTENDANCES

2559

2559 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-Jan-2013
Schedule Fee Start Date:
01-Jul-2014

Group
A18 - General Practitioner Attendance Associated With Pip Incentive Payments
Subgroup
3 - Completion Of The Asthma Cycle Of Care
Subheading
3 - Level D

Professional attendance by a general practitioner at a place other than consulting rooms, lasting at least 40 minutes and including any of the following that are clinically relevant:

(a) taking an extensive 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 that completes the minimum requirements of the Asthma Cycle of Care



The fee for item 2558, plus $25.95 divided by the number of patients seen, up to a maximum of six patients. For seven or more patients - the fee for item 2558 plus $2.00 per patient.
Ready Reckoner

(See para AN.0.9, AN.0.55 of explanatory notes to this Category)


Extended Medicare Safety Net Cap: 300% of the Derived fee for this item, or $500, whichever is the lesser amount

Results 11 to 18 of 18 matches


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