Medicare Benefits Schedule - Note MN.14.18

Item 82206 applies when a procedure outlined in item 82201 or 82202 has commenced, but is then discontinued for clinical reasons, or for other reasons that are beyond the participating nurse practitioner’s control.

Item 82206 is a derived fee item. It applies half of the schedule fee for the item it is billed with.

Examples of commenced procedure for LARC

Commenced procedure for IUD insertion means:

• The patient is in the procedure room or on the bed where the procedure is to be performed; and
• The patient has been exposed (i.e. clothing removed) and positioned on the bed where the procedure is to be performed; and
• Sterile equipment has been opened; and
• Attempts at speculum insertion have been made.

Commenced procedure for Implanon removal means:

• The patient is in the procedure room or on the bed where the procedure is to be performed; and
• The patient has been exposed (i.e. clothing removed) and positioned on the bed where the procedure is to be performed; and
• Sterile equipment has been opened; and
• Local anaesthetic has been infiltrated.

Additional information

Services Australia does not require claims for this item to be accompanied by details of the proposed procedure and the reasons why the procedure was discontinued. However, the participating nurse practitioner must maintain a clinical record of this information, which may be subject to audit.

82203 is not subject to the discontinued procedure rule.

Related Items: 82201 82202 82206

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Introduction of an intra-uterine device for abnormal uterine bleeding or contraception or for endometrial protection during oestrogen replacement therapy

(Anaes.)

Fee: $215.95 Benefit: 75% = $162.00 85% = $183.60

(See para MN.14.17, MN.14.18, MN.14.19 of explanatory notes to this Category)

Removal of etonogestrel subcutaneous implant

(Anaes.)

Fee: $105.15 Benefit: 75% = $78.90 85% = $89.40

(See para MN.14.17, MN.14.18, MN.14.19 of explanatory notes to this Category)

A procedure, being a service to which an item in Subgroup 4 of Group M14 would have applied had the procedure not been discontinued on clinical grounds, other than a service to which 82203 applies

50% of the fee which would have applied had the procedure not been discontinued

(See para MN.14.17, MN.14.18 of explanatory notes to this Category)