Medicare Benefits Schedule - Item 11730

Multi channel electrocardiogram monitoring and recording during exercise (motorised treadmill or cycle ergometer capable of quantifying external workload in watts), if:

(a) the patient is less than 17 years; and

(b) the patient:

(i) has symptoms consistent with cardiac ischemia; or

(ii) has other cardiac disease which may be exacerbated by exercise; or

(iii) has a first degree relative with suspected heritable arrhythmia; and

(c) the monitoring and recording:

(i) is not less than 20 minutes in duration; and

(ii) includes resting electrocardiogram; and

(d) a written report is produced by a medical practitioner that includes interpretation of the monitoring and recording data, commenting on the significance of the data, and the relationship of the data to clinical decision making for the patient in the clinical context; and

(e) the service is not a service:

(i) provided on the same occasion as a service to which item 11704, 11705, 11707 or 11714 applies; or

(ii) performed within 24 months of a service to which item 55141, 55143, 55145, 55146, 61324, 61329, 61345, 61349, 61357, 61394, 61398, 61406, 61410 or 61414 applies

 Applicable only once in any 24 month period

Fee: $182.15 Benefit: 75% = $136.65 85% = $154.85

(See para DN.1.30, DR.1.3 of explanatory notes to this Category)

• Previous - Item 11729
• Next - Item 11731

Indications interpretation

Heritable arrhythmias include those defined in the CSANZ guidelines for the diagnosis and management of catecholaminergic polymorphic ventricular tachycardia, familial long QT syndrome and genetic investigation of young sudden unexplained death and resuscitated out of hospital cardiac arrest.

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.

Paediatric Investigation and Consultation

For investigations performed by a specialist paediatric cardiologist, co-claiming of a consultation with the investigation is permitted even when a consultation was not specifically requested when:

• the paediatric patient was referred for an investigation; and
• the paediatric patient was not known to the provider; and
• the paediatric patient was not under the care of another paediatric cardiologist; and
• the findings on the investigation appropriately warranted a consultation.

Related Items: 11730

These services can be performed as an out-of-hospital service, hospital treatment or hospital-substitute treatment. 

Items 11729, 11730 and 11732 do not apply to a service unless:

   (i)   the patient’s body habitus, or other physical condition, is suitable for exercise stress testing or pharmacological induced stress testing; and

   (ii)  the patient can complete the exercise sufficiently or respond adequately to pharmacological induced stress, to take the required measurements; and

Items 11729 and 11730 do not apply to a service performed on a patient who is asymptomatic and has a normal cardiac examination.

Attendances and Exercise ECG stress testing 

(1) An item in Part 2 of this Schedule does not apply to a service (the attendance service) provided by a specialist, consultant physician or medical practitioner to a patient on a day if an electrocardiogram service to which item 11729 or 11732 applies is provided by the specialist, consultant physician or medical practitioner to the patient on the same day.

 (2) Subclause (1) does not apply if:

 (a) the patient has been referred to the specialist, consultant physician or medical practitioner; or

 (b) the patient is being provided with ongoing care by the specialist, consultant physician or medical practitioner; or

 (c) both of the following apply:

 (i) another medical practitioner has requested the electrocardiogram service;

 (ii) the attendance service is provided at the same time as, or after, the electrocardiogram service and is required because there is an urgent clinical need to make decisions about the patient’s care as a result of the electrocardiogram service.

Exercise testing and cardiopulmonary resuscitation

1. Items 11729, 11730 and 11732 apply to a service provided to a patient only if:

           (a) the service is performed on premises equipped with resuscitation equipment, including a defibrillator; and

           (b) a person trained in the matters mentioned in subclause (2) and cardiopulmonary resuscitation is in continuous personal attendance during the monitoring and recording; and

           (c) at the time the service is performed, a second person trained in cardiopulmonary resuscitation is located at the premises and is immediately available to respond if required; and

           (d) at least one of the persons mentioned in paragraphs (b) and (c) is a medical practitioner

       2. For the purposes of paragraph (1)(b), the matters are:

           (a) how to safely perform exercise or pharmacological stress monitoring and recording; and

           (b) how to recognise the symptoms and signs of cardiac disease.

The Taskforce recommended changes to the performance of exercise or pharmacological electrocardiogram stress testing for optimal patient safety. For a service to be performed, the person performing the monitoring and recording must be:

1. in continuous attendance; and
2. trained in “exercise testing” and cardiopulmonary resuscitation; and
3. A second person trained in cardiopulmonary resuscitation must be located at the premise and available to attend the electrocardiogram stress testing in an emergency.

Please refer to the Cardiac Society of Australia and New Zealand position statement on clinical exercise stress testing: https://www.csanz.edu.au/

Related Items: 11729 11730 11732