Appendix B -               Additional items: recommendations list

Item

Descriptor

Recommendation

Page reference

110

Professional attendance at consulting rooms or hospital, by a consultant physician in the practice of his or her specialty (other than psychiatry) following referral of the patient to him or her by a referring practitioner – initial attendance in a single course of treatment.

Change

31

116

Professional attendance at consulting rooms or hospital, by a consultant physician in the practice of his or her specialty (other than psychiatry) following referral of the patient to him or her by a medical practitioner — each attendance (not being a service to which item 119 applies) subsequent to the first in a single course of treatment.

Change

31

132

Professional attendance of at least 45 minutes duration for an initial assessment of a patient with at least two morbidities (this can include complex congenital, developmental and behavioural disorders), where the patient is referred by a referring practitioner, and where a) assessment is undertaken that covers: a comprehensive history, including psychosocial history and medication review; comprehensive multi or detailed single organ system assessment; the formulation of differential diagnoses; and b) a consultant physician treatment and management plan of significant complexity is developed and provided to the referring practitioner that involves: an opinion on diagnosis and risk assessment, treatment options and decisions, medication recommendations; not being an attendance on a patient in respect of whom, an attendance under items 110, 116 and 119 has been received on the same day by the same consultant physician. Not being an attendance on the patient in respect of whom, in the preceding 12 months, payment has been made under this item for attendance by the same consultant physician.

Referred

31

133

Professional attendance of at least 20 minutes duration subsequent to the first attendance in a single course of treatment for a review of a patient with at least two morbidities (this can include complex congenital, developmental and behavioural disorders), where a) a review is undertaken that covers: – review of initial presenting problem/s and results of diagnostic investigations, – review of responses to treatment and medication plans initiated at time of initial consultation comprehensive multi or detailed single organ system assessment, – review of original and differential diagnoses; and b) a modified consultant physician treatment and management plan is provided to the referring practitioner that involves, where appropriate: – a revised opinion on the diagnosis and risk assessment, – treatment options and decisions, – revised medication recommendations, not being an attendance on a patient in respect of whom, an attendance under item 110, 116 and 119 has been received on the same day by the same consultant physician or locum tenens. Being an attendance on a patient in respect of whom, in the preceding 12 months, payment has been made under item 132. Item 133 can be provided by either the same consultant physician or a locum tenens. Payable no more than twice in any 12 month period.

Referred

32

701

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or a consultant physician) to perform a brief health assessment, lasting not more than 30 minutes and including: (a) collection of relevant information, including taking a patient history; and (b) a basic physical examination; and (c) initiating interventions and referrals as indicated; and (d) providing the patient with preventive health care advice and information.

Referred

40

703

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or a consultant physician) to perform a standard health assessment, lasting more than 30 minutes but less than 45 minutes, including: (a) detailed information collection, including taking a patient history; and (b) an extensive physical examination; and (c) initiating interventions and referrals as indicated; and (d) providing a preventive health care strategy for the patient.

Referred

40

705

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or a consultant physician) to perform a long health assessment, lasting at least 45 minutes but less than 60 minutes, including: (a) comprehensive information collection, including taking a patient history; and (b) an extensive examination of the patient’s medical condition and physical function; and (c) initiating interventions and referrals as indicated; and (d) providing a basic preventive health care management plan for the patient.

Referred

40

707

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician) to perform a prolonged health assessment (lasting at least 60 minutes) including: (a) comprehensive information collection, including taking a patient history; and (b) an extensive examination of the patient’s medical condition, and physical, psychological and social function; and (c) initiating interventions or referrals as indicated; and (d) providing a comprehensive preventive health care management plan for the patient.

Referred

40

715

Attendance by a medical practitioner (including a general practitioner, but not including a specialist or consultant physician) at consulting rooms or in another place other than a hospital or residential aged care facility, for a health assessment of a patient who is of Aboriginal or Torres Strait Islander descent – not more than once in a 9 month period.

Referred

40

30390

Laparoscopy, diagnostic, not being a service associated with any other laparoscopic procedure, on a person 10 years of age or over. (Anaes.)

Referred

36

36516

Nephrectomy, complete. (Anaes.) (Assist.)

Referred

36

36531

Nephroureterectomy, complete, including associated bladder repair and any associated endoscopic procedure. (Anaes.) (Assist.)

Referred

36