Combination Billing Tips for MBS Item 23

MBS Item 23 is designed for GP consultations lasting between 6 and 20 minutes. It applies to various services such as patient history-taking, clinical examinations, arranging investigations, and providing preventive healthcare.

What Does MBS Item 23 Cover?

GP consultations under MBS Item 23 include:

• Patient History: Collecting relevant medical history.

• Clinical Examination: Performing necessary physical checks.

• Investigations: Ordering tests or referrals for further diagnosis.

• Management Plans: Implementing strategies to manage one or more health-related issues.

• Preventive Care: Offering advice and preventive healthcare services.

Time-Based MBS Items for General Attendance

‍To bill consultations accurately, select the appropriate item number based on consultation length:

• Item 3: Less than 6 minutes.

• Item 23: 6 to 20 minutes.

• Item 36: 20 to 40 minutes.

• Item 44: 40 to 60 minutes.

• Item 123: Over 60 minutes (new addition).

‍Combination Billing with MBS Item 23

‍MBS Item 23 allows for combination billing with other services, except care plan items (721, 723, 732).

‍Example: A patient presents with chest pain. You can bill:

• Item 23: General consultation.

• Item 11707: ECG for diagnostic purposes.

Ensure compliance by avoiding co-claims with care plan items.Key Tips for GPs

         1. Explore Alternatives First

• Consider whether another item (e.g., 36 or 44) better reflects the length and complexity of the consultation.

         2. Use Combination Billing

• Co-claim services where appropriate to reflect the full scope of care provided during a consultation.

         3. Stay Updated

• Keep up with the latest MBS explanatory notes to maintain compliance and improve billing efficiency.

         4. Document Thoroughly

• Accurate documentation is essential to meet Medicare requirements and ensure high-quality patient care.

Conclusion

‍MBS Item 23 is essential for accurately billing GP consultations between 6 to 20 minutes, offering flexibility for various healthcare services. By choosing the correct item number, using combination billing when applicable, and ensuring proper documentation, GPs can enhance both compliance and patient care.