Spotlight on specific service codes

Please take note of these reminders regarding service codes that could apply to your work.Care provider

K731 – Physician to physician telephone consultation (page A39 in the Schedule)

  • Referring physician required for the code, but these encounters are frequently not registered in PCS so SBS can't look up the referring and have to return the claim to the physician 
  • Consultations, assessments, visits or K-prefixed time-based services cannot be claimed on the same day or the next day following the physician-to-physician telephone consultation

 
C142/3 – Subsequent visit by the MRP following transfer from an intensive care area (page GP46 in the schedule)

  • Not allowed on the day the patient is transferred as the physician providing critical care, ventilatory support or comprehensive care will have submitted on that date
  • Example:  
    • September 1 – Physician A bills G401; patient transferred to the ward
    • September 2 – Physician B bills C142 & E083
    • September 3 – Physician B bills C143 & E084