Thank you for your questions.
- Can we go back and process the missed item numbers for 10997? – Answer: Yes, it is permitted. Please see https://generalpracticetraining.com.au/backdated-lodgement-of-bulk-bill-claims-for-medicare-for-item-10997/.
- Can that be billed on the same day as a care plan? – Answer: It is permitted but not recommended to bill 10997 with a Care Plan. It is OK to bill with the review.
- What must be noted in the nurse’s consult notes to justify the billing? – Answer: At a minimum, the notes should contain a record of any intervention related to the goals of the Care Plan, e.g., health education on the topic mentioned in the Care Plan, management of diabetic complications, collecting information for Care Plan review, and monitoring of clinical parameters as planned. I do not see it necessary to write ‘CDM follow-up’ in the notes as it would have no clinical value. However, Medicare may have a different opinion on that. I suggest that from now on, ‘CDM follow up’ be entered into the notes for item 10997.
Importantly, one must consider the existence of the patient’s consent for the service that is being backdated. For example, one has to be certain that the patient impliedly or otherwise consented to 10997 two weeks ago. (see attached)