Questions and Answers on the CDM items
Claiming 2 x #732 on the same day
"If a GPMP and TCAs are both reviewed on the same date and item 732 is to be claimed twice on the same day, both electronic claims and manual claims need to indicate they were rendered at different times:
Non electronic Medicare claiming of items 732 on the same date
The time that each item 732 commenced should be indicated next to each item
Electronic Medicare claiming of item 732 on the same date
Medicare Easyclaim: use the 'ItemOverrideCde" set to 'AP', which flags the item as not duplicate services
Medicare Online/ECLIPSE: set the 'DuplicateServiceOverrideIND' to 'Y', which flags the item as not duplicate."
Can a patient have more than 2 review items in a 3 month period?
"Yes, when exceptional circumstances apply, i.e. when there has been a significant change in the patient's clinical condition or care circumstances that necessitates the performance of the service for the patient.
When this is the case, both electronic and manual claims needs to indicate that exceptional circumstances apply. As there is no override indicator for Medicare electronic claiming, the free text field should be endorsed "exceptional circumstances" to identify which item they apply to. Claims under exceptional circumstances will not be able to be transmitted via Medicare Easyclaim".