Anaesthetic ECLIPSE Billing

This will be the majority of all anaesthetic ECLIPSE claims.

For this situation, add the items to the one voucher in the following order:  

1. Pre-anaesthesia consult item (17610-17625)  
2. Procedure related item(s) (Basic Unit Value item), e.g. 20810 or 20140. A Medicare benefit is payable for one Basic Unit Value item only 
3. Time Unit item (23010 - 24136)  
4. Physical modifier where applicable (25000 - 25010)  
5. Age modifier where applicable (25015)  
6. In Hours Emergency Modifier where applicable - (25020 - note this item cannot be claimed with the After Hours Emergency Modifier 25025)  
7. Therapeutic/Diagnostic Service/s - where applicable (22001 - 22055, 22065 - 22075)  
8. Emergency After Hours Modifier (25025 - note: this item cannot be claimed with the Emergency Modifier 25020)  

If you have a referral for your patient then the items need to be invoiced as per the steps below.

The items can be transmitted in the same ECLIPSE claim but need to be added to separate vouchers to avoid rejection.  

Voucher 1: This voucher must contain referral information 

1. Pre-anaesthesia consult item (17640 -17655)  

Voucher 2: This voucher must not have any referral information  

2. Procedure related item e.g. 20810 or 20140  

3. Time Unit item (23010 - 24136)  

4. Physical modifier where applicable (25000 - 25010)  

5. Age modifier where applicable (25015)  

6. Emergency Modifier where applicable - (25020 - note this item cannot be claimed with the After Hours Emergency Modifier 25025)  

7. Therapeutic/Diagnostic Service(s) - where applicable (22001 - 22055, 22065 - 22075)  

8. Emergency After Hours Modifier (25025 - note: this item cannot be claimed with the Emergency Modifier 25020)  

All accounts must: 

• Include account requirements listed in MBS explanatory note G7.1  
• Show the name(s) of the medical practitioner(s) that performed the associated procedure(s)  
• Have the appropriate time item 

Accounts for after-hours emergency anaesthesia or perfusion items must include:  

• The start, end and total time professional attention was provided to the patient during the anaesthetic  

Accounts for assistance in the administration of anaesthesia must show:  

• The name of the principal anaesthetist and proceduralist  
• The start, end and total time the assistant anaesthetist provided professional attention to the patient 

 Clinical details must be lodged with any claims for MBS item 21965 or 21997 as the item descriptors for these items contain the phrase ‘where it can be demonstrated that there is a clinical need for anaesthesia’. 

Cosmetic surgery and associated services do not attract Medicare benefits. Accounts for anaesthetic services associated with cosmetic surgery should be clearly identified.