You can use the requested (R) and non-requested (NR) type ultrasound services for a range of circumstances.
The following table lists some common scenarios where you can use requested (R) and non-requested (NR) type ultrasound services.
Make sure you read the relevant item descriptions, fact sheets and explanatory notes on the MBS Online website.
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| Situation | Example | Can claim R-Type item | Can claim NR-Type item | Notation required on claim or patient record |
|---|---|---|---|---|
| Specialist or consultant physician providing ultrasound service specifically requested by the requesting health professional | The patient has a request and a specialist in diagnostic radiology provides or supervises the service. No services other than those requested by the requesting health professional are needed. | Yes | Yes, if the service is provided as an additional or substituted service. | None |
| Patient doesn’t have a request from an eligible practitioner | The patient doesn’t have a request and has gone directly to the specialist in diagnostic radiology for the service. | No | Yes, provided the service is reasonably required for the patient’s condition. | None |
| Specialist or consultant physician who isn’t a diagnostic imaging specialist providing an ultrasound service | A cardiologist determines that an echocardiogram is required for their patient based on the patient’s presentation. The echocardiogram wasn’t specifically requested by the requesting health professional. | Yes, if they’re treating the patient in their specialty. | Yes | ‘SD’ (self-determined) |
| Additional services | The patient has a request for a specific ultrasound service, but the specialist in diagnostic radiology providing the service determines that an additional ultrasound is required based on the results obtained from the requested service. | Yes, if the requesting health professional is eligible to request the service. | Yes | Items provided as an additional service must be notated with ‘SD’ (self-determined). |
| Substituted services | The patient has a request for a specific ultrasound service, but the rendering practitioner determines that a different ultrasound service is required based on the presentation of the patient. The rendering practitioner consults with the requesting health professional, or takes all reasonable steps to do so, before providing the substituted service. | Yes, if the requesting health professional is eligible to request the service. | Yes | ‘SS’ (substituted service) Records must indicate either:
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| Remote areas | A practitioner with a remote area exemption performs an ultrasound in an area more than 30 kilometres by road from a hospital that performs radiology services or a free-standing radiology clinic. | Yes, only if the remote area exemption has been granted for the service and the practitioner. | Yes | None |
| Emergencies | A health professional who’s eligible to provide diagnostic imaging services determined that the service should be performed as quickly as possible because the need for the service arose in an emergency. | Yes | Yes | Emergency Records must indicate the nature of the emergency. |
| Lost requests | The patient had a request but has lost it. The rendering practitioner gets confirmation from the requesting health professional that the request had been made. | Yes | NA | Lost request Records must indicate the request was lost but confirmed by the requesting practitioner and the manner of confirmation (e.g. how and when).
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Read more about requests for diagnostic imaging services in Note IN.0.6 on the MBS Online website.
Read more about notation requirements in Note IN.0.8 on the MBS Online website.