Q&A Session – 21 October 2025
Q: What happens if you attend a patient in another ICU pod?
- ❓ Question: What happens if you attend a patient in another ICU pod (e.g. during a cardiac arrest)?
- 🔍 Scope: This scenario relates to multiple providers attending the same critically unwell patient and how MBS items apply in emergency attendances.
🏥 Key distinction: “in addition to” vs “instead of”
- The critical factor is whether you are attending a patient in addition to the rostered ICU specialist, not instead of them.
- This is particularly important for on-call arrangements — if you are covering instead of the rostered intensivist, you are considered the primary provider and all attendances are already covered under their claim.
🩺 Role of the rostered ICU specialist
- The rostered intensivist is the nominal treating specialist when they attend a patient.
- Their involvement is already covered under ICU daily items such as:
- 13870 / 13873 (daily management and support items)
- 🚫 These items include all attendances, so no additional claims can be made by the primary intensivist for attending to an emergency event itself.
🚑 Additional clinicians attending to emergency
- ✅ If you attend an emergency in addition to the treating intensivist, and the patient is in imminent danger of death, you may claim:
- MBS items 160–164 (depending on time spent)
- 👥 Multiple additional providers involved in the resuscitation can each claim these attendance items where appropriate.
🔧 Procedures performed while attending a patient
- ✅ When you attend a patient and perform procedures (including the nominal Intensivist) you can also claim for procedures you personally perform or supervise.
- ⚠️ Important rule:
- A single procedure can only be claimed once, by only one provider, even if multiple providers were involved. Multiple procedures covered by the same item number (for example separate insertion of a CVC and a vascath – 13815) however can be billed by separate practitioners, if they each performed a separate procedure.
- Clear communication is required to avoid duplicate claims.
⚠️ Important compliance points when you attend a patient
- The distinction between primary responsibility vs additional attendance is critical for claim validity.
- Emergency attendance items (160–164) rely on the patient being in imminent danger of death — documentation must support this.
- Duplicate procedural claims are a compliance and audit risk and must be actively avoided.
🧩 Practical takeaway
- ⚠️ Helping in an emergency ≠ automatically covered by ICU daily items
- If you are an additional clinician, your attendance and time may be billable — but only within the correct framework.
More info: 👉 Visit our Learning Center and watch the full Q&A video for further discussion:
Disclaimer
This blog is provided for educational and general informational purposes only and does not constitute legal, medical, or financial advice. While every effort has been made to ensure accuracy, billing requirements under the Medicare Benefits Schedule (MBS) are complex and subject to change. Clinicians should always consult the official MBS, relevant hospital policies, or seek independent professional advice before making billing decisions. While we use reasonable effort to ensure that our overview articles are accurate, current and complete, we do not represent, warrant, or guarantee (to the maximum extent permitted by law) their accuracy, currency, or completeness or imply that they are applicable to your individual situation. ClaimLogic accepts no liability arising from actions taken based on the content of this article.
