Medicare Restrictions
Many Ultrasounds have restrictions allowing for only one per visit. We usually try to split these up over consecutive days. Other restrictions include:
55808 – Shoulder/Upper arm ultrasound
To be eligible for a Medicare rebate, the request must state that the service is for the assessment of a specific or suspected condition.
Benefits are not payable when referred for:
55828 – Knee ultrasound
To be eligible for a Medicare rebate, the request must state that the service is for the assessment of a specific or suspected condition.
Benefits are not payable when referred for:
- Non-specific knee pain
- Meniscal and cruciate ligament tears; or
- Assessment of chondral surfaces