Item 17690 is a loading for in-rooms consultations. It attracts a Medicare rebate, but is usually not paid by health funds in their gap-cover schemes. This is because gap-cover schemes are intended for in-hospital services, while 17690 is for an out-of-hospital service.

 

The DVA will pay for this service, but only if using the DVA_OUT fee schedule. This schedule is specifically for out-of-hospital services. When using this, you should select 'Out-of-hospital' on the Operation page. If sending electronic claims, is best to avoid using both in- and out-of-hospital services in the one claim.

 

To specify that an individual item is an in- or out-of-hospital service, double click on the asterisk on the top left of the item number field on the items page. The presence of the asterisk indicates that the item was performed in-hospital. Normally the asterisk is inserted (or not) automatically according to what is specified on the Operation page.