MBS item scrutiny profile
MBS Item 42738 — PSR scrutiny profile
Appears in 2 published determinations since 2025, with related issues and repayments shown only where recorded.
Scrutiny profile
Co-occurring issue categories
- Inadequate documentation2
- Incorrect item use1
- Procedural consent1
Specialties involved
- Ophthalmology2
Repayment range
Calculated only across the 1 published case where a repayment amount is recorded.
Published cases mentioning item 42738
What survives review
Documentation has to stand alone
The note should show the presenting problem, assessment, clinical reasoning, time or complexity when relevant, and the plan without relying on memory.
Tie the note back to the descriptor
The record should show the facts that made the item available, including patient status, service content, timing and any required review cycle.
Procedural consent
Keep the source record clear enough for an external peer to connect the patient need, the service provided, and the item claimed.
Educational disclaimer
This educational module is based on publicly available PSR case-outcome material. It is general educational information only and does not constitute legal advice, billing advice, or a substitute for reviewing the MBS, PSR material, or obtaining professional advice.