Multiple operation rules

Multiple operation rules

For surgeons and assistant surgeons, where there are several billable surgical items on an invoice the appropriate Multiple Operation Rule will apply. CESoft will apply the appropriate rule when you select a fund.

In most cases this is the MBS rule which pays 100% of the item with the highest value, 50% of the second item and 25% for all subsequent items. See http://www9.health.gov.au/mbs/fullDisplay.cfm?type=note&q=TN.8.2

The AMA rule which applies to WorkCover NSW pays 100% of the item with the highest value, and 75% of all subsequent items. The exceptions here are for amputations, dislocations, and fractures which always pay at 100%, and for some spinal and neurosurgical items which also pay at 100%

WorkCover Victoria follows the 100:75 rule for orthopaedics and the 100:50:25 rule for other surgical items.

CESoft also gives you the option to override the multiple operation rule for private billing. This should not be used for claims to funds as it will generate an incorrect fee.
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