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Home Medicare Healthy Heart Check: Helping to prevent a silent killer

Healthy Heart Check: Helping to prevent a silent killer

  • Key Points:
  • From 1 April 2019, MBS heart health check items (699 and 177) allow GPs and medical practitioners to conduct comprehensive heart health assessments.The items fund one heart check per patient in a 12-month period, if other health assessments have not been claimed in that 12-month period. Appointments should last at least 20 minutes.
  • Assessments must include taking patient history, aimed at identifying cardiovascular disease risk factors, conducting a physical examination, and as required initiating interventions, and implementing a management plan.
  • Absolute cardiovascular disease risk must be calculated, using a validated calculator.

According to the Heart Foundation, 48 Australians die from Heart Disease Every Day

Since 1 April 2019 there are two new Medicare item numbers for General Practice dedicated to Heart Health Checks! A Heart Health Check is a regular checkup performed by the nurse and GP. A Heart Health Check helps the patient to understand their risk for heart disease and estimate how likely they are to have a heart attack or stroke in the next five years.

If a patient is 45 years or older (30 years or older for Aboriginal and Torres Strait Islander peoples) and have not had a heart attack or stroke, then they are are eligible for a Healthy Heart Check under Medicare.

The Item Numbers and Co-Claiming

There are two Medicare Item numbers dedicated to heart health checks. Item 699 is for General Practitioners and Item 177 is for a medical practitioner working in General Practice. The rebate is $72.80 (equivalent to a Level C). These items will provide patients a comprehensive assessment of their cardiovascular health, identification of any physical or lifestyle-related risks to their cardiovascular health, and a comprehensive preventive health care plan to improve their cardiovascular health.

Also an ECG item number (11707) can be claimed with the same visit but you cannot claim a time based consultation item number unless it was not related. As a side note, I believe one of the reasons the ECG rebate was lowered was due to the prevalence of the Healthy Heart Check being billed by across Australia since it was first introduced in April 2019.

Medicare have released an item description which can be found below. Also Medicare have release the following guidance for billing an item 699 (Heart Health Assessment:

  • Cannot be billed with a Health Assessment (Items 701-707)
  • Only a Health Assessment or a 699 can be billed in a year (not both)
  • Can be billed with a Chronic Disease Care Plan

I have noticed the Medicare item description keeps getting slightly adjusted too, so good idea to keep coming back for the next few weeks.

What is a Healthy Heart Check?

A Heart Health Check comprises of the following activities:

  • Discussing the patient’s diet, lifestyle, exercise and family health history;
  • Discussing the patient’s overall health, importantly kidney disease and diabetes;
  • Ordering pathology to test the patient’s cholesterol (LDL and HDL);
  • Taking the patient’s blood pressure
  • Developing a plan with the patient, how to improve their diet, lifestyle and exercise.

The Heart Foundation have a good list of questions patients could ask (or the doctor or nurse could cover) here.

Healthy Heart Check Template

When recording a Healthy Heart Check in clinical software, the following template may be useful:

When recording a Healthy Heart Check in clinical software, the following template may be useful:


Heart Health Check 

(20 minute minimum)

Item 699

Patient presents for Heart Health Check

Description of assessment provided to patient and verbal consent obtained.

ECG completed – Yes/No

BSL taken – Yes/No

BP, height, weight, waist & BMI updated – Yes/No

Does this patient have any of the following:

Family history of cardiovascular disease – Yes/No

Hypertension – Yes/No Medicated – Yes/No

High cholesterol – Yes/No Medicated – Yes/No

Diabetes – Yes/No Controlled – Yes/No

Heart Disease/Condition – Yes/No

Kidney Disease/Condition – Yes/No 

Peripheral Odema – Yes/No

Diet, physical and lifestyle-related behaviours discussed – Yes/No

Smoking – Yes/No (# per day)

Alcohol – Yes/No (how often)

Other risks identified – Yes/No

<<Yes – provide details>>

I have directed this patient to the following website for additional information:

https://www.heartfoundation.org.au


This text can be saved as a shortcut in your clinical software. 

I hope this information helps.

K x

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