Medicare benefits for shoulder and knee musculoskeletal ultrasounds are payable when the following clinical indicators are written on the request by the referrer. Benefits are not payable when referred for non specific shoulder or knee pain alone or other knee conditions.

CLINICAL INDICATORS FOR SHOULDER OR UPPER ARM:

• Evaluation of injury to tendon, muscle or muscle / tendon junction
• Rotator cuff tear / calcification / tendinosis (biceps, subscapular, supraspinatus, infraspinatus)
• Biceps subluxation
• Capsulitis and bursitis
• Evaluation of mass including ganglion
• Occult fracture
• Acromioclavicular joint pathology.

CLINICAL INDICATORS FOR KNEE:

• Abnormality of tendons or bursae about the knee
• Meniscal cyst, popliteal fossa cyst, mass or pseudomass
• Nerve entrapment, nerve or nerve sheath tumour
• Injury of collateral ligaments.

IMAGING OF TENDONS ON ULTRASOUND CAN DIAGNOSE:

• Tears – partial or complete
• Tendinosis / tendinitis
• Tendon stability, adhesion, entrapment, triggering
• Insertional abnormalities
• Tendon calcification.

Please contact our Radiologists to discuss any issues related to the above Medicare requirements.

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