This page was created on 21 April 2020. On 19 May 2020 the Summary of Changes was updated to reflect that three Diagnostic Imaging items (items 63460, 63542 and 63544) ceased on 1 May 2020 as they were NK items.


The May 2020 XML file is available to be downloaded from the May 2020 downloads page.

SUMMARY OF CHANGES
GENERAL MEDICAL SERVICES CHANGES
Nuclear medicine items 12503, 12506, 12509, 12512, 12515, 12518, 12521 and 12530
Eight nuclear medicine items (12503, 12506, 12509, 12512, 12515, 12518, 12521 and 12530) will cease as they no longer reflect clinical practice. This was recommended by MBS Review Taskforce.

Anaesthesia items
Item 25015 will be replaced by two new anaesthesia items 25013 and 25014 to clarify the ages of eligible patients.

Item 25013 is for patients under 4 years and item 25014 for patients 75 years or over.

Breast biopsy items as recommended by the MBS Taskforce

· Three bore-enbloc stereotactic biopsy breast biopsy items (31539, 31542 and 31545) will cease as they no longer reflect clinical practice.
· The schedule fee for mechanical breast biopsy item 31548 will increase from $140.10 to $203.20 to reflect the higher costs, clinical superiority and technical difficulty of mechanical breast biopsy compared to fine needle aspiration biopsy.

Colonoscopy items
Items 32084, 32087 and 32224 have been amended to clarify their intended purpose and to remove redundant terminology:

· items 32084 and 32087 have been amended to remove the requirement that sigmoidoscopies and colonoscopies must be ‘flexible’ or ‘fibreoptic’. These terms are redundant as all contemporary colonoscopies and sigmoidoscopy use flexible endoscopes with digital technology;
· item 32087 has been further amended by deleting “the treatment of radiation proctitis, angiodysplasia or post-polypectomy bleeding by argon plasma coagulation” in the descriptor. This change will clarify that doctors should generally be claiming item 32227 for therapeutic colonoscopy service for the treatment of radiation proctitis, angiodysplasia or post-polypectomy bleeding; and
· amendment to item 32224 to ensure patient entitlement where a certain adenoma is exactly 10 mm in diameter.

Micro-bypass glaucoma surgery (MBGS) standalone procedure
A new MBS item for Micro-bypass glaucoma surgery (MBGS) as a standalone procedure. This change inserts a new glaucoma item (42504) for the insertion of micro-stents in the eye. The new item is for patients with open angle glaucoma for whom conservative treatment has failed or is contraindicated. This change is the result of an MSAC recommendation (application 1541) to Government. MSAC determined that the micro-bypass glaucoma surgery procedure has an acceptable safety profile and may delay or avoid the need for trabeculectomy (a more invasive procedure) in some patients not adequately controlled with medical therapy.

The new item can be performed by specialists and consultant physicians who have certification and training recognised by the Conjoint Committee for the Recognition of Training in Micro-Bypass Glaucoma Surgery. The Conjoint Committee comprises representatives from the Australian and New Zealand Glaucoma Society and the Royal Australian and New Zealand College of Ophthalmologists.

New item 37226 for prostate MRI under MRI guidance
This change will create a new MBS item for biopsy of the prostate when guided by MRI. This new item was recommended by MSAC Executive at its meeting of 29 June 2018, as an addition to ultrasound- guided prostate biopsy. This change will provide doctors flexibility to choose the most appropriate modality to guide biopsy, allow a Medicare rebate to be paid for patients who receive a prostate biopsy under MRI-guidance.

Schedule fee increase for items 37207 and 37208
Schedule fees for items 37207 and 37208 were increased to align with transurethral resection of the prostate items 37203 and 37206.

DIAGNOSTIC IMAGING SERVICES CHANGES
Changes to Subgroup descriptors in Category 5 Diagnostic Imaging Services Group 5 Magnetic Resonance Imaging

• Subgroup 6—Scan of spine—one region or 2 contiguous regions— for infection or tumour
• Subgroup 7—Scan of spine—one region or 2 contiguous regions— for other conditions
• Subgroup 8—Scan of spine—3 contiguous or 2 non contiguous regions— for infection or tumour
• Subgroup 9—Scan of spine—3 contiguous or 2 non contiguous regions— for other conditions
• Subgroup 11—Scan of musculoskeletal system— for tumour, infection or osteonecrosis
• Subgroup 12—Scan of musculoskeletal system— for joint derangement
• Subgroup 13—Scan of musculoskeletal system— for Gaucher disease
• Subgroup 17—Magnetic resonance imaging— person under the age of 16 years – for physeal fusion or Gaucher disease
• Subgroup 18—Magnetic resonance imaging— person under the age of 16 years – for other conditions
• Subgroup 20—Scan of pelvis and upper abdomen— for specified conditions
• Subgroup 21—Scan of body— for suspected hepato-biliary or pancreatic pathology
• Subgroup 33—Scan of body— person under the age of 16 years – general practice requests
• Subgroup 34—Scan of body— person over the age of 16 years – general practice requests

Item 63454 moved from Subgroup 19 - Scan of body - for specified conditions to Subgroup 20 - Scan of pelvis and upper abdomen - for specified conditions

Capital sensitivity

• From 1 May 2020, benefits will no longer be payable for diagnostic imaging services rendered on equipment that has reached its effective life age or maximum extended life age unless there is a remote area exemption or special exemption in place.
• All ‘NK’ items will be deleted from the MBS and remaining items will no longer include the annotation ‘K’.

Ultrasound

• Two new items for ultrasound of the breast in conjunction with a surgical procedure 55066 (both breasts) and 55071 (one breast). The relevant surgical procedure item in the General Medical Services Table is able to be claimed in conjunction with these items.
• Items covering musculo-skeletal ultrasound of the extremities will be deleted and replaced with items covering unilateral and bilateral scans. The unilateral scans will retain the same schedule fee as the items being deleted. The bilateral scan fees will be approximately 11% higher than the unilateral scan fees.
• Item descriptors for general ultrasound, obstetric and gynaecological ultrasound and musculoskeletal ultrasound will be amended to remove co-claiming restrictions with cardiac or vascular ultrasound. A restriction will still apply for vascular ultrasound of the lower leg and musculo-skeletal ultrasound of the lower leg.
• The general pelvic ultrasound items 55065 and 55068 will no longer be able to claimed where an obstetric ultrasound item would apply.
• The descriptor for breast ultrasound items 55076 and 55079 will be amended so that they also apply to post mastectomy surveillance. The chest or abdominal wall items 55812 and 55814 will no longer be able to be co-claimed with the breast ultrasound items (items 55070, 55073, 55076 and 55079).
• The schedule fees for the interventional ultrasound items 55848 and 55850 will be increased.
• The list of conditions in the obstetric ultrasound items will be deleted. For the less than 12 week scan items (item 55700 and 55703), the items apply where the scan is for ‘determining the gestation, location, viability or number of foetuses’. For the 12 to 16 week scan, the items (55704 and 55705) apply for determining the structure, gestation, viability or number of foetuses’. The later obstetric scans apply where clinically appropriate.
• MSAC change: the descriptors for abdominal ultrasound items 55036 and 55037 will be amended to include the term ‘morphological assessment’ so that the items should only be used for imaging purposes, not for non-imaging techniques such as transient elastography.

Computed tomography (CT)

• The scan of extremities items 56619 and 56625 will be deleted and replaced by items covering the lower and upper limbs. The new items will be 56622 (scan of lower limb or limbs without contrast), 56623 (scan of lower limb or limbs with contrast), 56627 (scan of upper limb or limbs without contrast) and 56628 (scan of upper limb or limbs with contrast). The schedule fees for these items will be the same as the replaced contrast and non contrast items.
• The descriptor for item 57341 (CT in conjunction with a surgical procedure) will be amended to allow it to be co-claimed with any other diagnostic imaging item.
• The CT spiral angiography item 57350 will be deleted and replaced by three new items overing CT angiography of different arterial regions. The schedule fees for these items will remain the same as the items they replaced.
• MSAC change: item 57362 (cone beam computed tomography – CBCT) will be able to be claimed when the service is rendered on equipment that can also provide other services (such as x-ray and OPG). Currently, CBCT services can only be rendered on dedicated CBCT equipment in order to attract Medicare benefits. ‘Approved dental practitioners’ will be able to request this service.

Diagnostic radiology

• Items 57903 (radiographic examination of the sinuses) and 57912 (radiographic examination of the facial bones) will be deleted and replaced with one item covering either the sinuses or facial bones. The new item will be item 57907 and have a schedule fee of $47.30.
• Items 57906 (radiographic examination of the mastoids) and 57909 (radiographic examination of the petrous temporal bones) will be deleted and replaced with one item covering either the mastoids or petrous temporal bones. The new item will be item 57905 and have a schedule fee of $64.50.
• The descriptors for the mammography items 59300 (both breasts), 59303 (one breast), 59302 (three dimensional breast tomosynthesis - both breasts) and 59305 (three dimensional breast tomosynthesis - one breast) will be amended to ensure that the items are used in the investigation of a clinical abnormality of the breast/s and not for individual, group or opportunistic screening of asymptomatic patients.
• Items 59306 (mammary ductogram – one breast) and 59309 (mammary ductogram – both breasts) will be deleted.
• Fluoroscopy items 60506, 60509 and 61109 will now be able to be co-claimed with any other diagnostic imaging service, except a diagnostic radiology service in Group I03 of the Diagnostic Imaging Services Table (DIST). Currently, the items cannot be co-claimed with any other item in the DIST.

Nuclear Medicine Imaging

• Items 61302, 61306, 61352, 61401, 61405, 61417, 61437, 61458 and 61484 will be deleted. The items cover various procedures considered to be obsolete.
• Items 61316, 61317 and 61320 (cardiac blood studies) will be deleted and the indications for these items will be included in item 61314.
• The item descriptors for most items that contain a reference to planar imaging or single photon emission tomography (SPECT) will be amended to remove those references.
• The descriptor for item 61473 will be amended to remove the phrase ‘including uptake measurement when undertaken’.
• Item 61505 (CT for attenuation correction and anatomical localisation of single photon emission tomography) will now be able to be co-claimed with positron emission tomography (PET). Consequently, the descriptor for item 61647 (Whole body 68Ga-DOTA-peptide PET study) will be amended to exclude references to CT for attenuation correction and anatomical localisation and the schedule fee item 61647 will be reduced by $100.
• MSAC change: the descriptors for items 61446 and 61449 (regional bone studies) will be amended so that they can be claimed for scans on other body parts.

Magnetic resonance imaging (MRI)

• Items 63501 and 63502 (MRI of the breasts for Poly Implant Prosthése implant integrity) will now be only able to claimed once in 24 months. Currently, these items can be claimed every 12 months.

PATHOLOGY SERVICES CHANGES
Heritable mutations associated with Familial Hypercholesterolaemia - item 73352
The introduction of a new MBS Item: diagnostic genetic testing for heritable mutations predisposing to familial hypercholesterolaemia (FH) in clinically affected individuals.

Heritable mutations associated with Familial Hypercholesterolaemia - cascade testing
Predictive genetic testing (or ‘cascade testing’) of the family members of those affected individuals who are shown to have heritable mutations predisposing to familial hypercholesterolaemia diagnosed under MBS Item 73352.

Heritable mutations which increase risk in colorectal and endometrial cancer - items 73354, 73355, 73356
New MBS listings for genetic testing to identify inheritable mutations predisposing to colorectal and endometrial cancer, specifically the identification of heritable mutations associated with the clinical presentations of Lynch Syndrome (LS), Familial Adenomatous Polyposis (FAP), MUTYH-Associated Polyposis (MAP), Juvenile Polyposis Syndrome (JPS), Peutz-Jeghers Syndrome (PJS), and Hereditary Mixed Polyposis Syndrome (HMPS).

Heritable mutations which increase risk in colorectal and endometrial cancer - item 73357
MBS listing for genetic testing to identify inheritable mutations predisposing to colorectal and endometrial cancer, specifically the identification of heritable mutations associated with the clinical presentations of Lynch Syndrome (LS), Familial Adenomatous Polyposis (FAP), MUTYH-Associated Polyposis (MAP), Juvenile Polyposis Syndrome (JPS), Peutz-Jeghers Syndrome (PJS), or Hereditary Mixed Polyposis Syndrome (HMPS), in family members of affected individuals identified under MBS item 73354, 73355 or 73356.

Genetic testing for childhood syndromes - item 73358
New item for whole exome sequencing (WES) or whole genome sequencing (WGS) to identify childhood syndromes in affected individuals.

Genetic testing for childhood syndromes - trio testing item 73359
Whole exome sequencing (WES) or whole genome sequencing (WGS) for childhood syndromes in affected individuals, where characterisation is performed using samples from the patient and their biological parents (trio testing)

Genetic testing for childhood syndromes - reanalysis item 73360
Reanalysis of whole exome sequencing (WES) or whole genome sequencing (WGS) results for characterisation of previously unreported germline gene variants related to the clinical phenotype, for childhood syndromes in affected individuals

Genetic testing for childhood syndromes - cascade testing 1 item 73361
Detection of a single gene variant for diagnostic purposes in a biological sibling of a patient with a known monogenic condition

Genetic testing for childhood syndromes - cascade testing 2 item 73362
Testing for a single gene variant to inform reproductive decision making, where a patient has a first degree relative with a known monogenic condition.

Genetic testing for childhood syndromes - cascade testing 3 item 73363
Testing for a single gene variant for segregation purposes in relation to a person, where the patient is a biological relative of the person and has similarities in phenotype to the person or has a suspected monogenic condition. Results are then used to help characterise the monogenic condition of the person.

Twenty new genetic testing items for the diagnosis and prognosis of certain cancers
The introduction of 20 new items on the MBS to test for somatic gene variants to aid in the diagnosis and prognosis of certain cancers.

Items announced on 30 April, commencing on 1 May 2020
Pathology items
Item 72860 - retrieval and review of archival tissue - the application of this item has been updated to remove the requirement for the treating practitioner to specifically request item 72860, as item 72860 will be pathologist determinable from 1 May 2020.

Item 73341 - fluorescence in situ hybridisation (FISH) testing of tumour tissues - this item has been expanded to replace the list of individual PBS listed medicines with reference to the therapeutic class - "anaplastic lymphoma kinase inhibitors". The amendment will enable access to the anaplastic lymphoma kinase inhibitors currently specified in MBS item 73341 as well as brigatinib, which is scheduled to be listed on the PBS for this purpose on 1 May 2020.

PROFESSIONAL ATTENDANCES
Explanatory notes AN.7.12 and AN.0.69 ADF Post-Discharge Health Assessment have been renamed to One-Off Veterans' Health Check
Explanatory notes AN.0.57 and AN.7.23 have been amended to include Eye Movement Desensitisation Reprocessing therapy under focussed psychological strategies

MISCELLANEOUS SERVICES (Allied mental health)
Explanatory notes MN.7.1, and MN.17.1 have been amended to include Eye Movement Desensitisation Reprocessing therapy under focussed psychological strategies

Deleted Items

12503	12506	12509	12512	12515	12518	12521	12530	25012	25015	31539	31542	31545
55005	55007	55008	55010	55011	55013	55014	55016	55017	55019	55023	55025	55026
55059	55060	55061	55062	55063	55064	55067	55069	55119	55120	55121	55122	55123
55125	55131	55136	55220	55221	55222	55223	55224	55226	55227	55228	55229	55230
55232	55233	55235	55236	55601	55604	55701	55702	55710	55711	55713	55714	55716
55717	55719	55720	55722	55724	55726	55727	55730	55735	55737	55760	55763	55765
55767	55769	55771	55773	55775	55800	55801	55802	55803	55804	55805	55806	55807
55808	55809	55810	55811	55813	55815	55816	55817	55818	55819	55820	55821	55822
55823	55824	55825	55826	55827	55828	55829	55830	55831	55832	55833	55834	55835
55836	55837	55838	55839	55840	55841	55842	55843	55845	55847	55849	55851	55853
55855	56041	56047	56050	56053	56056	56062	56068	56070	56076	56141	56147	56227
56228	56229	56230	56231	56232	56235	56236	56239	56240	56259	56341	56347	56441
56447	56449	56452	56541	56547	56555	56619	56625	56659	56660	56665	56666	56841
56847	57041	57047	57247	57345	57350	57355	57356	57361	57363	57529	57530	57532
57533	57535	57536	57537	57538	57539	57540	57702	57705	57708	57711	57714	57717
57723	57903	57906	57909	57911	57912	57914	57917	57920	57923	57926	57929	57932
57935	57938	57941	57944	57947	57950	57953	57956	57959	57962	57965	57968	58102
58105	58111	58114	58117	58123	58124	58126	58127	58302	58308	58502	58505	58508
58511	58523	58526	58529	58702	58708	58717	58720	58723	58902	58905	58911	58914
58917	58920	58923	58929	58935	58938	58941	59104	59301	59304	59306	59307	59309
59310	59313	59315	59319	59701	59704	59713	59716	59719	59725	59734	59740	59752
59755	59764	59971	59972	59973	59974	60001	60004	60007	60010	60013	60016	60019
60022	60025	60028	60031	60034	60037	60040	60043	60046	60049	60052	60055	60058
60061	60064	60067	60070	60073	60076	60079	60501	60504	60507	60510	61110	61316
61317	61320	61352	61401	61405	61417	61437	61458	61484	61651	61652	61653	61654
61655	61656	61657	61658	61659	61660	61661	61662	61663	61664	61665	61666	61667
61668	61669	61670	61671	61672	61673	61674	61675	61676	61677	61678	61679	61680
61681	61682	61683	61684	61685	61686	61687	61688	61689	61690	61691	61692	61693
61694	61695	61696	61697	61698	61699	61700	61701	61702	61703	61704	61705	61706
61707	61708	61709	61710	61712	61713	61714	61715	61716	61717	61718	61719	61729
63013	63014	63016	63017	63074	63075	63076	63077	63078	63079	63080	63081	63082
63083	63084	63085	63104	63117	63119	63134	63135	63136	63157	63158	63186	63187
63188	63189	63190	63191	63192	63193	63194	63207	63208	63257	63258	63259	63260
63261	63262	63263	63264	63265	63282	63283	63284	63285	63310	63311	63313	63341
63342	63343	63345	63346	63347	63348	63364	63392	63393	63394	63396	63398	63407
63408	63419	63432	63433	63447	63448	63449	63455	63457	63458	63479	63481	63484
63486	63488	63490	63508	63511	63514	63517	63520	63523	63532	63534	63548	63552
63555	63558	63561	63744	63746	63747

Items 63460, 63542 and 63544 ceased on 1 May 2020 and should be taken as listed in the deleted table above.

New Items

25013	25014	37226	42504	55066	55071	55856	55857	55858	55859	55860	55861	55862
55863	55864	55865	55866	55867	55868	55869	55870	55871	55872	55873	55874	55875
55876	55877	55878	55879	55880	55881	55882	55883	55884	55885	55886	55887	55888
55889	55890	55891	55892	55893	55894	55895	56622	56623	56627	56628	56629	56630
57352	57353	57354	57905	57907	73352	73353	73354	73355	73356	73357	73358	73359
73360	73361	73362	73363	73364	73365	73366	73367	73368	73369	73370	73371	73372
73373	73374	73375	73376	73377	73378	73379	73380	73381	73382	73383

Description Amended

31530	31536	31548	32084	32087	32224	37207	55028	55029	55030	55031	55032	55033
55036	55037	55038	55039	55048	55049	55054	55065	55068	55070	55073	55076	55079
55084	55085	55113	55114	55115	55116	55117	55118	55130	55135	55238	55244	55246
55248	55252	55274	55276	55278	55280	55282	55284	55292	55294	55296	55600	55603
55700	55703	55704	55705	55706	55707	55708	55709	55712	55715	55718	55721	55723
55725	55729	55736	55739	55759	55762	55764	55766	55768	55770	55772	55774	55812
55814	55844	55846	55848	55850	55852	55854	56001	56007	56010	56013	56016	56022
56028	56030	56036	56101	56107	56219	56220	56221	56223	56224	56225	56226	56233
56234	56237	56238	56301	56307	56401	56407	56409	56412	56501	56507	56553	56620
56626	56801	56807	57001	57007	57201	57341	57351	57360	57362	57506	57509	57512
57515	57518	57521	57522	57523	57524	57527	57700	57703	57706	57709	57712	57715
57721	57901	57902	57915	57918	57921	57924	57927	57930	57933	57939	57942	57945
57960	57963	57966	57969	58100	58103	58106	58108	58109	58112	58115	58120	58121
58300	58306	58500	58503	58506	58509	58521	58524	58527	58700	58706	58715	58718
58721	58900	58903	58909	58912	58915	58916	58921	58927	58933	58936	58939	59300
59302	59303	59305	59312	59314	59318	59700	59703	59712	59715	59718	59724	59733
59739	59751	59754	59763	59903	59912	59925	59970	60000	60003	60006	60009	60012
60015	60018	60021	60024	60027	60030	60033	60036	60039	60042	60045	60048	60051
60054	60057	60060	60063	60066	60069	60072	60075	60078	60500	60503	60506	60509
60918	60927	61109	61302	61303	61306	61307	61310	61313	61314	61328	61340	61348
61353	61356	61360	61361	61364	61368	61369	61372	61373	61376	61381	61383	61384
61386	61387	61389	61390	61393	61397	61402	61409	61413	61421	61425	61426	61429
61430	61433	61434	61438	61441	61442	61445	61446	61449	61450	61453	61454	61457
61461	61462	61469	61473	61480	61485	61495	61499	61505	61647	61650	63001	63004
63007	63010	63040	63043	63046	63049	63052	63055	63058	63061	63064	63067	63070
63073	63101	63111	63114	63125	63128	63131	63151	63154	63161	63164	63167	63170
63173	63176	63179	63182	63185	63201	63204	63219	63222	63225	63228	63231	63234
63237	63240	63243	63271	63274	63277	63280	63301	63304	63307	63322	63325	63328
63331	63334	63337	63340	63361	63385	63388	63391	63395	63397	63401	63404	63416
63425	63428	63440	63443	63446	63454	63461	63464	63467	63470	63473	63476	63482
63487	63489	63491	63494	63496	63497	63501	63502	63507	63510	63513	63516	63519
63522	63531	63533	63545	63546	63547	63551	63554	63557	63560	63740	63741	63743

72860 and 73341 were added to the XML on 30 April 2020



Fee Amended

31548

37207

37208

55848

55850

61647

EMSN Amended

55054

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