Changes to Dermatology and Allergy items

Page last updated: 05 November 2018

Dermatology and Allergy items - Factsheet (PDF 232 KB)
Dermatology and Allergy items - Factsheet (DOC 521 KB)

What are the changes?

From 1 November 2018, there will be changes to dermatology and allergy items as a result of recommendations from the MBS Review Taskforce. These changes include:


    ˇ Deletion of items 30185 and 30186 for removing palmar or plantar warts

    ˇ A new item (30191) for the treatment of tumours with laser

    ˇ Deletion of an item for removal of benign neoplasms (30195) and an item for removal of more than 10 malignant neoplasms (30197)

    ˇ Amendment of an item for removal of malignant neoplasms (30196)

    ˇ Consolidation of cryotherapy items (30202, 30203, 30205) under an amended item (30202)

    ˇ Amendment of the items for hydrocortisone injections (30207 and 30210)

    ˇ Deletion of the item for diathermy or sclerosant injection treatment of telangiectases or starburst vessels (30213)

    ˇ Expansion of the items and requirements for Mohs surgery (31000-31005)

    ˇ Amendment of an item to require biopsy evidence before undertaking vermilionectomy for cellular atypia (45669)

    ˇ Consolidation of skin sensitivity testing for allergens under 6 new and amended items (12000-12005)

    ˇ Simplification of the items for laser photocoagulation (14100-14124)


What does this mean for providers?

Mohs Surgery

Only doctors with appropriate training and expertise should be performing Mohs surgery. Doctors who wish to perform Mohs surgery from 1 November 2018 will need to be registered with the Australasian College of Dermatologists (ACD) as approved Mohs surgeons in order for their patients to receive a rebate from Medicare.

Doctors who have undertaken accreditation with the ACD should in most cases be automatically included in the register of approved Mohs Surgeons, however individuals are responsible for confirming this independently. Providers with queries regarding accreditation or inclusion on this register can contact the ACD via admin@dermcoll.edu.au.

Skin sensitivity testing

Skin sensitivity items are being restructured to reflect the type of allergy testing being undertaken. Items for testing more than 20 items in one service have been removed.

Doctors and specialists will have different ability to bill MBS items for skin prick testing for aeroallergens. Doctors will be restricted to billing skin prick testing for aeroallergens a maximum of two times under items 12001 and 12002, while specialists will be able to bill skin prick testing for aeroallergens under item 12000.

The Australasian Society of Clinical Immunology and Allergy has further information on the scope of practice for these items.

Laser photocoagulation

Claiming of MBS items for laser photocoagulation of vascular abnormalities of the head or neck will require photographic evidence demonstrating the need for the service, and will be restricted to a maximum of four sessions in a year.

MBS items for other conditions have been reduced from five to three, while maintaining the emphasis on area of treatment.

Why are the changes being made?

These changes are a result of a review by the MBS Review Taskforce, which was informed by the Dermatology, Allergy and Immunology Clinical Committee (DAICC). More information about the Taskforce and associated Committees is available at MBS Reviews Taskforce website.

A full copy of DAICC’s final report can be found at the DAICC website.

What does this mean for patients?

Patients will continue to have access to clinically relevant services. The overall effect of the changes is to simplify billing and ensure patient safety.

Where can I find more information?

Full item descriptors and information on other changes to the MBS can be found at the MBS Online website or by calling the Department of Human Services on 132 150.

New items

(Draft wording of items to be finalised through regulatory amendments)

New/amended item Item descriptorFee ($)
30190Angiofibromas, trichoepitheliomas or other severely disfiguring tumours of the face or neck (excluding melanocytic naevi, sebaceous hyperplasia, dermatosis papulosa nigra, Campbell De Morgan angiomas and seborrheic or viral warts), suitable for laser ablation as confirmed by the opinion of a specialist in the specialty of dermatology—removal of, by carbon dioxide laser or erbium laser ablation, including associated resurfacing (10 or more tumours) (Anaes.)$397.75
30191Angiofibromas, trichoepithelioma, epidermal naevi, xanthelasma, pyogenic granuloma, genital angiokeratomas, hereditary haemorrhagic telangiectasia and other severely disfiguring or recurrently bleeding tumours (excluding melanocytic naevi, sebaceous hyperplasia, dermatosis papulosa nigra, Campbell De Morgan angiomas and seborrheic or viral warts), treatment of, with carbon dioxide/erbium or other appropriate laser (or curettage and fine point diathermy for pyogenic granuloma only), if confirmed by the opinion of a specialist in the specialty of dermatology. One or more lesions.$63.50
30196MALIGNANT NEOPLASM OF SKIN OR MUCOUS MEMBRANE that has been:

proven by histopathology; or

confirmed by the opinion of a specialist in the specialty of dermatology where a specimen has been submitted for histologic confirmation,

removal of, by serial curettage or carbon dioxide laser or erbium laser excision ablation, including any associated cryotherapy, or diathermy (Anaes.)

$126.30
30202Malignant neoplasm of skin or mucous membrane proven by histopathology or confirmed by the opinion of a specialist in the specialty of dermatology, removal of, by liquid nitrogen cryotherapy using repeat freeze-thaw cycles$48.35
30207Skin lesions, multiple injections with glucocorticoid preparations (Anaes.)$44.60
30210Keloid and other skin lesions, extensive, multiple injections of glucocorticoid preparations, if undertaken in the operating theatre of a hospital on a patient less than 16 years of age (Anaes.)$162.95
31000Mohs surgery of skin tumour located on the head, neck, genitalia, hand, digits, leg (below knee) or foot, utilising horizontal frozen sections with mapping of all excised tissue, and histological examination of all excised tissue by the specialist performing the procedure, if the specialist is recognised by the Australasian College of Dermatologists as an approved Mohs surgeon—6 or fewer sections (Anaes.)$580.90
31001Mohs surgery of skin tumour located on the head, neck, genitalia, hand, digits, leg (below knee) or foot, utilising horizontal frozen sections with mapping of all excised tissue, and histological examination of all excised tissue by the specialist performing the procedure, if the specialist is recognised by the Australasian College of Dermatologists as an approved Mohs surgeon—7 to 12 sections (inclusive) (Anaes.)$726.05
31002Mohs surgery of skin tumour located on the head, neck, genitalia, hand, digits, leg (below knee) or foot, utilising horizontal frozen sections with mapping of all excised tissue, and histological examination of all excised tissue by the specialist performing the procedure, if the specialist is recognised by the Australasian College of Dermatologists as an approved Mohs surgeon—13 or more sections (Anaes.)$871.30
31003Mohs surgery of skin tumour utilising horizontal frozen sections with mapping of all excised tissue, and histological examination of all excised tissue by the specialist performing the procedure, if the specialist is recognised by the Australasian College of Dermatologists as an approved Mohs surgeon—6 or fewer sections

Not applicable to a service performed in association with a service to which item 31000 applies (Anaes.)

$580.90
31004Mohs surgery of skin tumour utilising horizontal frozen sections with mapping of all excised tissue, and histological examination of all excised tissue by the specialist performing the procedure, if the specialist is recognised by the Australasian College of Dermatologists as an approved Mohs surgeon—7 to 12 sections (inclusive)

Not applicable to a service performed in association with a service to which item 31001 applies (Anaes.)

$726.05
31005Mohs surgery of skin tumour utilising horizontal frozen sections with mapping of all excised tissue, and histological examination of all excised tissue by the specialist performing the procedure, if the specialist is recognised by the Australasian College of Dermatologists as an approved Mohs surgeon—13 or more sections

Not applicable to a service performed in association with a service to which item 31002 applies (Anaes.)

$871.30
31340Muscle, bone or cartilage, excision of one or more of, if clinically indicated, and if:

(a) the specimen excised is sent for histological confirmation; and

(b) a malignant tumour of skin covered by item 31000, 31001, 31002, 30003, 31004, 31005, 31356, 31358, 31359, 31361, 31363, 31365, 31367, 31369, 31371, 31372, 31373, 31374, 31375 or 31376 is excised

(Anaes.)

Derived
45201Muscle, myocutaneous or skin flap, where clinically indicated to repair one surgical excision made in the removal of a malignant or non-malignant skin lesion (only in association with items 31000, 31001, 31002, 30003, 31004, 31005, 31358, 31359, 31360, 31363, 31364, 31369, 31370, 31371, 31373 or 31376)—may be claimed only once per defect (Anaes.)$413.95
45652Rhinophyma of a moderate or severe degree, carbon dioxide laser or erbium laser excision—ablation of (Anaes.)$356.35
45669Vermilionectomy for biopsy-confirmed cellular atypia, using carbon dioxide laser or erbium laser excision—ablation (Anaes.)$326.05
12000Skin prick testing for aeroallergens by a specialist or consultant physician in the practice of his or her specialty, including all allergens tested on the same day, not being a service associated with a service to which item 12001, 12002, 12005, 12012, 12017, 12021, 12022 or 12024 applies$38.95
12001Skin prick testing for aeroallergens, including all allergens tested on the same day, not being a service associated with a service to which item 12000, 12002, 12005, 12012, 12017, 12021, 12022 or 12024 applies. Applicable only once per 12 month period$38.95
12002Repeat skin prick testing for aeroallergens, including all allergens tested on the same day, if:

(a) further testing for aeroallergens is indicated in the same 12 month period to which item 12001 applies; and

(b) the service is not associated with a service to which item 12000, 12001, 12005, 12012, 12017, 12021, 12022 or 12024 applies

Applicable only once per 12 month period

$38.95
12003Skin prick testing for food and latex allergens, including all allergens tested on the same day, not being a service associated with a service to which item 12012, 12017, 12021, 12022 or 12024 applies$38.95
12004Skin testing for medication allergens (antibiotics or non-general anaesthetics agents) and venoms (including prick testing and intradermal testing with a number of dilutions), including all allergens tested on the same day, not being a service associated with a service to which item 12012, 12017, 12022 or 12024 applies$58.85
12005Skin testing:

(a) performed by or on behalf of a specialist or consultant physician in the practice of the specialist or consultant physician’s specialty; and

(b) for agents used in the perioperative period (including prick testing and intradermal testing with a number of dilutions), to investigate anaphylaxis in a patient with a history of prior anaphylactic reaction or cardiovascular collapse associated with the administration of an anaesthetic; and

(c) including all allergens tested on the same day; and

(d) not being a service associated with a service to which item 12000, 12001, 12002, 12003, 12012, 12017, 12021, 12022 or 12024 applies

$79.20
14050UVA or UVB phototherapy administered in a whole body cabinet or hand and foot cabinet including associated consultations other than the initial consultation, if treatment is initiated and supervised by a specialist in the specialty of dermatology

Applicable not more than 150 times in a 12 month period

$52.75
14100Laser photocoagulation using laser radiation in the treatment of vascular abnormalities of the head or neck, including any associated consultation, if:

(a) the abnormality is visible from 3 metres; and

(b) photographic evidence demonstrating the need for this service is documented in the patient notes;

to a maximum of 4 sessions (including any sessions to which this item or any of items 14106 to 14118 apply) in any 12 month period (Anaes.)

$152.50
14106Laser photocoagulation using laser radiation in the treatment of vascular malformations, infantile haemangiomas, café-au-lait macules and naevi of Ota, other than melanocytic naevi (common moles), if the abnormality is visible from 3 metres, including any associated consultation, up to a maximum of 6 sessions (including any sessions to which this item or any of items 14100 to 14118 apply) in any 12 month period—area of treatment less than 150 cm2 (Anaes.)$160.15
14115Laser photocoagulation using laser radiation in the treatment of vascular malformations, infantile haemangiomas, café-au-lait macules and naevi of Ota, other than melanocytic naevi (common moles), including any associated consultation, up to a maximum of 6 sessions (including any sessions to which this item or any of items 14100 to 14118 apply) in any 12 month period—area of treatment 150 cm2 to 300 cm2 (Anaes.)$256.50
14118Laser photocoagulation using laser radiation in the treatment of vascular malformations, infantile haemangiomas, café-au-lait macules and naevi of Ota, other than melanocytic naevi (common moles), including any associated consultation, up to a maximum of 6 sessions (including any sessions to which this item or any of items 14100 to 14115 apply) in any 12 month period—area of treatment more than 300 cm2 (Anaes.)$325.75
14124Laser photocoagulation using laser radiation in the treatment of vascular malformations, infantile haemangiomas, café-au-lait macules and naevi of Ota, other than melanocytic naevi (common moles), including any associated consultation, if:

(a) a seventh or subsequent session (including any sessions to which this item or any of items 14100 to 14118 apply) is indicated in a 12 month period commencing on the day of the first session; and

(b) photographic evidence demonstrating the need for this service is documented in the patient notes

(Anaes.)

$152.50