Changes to Ear, Nose and Throat Items 41674, 41789, 41793 and 41801

Effective 1 November 2017 (subject to the passage of legislation)

Page last updated: 22 August 2017

Ear, Nose and Throat Items (PDF 200 KB)
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What do the changes involve?

The changes to Medicare Benefits Schedule items 41674, 41789, 41793 and 41801 for ear, nose and throat (ENT) surgery involve:

Amendment to item 41674 to remove MBS coverage for cauterisation of the pharynx as this is no longer considered appropriate clinical practice.

Amendment to the items for tonsillectomy (41789 and 41793) and adenoidectomy (item 41801) to clarify that the item covers the service of injection of local anaesthetic and examination of the post nasal space to prevent inappropriate billing.

Why is the Government making this change?

The changes support the Government’s priority of ensuring that Medicare funded services are safe, clinically effective and cost effective. They are based on recommendations of the Medicare Benefits Schedule Review Taskforce.

What does this mean for MBS claiming?

The changes to the ENT items will support safe clinical practice and prevent inappropriate billing.

Change to item description: (words to be added in red, words to be deleted with strikethrough)

41674Cauterisation (other than by chemical means) or cauterisation by chemical means when performed under general anaesthesia or diathermy of septum or turbinates or pharynx—one or more of these procedures (including any consultation on the same occasion) other than a service associated with another operation on the nose (Anaes.)
Fee: $100.50 Benefit: 75% = $75.40 85% = $85.45
41789Tonsils or tonsils and adenoids, removal of, in a person aged less than 12 years, including any examination of the postnasal space and nasopharynx and infiltration of local anaesthetic; not being a service associated with item 41764 (S) (H) (Anaes.)
Fee: $295.70 Benefit: 75% = $221.80
41793Tonsils or tonsils and adenoids, removal of, in a person 12 years of age or over, including any examination of the postnasal space and nasopharynx and infiltration of local anaesthetic; not being a service associated with item 41764 (S) (H) (Anaes.)
Fee: $371.50 Benefit: 75% = $278.65
41801Adenoids, removal of, including any examination of the postnasal space and nasopharynx and infiltration of local anaesthetic; not being a service associated with item 41764 (S) (H) (Anaes.)
Fee: $162.95 Benefit: 75% = $122.25