The 1 November 2014 MBS files (DOC, PDF, ZIP, ASCII and XML) can now be downloaded from the 1 November 2014 downloads page.
The following changes will take effect from 1 November 2014 (updated 30 October 2014):
18379 35534 57362 57363 63740 63741 63743 63744 63746 63747 66833 66834 66835 66836 66837 66838 66839 66840 66841 73339 73340
18356 18358 56025 56026 66599 66602 66608 66609 73328 73330
Chronic Disease and General Consultation Items
A restriction will be introduced to prevent co-claiming of GP consultation items 3, 4, 23, 24, 36, 37, 44, 47, 52, 53, 54, 57, 58, 59, 60, 65, 597, 599, 598, 600, 5000, 5003, 5020, 5023, 5040, 5043, 5060, 5063, 5200, 5203, 5207, 5208, 5220, 5223, 5227 and 5228 with chronic disease management items 721, 723, or 732 for the same patient, on the same day.
Home-based Sleep Studies Item
Item 12250 will be amended to clarify that the item cannot be provided on the same occasion as another service mentioned in items 11000 to 11005, 11503, 11700 to 11709, 11713 and 12203.
Botulinum Toxin Items
An improved structure of fourteen items (18350 – 18373) for injecting botulinum toxin will be introduced. The updated structure will result in the removal of items 18356 and 18358 as the clinical indications for these items will be incorporated into existing botulinum toxin item 18354.
Sixteen items (18350 – 18377) for injecting botulinum toxin will be updated to specify the full name of the applicable medicine - ‘Clostridium Botulinum Type A Toxin-Haemagglutin Complex (Dysport)’ and/or ‘Botulinum Toxin Type A Purified Neurotoxin Complex’ (Botox).
A new item (18379) will be listed for the intravesical injection of Botox for the treatment of certain patients with urinary incontinence due to idiopathic overactive bladder. As a consequence, items 36851 and 37339 will be amended to ensure that a service to which the new item applies cannot be claimed with items 36851 and 37339.
Assisted Reproductive Technology Items
Amendments will be made to make clear that a treatment cycle for assisted reproductive services ends either; if a service mentioned in item 13212, 13215 or 13221 is provided in connection with the series of treatments—on the day after the day on which the last of those services is provided or in all other cases not more than 30 days from when the treatment cycle begins. This is to ensure that patients with an irregular menstrual cycle are not disadvantaged.
The restriction on claiming the introduction of an intra-uterine contraceptive device (35503) with a service which removes etonogestrel subcutaneous implant (30062) on the same day will be removed, as it maybe clinically appropriate for these two services to occur in the same consultation.
Five rhinoplasty items (45632, 45635, 45641, 45644, and 45650) will be amended to include reference to clinical indications.
Vulvoplasty item 35533 will be clarified by splitting it into two separate items (35533 and 35534) to include reference to clinical indications to which the service applies. Claiming of item 35534 will require pre-approval from the Medicare Claims Review Panel (MCRP).
Items 18350 to 18373 for Injections of Botulinum Toxin:
Following an MBS Review of items 18350 to 18373 for injection of botulinum toxin, an improved structure of these items has been MBS-listed from 1 November 2014.
Changes to Vitamin B12 and Folate testing items
Items 66599 and 66602 have been deleted and new items 66838, 66839 and 66840 have been added to the Schedule for vitamin B12 and folate testing. Note that vitamin B12 and folate testing has been separated and folate testing is restricted to patients with risk of folate deficiency. A new item for the test of vitamin B12 markers has been listed.
Changes to Vitamin D testing items
Items 66608 and 66609 have been deleted and new items 66833, 66834, 66835, 66836 and 66837 have been added to the Schedule for Vitamin D testing. Note the patient criteria listed in the new item descriptors.
Item for HbA1c test for diagnosis of Diabetes Mellitus
Item 66841 has been added to the Schedule for HbA1c test for diagnosis of Diabetes Mellitus.
Two new items for RET
Two new items have been listed for the detection of germline mutations in the RET gene in patients and with a suspected clinical diagnosis of multiple endocrine neoplasia type 2 (MEN2) and in an asymptomatic relative of a patient with a documented pathogenic germline RET mutation.
Items 73336, 73337 and 73328
Inserting two current MBS items (73336 and 73337) into the Principle Regulation from the Health Insurance (Pharmacogenetic Testing) Determination 2013 (No.1) and the Health Insurance (Pharmacogenetic Testing Epidermal Growth Factor Receptor) Determination 2013. This will be an administrative change that ensures the Principle Regulation is reflective of current MBS pathology services. As a consequence, item 73328 will be removed as that item was made redundant when items 73336 and 73337 were listed on the MBS.
Item 73330 has been superseded by item 73338 which has been added to the schedule by the Health Insurance (Pharmacogenetic Testing - Kirsten ras (KRAS)) Determination 2014. As a consequence, item 73330 has been made redundant and has been removed.
Replacement of CBCT dental items from 1 November 2014, with added restrictions on the new items
From 1 November 2014, interim CBCT dental items 56025 and 56026 will be replaced with items 57362 and 57363, which have the following restrictions:
- The new items can be requested by medical practitioners and specialist dentists;
- To be Medicare eligible, services must be delivered in practices accredited under the Diagnostic Imaging Accreditation Scheme, and performed on dedicated (rather than hybrid) CBCT units;
- Claims for more than one CBCT per patient per day are excluded; and
- Claiming with two-dimensional imaging in the same episode (items 57959-57969) and with CT in the same episode (items 56001-57361) is also excluded.