Medicopolitical

MBS Review takes effect in dermatology


Out-of-date item numbers have been removed and a raft of other changes to dermatology, allergy and immunology item numbers have been implemented from November 1 following a comprehensive MBS Review process.

The update will have the effect of modernising item descriptors, encouraging best practice and improving patient care and safety.

Associate Professor Stephen Shumack, chair of the Dermatology, Allergy and Immunology Clinical Committee for the Review, told the limbic the process was relatively seamless.

“We consulted widely because we knew any changes we were going to make would have much wider impact than the specific interest group of dermatology, allergy and immunology,” he said.

The Committee also included a GP, plastic surgeon and consumer representative and was supported by a Laser Photocoagulation and Mohs Surgery Working Group.

One of the key changes was the consolidation of previous item numbers around laser into just three items.

“Laser is an area where things have moved along really quickly – the types of instruments and the areas where they are being used are changing. New options are becoming available so we broadened some of those areas and just made it more logical and basically easier for people to read and make sure the item numbers are being used correctly.”

To address safety concerns about excess phototherapy (PUVA/UVB) treatment, items 14050 and 14053 were combined into one item number, an upper limit on the number of treatments was set with a stipulation that treatment was initiated and managed by a specialist dermatologist.

“Again, basically 150 treatments per year is three per week and a reasonable upper limit. We looked at the data we actually had and there were a very small number of individuals who have had more than that and we though it was hard to justify that within the MBS rebate system. That’s why we put in the upper limit.”

Associate Professor Shumack said there were also some changes regarding allergy testing including removing the specific item for testing more than 20 allergens – an item number that may have been encouraging misuse.

“Obviously there are some deleted item numbers – for example, some outdated ones like surgical excision of warts, some that were hardly ever used and a couple such as 30195 [Destructive removal of lesions] for instance, where we thought the public could be better served with some of the other item numbers.”

“It [30195] had been used quite markedly by a small number of practitioners and many practitioners never or hardly ever use it. We thought if things are being taken off, that they really should be having a biopsy and sent to pathology and you didn’t have to do that with 30195.”

“Some things had been around for a long time and needed to be reconsidered and what’s what I think we have done. By making the changes that we’ve suggested, this will improve the use of the MBS as far as patient care in concerned.”

 

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