Gastroenterologists will soon have to bill a new MBS item for any colonoscopies performed following a positive faecal occult blood test (FOBT).
From 1 July, the wording of the current colonoscopy item (MBS item 32222) will change to remove the FOBT reference from its descriptor, making way for a new standalone item covering positive FOBT indications (MBS item 32219).
The Department of Health, Disability and Ageing said the intention behind separating out the indication from the others listed in item 32222 was to improve interaction between the MBS and the National Bowel Cancer Screening Program, and provide a clearer patient pathway following a positive FOBT.
It would also help track appropriate use of the items, the department said.
“The new item (32219) will provide for colonoscopy following a positive FOBT when the test has been performed for screening purposes (i.e., when a patient is asymptomatic). This would include the relatively small number of patients who receive their test kit outside the National Bowel Cancer Screening Program,” it said in a fact sheet.
A new item was one of the recommendations the MBS Review Advisory Committee made in its post-implementation review of colonoscopy item changes made back in November 2019.
The item will have the same fee as item 32222.
Here’s how the item will look:
| Category 3 – THERAPEUTIC PROCEDURES |
| Group T8 – Surgical Operations |
| Subgroup 2 – Colorectal |
| 32219
Endoscopic examination of the colon to the caecum by colonoscopy, for an asymptomatic patient following a positive result from a faecal occult blood test undertaken for screening purposes. Applicable once per day under a single episode of anaesthesia or other sedation (H) (Anaes.) Private Health Insurance Classification: • Clinical category: Gastrointestinal endoscopy • Procedure type: Type B Non-band specific |
Meanwhile, colorectal surgeons will no longer be able to use MBS item 32150 for providing injections with botulinum toxin to treat anal fissure, with the reference removed from the descriptor, undoing a change made on 1 July 2022.
The department said the amendment was necessary considering there were no botulinum toxins listed on the Australian Register of Therapeutic Goods for anal fissure, meaning all prescribing was done off label and not eligible for MBS billing.
Item 32150 will continue to provide an MBS benefit for other surgical procedures for the management of anal fissure, including excision or sphincterotomy.