Amended neurology-related items for EEG, nerve conduction studies and infusion pumps recommended by the MBS Review Taskforce will come into effect after 1 November, according to Medicare.
The Federal Department of Health says the updated items are being introduced “to simplify the MBS and promote high value testing and care (discourage low value use).”
The changes include the replacement of multiple billing items covering for the use of infusion pumps for chronic spasticity, into two new items (14234, 14237) that consolidate items into single items for the implantation, removal and refilling of infusion pumps and/or reservoir.
There are also four amended items (11003, 11004, 11005, 11009) for EEG services that now require a 10-20 electrode placement pattern in line with the standard from the International Federation of Clinical Neurosurgery.
Six items (11006, 14230, 14233, 14236, 14239, 14242) for EEG services are deleted because they are considered obsolete or consolidated under new items.
There are also new explanatory notes, for nerve conduction studies and EMG to discourage inappropriate use in indications such as muscle pain in the absence of other abnormalities on examination or laboratory testing, and EMG for low back pain without leg pain or sciatica.
“In some of these situations these tests would be of relatively low diagnostic value, while in others it would be more appropriate to refer the patient for alternative investigations first (e.g. MRI in mild radiculopathy),” the Medicare Review Taskforce report stated.
It also recommended closer monitoring of ‘outlier’ neurologists’ overuse use of items for (nerve conduction studies, electromyography and evoked response testing to discourage unnecessary or unhelpful testing.
The amendments were recommended by the Taskforce’s Neurosurgery and Neurology Clinical Committee in 2018.
“Providers will need to familiarise themselves with the changes in the neurosurgery and neurology schedule and any associated rules and explanatory notes. Providers have a responsibility to ensure that any services they bill to Medicare fully meet the eligibility requirements outlined in the legislation,” Medicare said in an advisory statement.