TSANZ members are being encouraged to provide their input to draft recommendations regarding pulmonary embolism (PE) and allergy testing, as part of the ongoing overhaul of the MBS.
TSANZ president Professor Allan Glanville told the limbic clinicians had a duty to be aware of the proposed changes.
“If we’re going to practice as thoughtful clinicians, we need to make use of the best available evidence. Part of the Thoracic Society’s job is to notify members of the changes and educate them on governance in the sector.”
A report from the Diagnostic Imaging Clinical Committee on pulmonary embolism and deep vein thrombosis found use of MBS items for PE imaging was ‘reasonable and compatible with clinically appropriate imaging use’.
The items were CT (57351 and 57356), lung perfusion (61328), lung ventilation (61340) and a combined lung perfusion and ventilation study (61348).
The report recommended the introduction of a MBS explanatory note that doctors referring patients with suspected PE become familiar with RANZCR Choosing Wisely advice:
Don’t request any diagnostic testing for suspected pulmonary embolism (PE) unless indicated by Wells Score (or Charlotte Rule) followed by PE Rule-out Criteria (in patients not pregnant). Low risk patients in whom diagnostic testing is indicated should have PE excluded by a negative D dimer, not imaging.
However the Committee advised against replacing imaging tests with PE-rule out tools or incorporating them into MBS item descriptors.
The report made a similar recommendation for DVT ultrasound and also recommended against co-claiming duplex scanning for both DVT and chronic venous disease.
A Dermatology, Allergy and Immunology Clinical Committee report made a number of recommendations regarding allergen testing to ‘address concerns about potential misuse’.
The report recommended removal of item 12003 (skin sensitivity testing for >20 allergens) given that over-testing was likely to identify clinically irrelevant positives and lead to overdiagnosis.
It said skin prick testing for allergic rhinitis, asthma or atopic dermatitis should be limited to common environmental allergens such as house dust mites, furred animals, grass pollens, weed pollen and tree pollen.
The report recommended item 12000 be restructured into three new items for aeroallergens, food and latex allergens, and medication and venom allergens.
Both reports are open for consultation until Friday 21 July.