Asthma

New MBS items will increase fees for lung function testing


Revisions to MBS items for spirometry and complex lung function tests  from 1 November include two new items for FeNO with spirometry and Cardiopulmonary Exercise Testing.

The revisions are based on recommendations of the MBS Review Taskforce and include a doubling of the fee for GP spirometry to encourage wider use for diagnosis of COPD and asthma in primary care.

Under the new revisions, the old item for complex lung function tests 11503 is retained with the same fee ($138.65), but with revised wording to require that tests must be performed under the supervision of a consultant respiratory physician who is responsible for issuing written reports on the tests performed.

A new item (11507) is introduced for FeNO Spirometry for patients who have airway inflammation as a cause of their symptoms, with a lower fee ($100.20) to reflect its relative lack of complexity.

Another new item – 11508 – is introduced for Cardiopulmonary Exercise Testing, for use in specific circumstances including patients who have breathlessness for which standard tests have not resulted in a diagnosis, or patients who are having major surgery and are at risk of a complication.

The existing item for lab-based spirometry, 11512, is retained with the same fee ($61.75) and it absorbs item 11509 for measurement of respiratory function, which has been removed from the schedule.

For office-based spirometry the MBS item 11506 is retained at $20.55 but is now defined as being for monitoring. A new office-based pre/post bronchodilator MBS item (11505) is introduced for diagnosis, with a higher fee of $41.10.

Lung Foundation Australia’s GP Advisory Group Chair, Dr Kerry Hancock, said the increased rebate was a step towards addressing underuse of spirometry in primary care, but training and quality assurance programs are also needed to improve the skills and confidence of GPs and their practice nurses in performing high quality spirometry testing.

And not all GPs will be able to make use of the benefit, Dr Hancock said.

“Unfortunately, the increased rebate does not meet the true cost of performing spirometry in general practice. This means many GPs will still require access to refer their patients to other facilities that perform spirometry such as lung function laboratories in public hospitals or services associated with private respiratory specialists.”

Revised MBS items for sleep diagnostic services also take effect from 1 November.

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