November 2019 Item Update

November 2019 Item Update

The November 1 2019 item update is now available to download.

Please read through all these notes prior to running your item update.

If you are prompted, please update your Medcomms.

This update includes an increase in the maximum patient gap. If you are unsure how to update this within Impulse, you can find the instructions here: https://support.mednet.com.au/portal/kb/articles/add-max-gap

Current annual support customers can download the new fees via the item update button in Impulse. If you are unsure of this process, you can find the instructions here: https://support.mednet.com.au/portal/kb/articles/updating-items

Released (last updated 18/11/2019)

  1. Medicare
  2. DVA
  3. AHSA
  4. BUPA
  5. HCF
  6. Medibank Private
  7. Mildura Health Fund
  8. NIB
  9. St Luke's

Summary of Changes

New items

2461
2463
2464
2465
2471
2472
2475
2478
2480
2481
2482
2483
18297
22041
22042
23025
23035
23045
23055
23065
23075
23085
32222
32223
32224
32225
32226
32227
32228
32229
41501
45627
57541
61524
61525
63531
63532
63533
63534
82350
82351
82352
82353
82354
82355
82356
82357
82358
82359
82360
82361
82362
82363
82364
82365
82366
82367
82368
82369
82370
82371
82372
82373
82374
82375
82376
82377
82378
82379
82380
82381
82382
82383
90250
90251
90252
90253
90254
90255
90256
90257
90260
90261
90262
90263
90264
90265
90266
90267
90268
90269
90271
90272
90273
90274
90275
90276
90277
90278
90279
90280
90281
90282

Deleted items
20705
20805
20953
21927
22001
22018
22040
22045
22050
22070
23021
23022
23023
23031
23032
23033
23041
23042
23043
23051
23052
23053
23061
23062
23063
23071
23072
23073
23081
23082
23083
32088
32089
32090
32093
41846

Description amended
52
53
54
57
58
59
60
65
99
104
105
106
107
108
109
110
111
112
113
114
116
117
119
120
122
128
131
132
133
135
141
143
145
147
149
170
171
172
177
288
289
291
293
296
297
299
300
302
304
306
308
310
312
314
316
318
319
320
322
324
326
328
330
332
334
336
338
342
344
346
348
350
352
353
355
356
357
358
359
361
364
366
367
369
370
384
385
386
387
388
389
501
503
507
511
515
519
520
530
532
534
536
699
820
822
823
825
826
828
830
832
834
835
837
838
855
857
858
861
864
866
880
2799
2801
2806
2814
2820
2824
2832
2840
2946
2949
2954
2958
2972
2974
2978
2984
2988
2992
2996
3000
3003
3005
3010
3014
3015
3018
3023
3028
3032
3040
3044
3051
3055
3062
3069
3074
3078
3083
3088
3093
6007
6009
6011
6013
6015
6016
6018
6019
6023
6024
6025
6026
6028
6029
6031
6032
6034
6035
6037
6038
6042
6051
6052
6057
6058
6059
6060
6062
6063
6064
6065
6067
6068
6071
6072
6074
6075
11507
11508
11512
12205
12207
12208
18216
18219
18226
18227
20160
20162
20706
20745
20750
20790
20840
20902
21952
22002
22012
22014
22025
22031
25015
30075
30078
30275
30329
30330
32084
32087
35551
35664
35670
45626
51051
51052
51053
51061
51062
51063
51064
51065
51066
52027
73832
90092
90093
90095
90096

Fee amended
177
699
20142
20144
20145
20410
20745
20750
21922
21926
21936
21952

INCREASE IN MAXIMUM PATIENT GAP
The maximum patient gap between the Medicare Benefits Schedule (MBS) fee and the benefits payable for out-of-hospital services increases to $84.70 as at 1 November 2019. The 85% benefit level will apply for all fees up to $564.70, after which benefits are calculated at the Schedule fee less $84.70.
Instructions to update maximum patient gap: https://support.mednet.com.au/portal/kb/articles/add-max-gap

Heart Health Assessment 1 November 2019 update
From 1 November 2019 an administrative amendment will be made to items 699 and 177 to make all health assessment items have a 100% benefit. The fees will be adjusted for items 699 and 177 so there is no change to the Medicare rebate patients will receive for a heart health assessment service.

Amendment to eight A2 services
Amends the descriptor of eight A2 services (items 52, 53, 54, 57, 58, 59, 60 and 65) by omitting reference to clause 2.3.1.

Remove gender specific text from professional attendance items
Gender specific text has been removed from Professional Attendance items in Groups: A3, A4, A8, A21, A24, A6, A12, A26, A29, A31, A15, A28, and A32.

GP Telehealth items (MMM 6-7)
Twelve new video conferencing items for patients in rural and remote areas (as defined by Modified Monash areas 6 to 7) to assist with access to general practice services.
To view and update rural and remote locations within Impulse: https://support.mednet.com.au/portal/kb/articles/regional-rural-and-remote-area-codes

Amendment to items 90092, 90093, 90095 and 90096
This amends the descriptor of four attendance items provided by omitting the rendering cohort of doctors in paragraphs (a) and (b) and substituting with “by a medical practitioner who is not a general practitioner”.

Sleep study items 12205 and 12207
From 1 November 2019, minor amendments will be made to items 12205 and 12207 to provide more clarity on the clinical circumstances to which these items apply.

Sleep study item 12208
On 1 November 2019, a minor update will be made to improve the readability of the item descriptor.

Anaesthesia MBS Changes from 1 November 2019
MBS items for anaesthesia services are changing to reflect contemporary anaesthesia practice. These changes are a result of the MBS Review Taskforce recommendations and consultation with stakeholders. The revised structure contains twenty eight amended items, proposes ten new items and deletes thirty one items.

New Items for Colonoscopy
Amending existing colonoscopy services to distinguish eligible patient cohorts by appropriate interval screenings, as recommended by the Taskforce.

Minor amendments to items 30075, 30078, 30275, 30329, 30330, 35551, 35664, 35670 and 52027
Terminology for these items has been improved by replacing references to "lymph gland/s” with the term “lymph node/s”.

Split of item 45626 to delineate between trachomatous and non-trachomatous cause
Splitting MBS item 45626 into two items to be able to identify utilisation of this procedure to treat delineating ectropion / entropion repair for trachoma and non-trachomatous causes

Minor amendments to spinal surgery items from 1 November 2019
Items 51051, 51052 and 51053
The term ‘motion segment’ will be replaced with the appropriate clinical term ‘vertebra’ or ‘vertebrae’.

Items 51061 to 51066
The term 'spine fusion' will be replaced with the appropriate clinical term “spinal fusion”.

Items 51113 and 51114
The co-claiming restrictions for items 51113 and 51114 will be revised to enable appropriate co-claiming of these items with the paediatric scoliosis or kyphosis items (50600 to 50644).

Item 51145
The item will enable a second medical practitioner to be remunerated for providing assistance at the operation through the inclusion of the term (Assist.) in the item descriptor.

New item for mobile x-ray at residential aged care facilities
One new item providing a flagafall fee for the provision of skeletal x-ray (following a fall), chest x-ray (for suspected pneumonia or heart failure) and abdominal X-ray (for suspected acute abdomen or bowel obstruction) to patients within a residential aged care facility.

New items for Whole body 18F-FDG PET study for breast cancer
New items for: whole body 18F-FDG positron emission tomography (PET) study for: staging of locally advanced breast cancer; or evaluation of suspected metastatic or suspected locally or regionally recurrent breast carcinoma.

New MBS items for Breast MRI for specified populations
This change will introduce four new interim items for magnetic resonance imaging for breast cancer. These new items are for the diagnosis of breast cancer where other imaging is inconclusive, and for treatment planning for breast cancer.

Amendment to Pathology Services Table Item 73832
Item 73832 has been amended to ensure that the same requirements that apply for performance of item 73805 also apply to item 73832.

Amendment to Pathology Services Table Item 72860
This item has been amended to clarify that the retrieval and review of archived formalin fixed paraffin embedded block(s) to determine the appropriate sample(s) for the purposes of further genetic testing does not apply if the subsequent genetic test(s) is performed in the same laboratory. The item will apply if the subsequent genetic test(s) is performed in a different laboratory, including laboratories within the same laboratory network provided the laboratories are at separate locations.

New MBS items for Eating Disorders
This change will introduce, a suite of 64 Eating Disorder items to support a model of best practice evidence based care for patients with anorexia nervosa and other eligible patients with eating disorders.

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