Appendix B                      Summary for consumers

This section includes tables which describe the medical service, the recommendation(s) of the clinical experts and why the recommendation(s) has been made.

Recommendation 1

Item

What it does

Committee recommendation

What would be different

Why

63513 and 63514

A MRI scan of the knee.

Remove the current requirement of mandatory plain radiography before an MRI in patients under the age of 16 years.

Likely to reduce unnecessary x-ray radiation in children.

To avoid radiation exposure and associated radiography costs in children who do not require preliminary plain radiography (x-rays) before MRI.

Recommendation 2 and 2.1

Item

What it does

Committee recommendation

What would be different

Why

63560 and 63561

A MRI scan of the knee.

Introduction of an additional age cut-off for GP knee MRI referrals for patients over 50 years.

 

 

Restrict the number of GP-referred MRIs to three per annum per patient.

GPs will no longer be able to request MRI of the Knee for patients over 50 years.  Patients over 50 will still be able to be undertake an MRI of the knee through a request from a medical specialist (other than a radiologist).

 

Any further MRI (> 3) will need to be requested by a specialist if the referral falls within the 12 month period.

MRI has low utility in patients over 50 years and also with regard to subsequent clinical decision making in patients who are thought to have symptomatic knee osteoarthritis.

 

 

To improve appropriate utilisation of GP requested MRI of the knee.

 


Recommendation 3

Item

What it does

Committee recommendation

What would be different

Why

55828, 55829, 55830 and 55831

Ultrasound of the knee.

Remove the indication of ‘injury of collateral ligaments’ from the current descriptor.

This item can no longer be used to examine injuries of collateral ligaments.

A low-clinical-utility examination in diagnosing the cause of symptomatic knee painin the context of suspected meniscal, articular cartilage or cruciate ligament injury.

Recommendation 4

Item

What it does

Committee recommendation

What would be different

Why

57518, 57521, 57535 and 57536

X-ray of the foot, ankle, leg, knee or femur.

Separate the MBS items for the knee from the current X-ray items, which encompass foot, ankle, leg, knee or femur.

Requestors are to use a different item number for X-ray of the knee only.

Currently, it is not possible to identify the number of X-ray services performed specifically for the knee. Separating the knee will allow usage to be monitored.

Recommendation 5

Item

What it does

Committee recommendation

What would be different

Why

56619, 56625, 56659 and 56665

CT scan of extremities.

Separate the MBS items for the knee from the current CT items.

Requestors are to use a different item number for a CT scan of the knee only.

There are no specific CT items for the knee. Therefore it is not possible to identify the number of CT scans performed specific for the knee. Separating the knee will allow usage to be monitored.