Appendix B                      Consumer Summary Table

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:  A new schedule of MBS items for spinal surgery

Items

What they do

Committee recommendation

What would be different

Why

The 74 current items for spinal surgery are 40300 to 40351; 48600 to 48694; and 47681 to 47717.

The 74 items cover a range of services for spinal surgery.

The Committee recommends a new schedule of items for spinal surgery. In practice, the 74 existing items for spinal surgery will be replaced by 59 new items.

The new schedule of spinal surgery items provides a logical MBS claiming system that better describes current spinal surgery practice. The new item descriptors are less ambiguous/open to interpretation than the current schedule of items. It will be easier for consumers to understand how the MBS items necessary relate to their surgery.

Greater clarity and usability of MBS items for spinal surgery will increase consistency in how items are claimed by surgeons. This will remove potential differences in Medicare benefits provided to patients for the same surgery.

Recommendation 2: New rules to underpin the new schedule of MBS items for spinal surgery

Committee recommendation

The Committee recommends that the proposed schedule of items for spinal surgery is accompanied by new rules that will be specific to the operation of the spinal surgery schedule. The intention of adding the rules is to reduce any inappropriate claiming of multiple MBS items for spinal surgery. Greater clarity and usability of MBS items for spinal surgery will increase consistency in how items are claimed by surgeons. This will reduce potential differences in Medicare benefits provided to patients for the same surgery.

 

 


Recommendation 3: Obsolete items

Committee recommendation

The Committee recommends that three obsolete items are removed from the MBS. The services will not be covered by the new schedule of items for spinal surgery.