Some case examples of MBS claiming can be found in the C ase Example Guide.
If you are using a downloaded PDF version of the MBS, an index of services is provided within each category to assist you in locating the appropriate item number for the service provided. To assist you in navigating the new schedule, the Quick Reference Guide outlines the new items and relevant explanatory notes.
Explanatory notes explain the service requirements in more detail and outline the range of treatments and/or assessments you need to provide to meet the requirements for billing the service. To provide more guidance, certain items include additional information in the form of explanatory notes. The item descriptor outlines the service requirements which must be met before the item can be claimed. These services cannot be billed with any other service from groupT8 (surgical operations) when performed for the purpose of spinal surgery. How do I know what item to claim on the new schedule?Īll new spinal surgery items are located within sub-group 17 (spinal surgery) of group T8 (surgical operations) on the MBS (Items 51011 to 51171). The Clinical Committee considered the feedback received from stakeholders before providing recommendations to the MBS Review Taskforce. The recommendations from the Clinical Committee were released for stakeholder consultation in 2017. The Spinal Surgery Clinical Committee was established in 2016 to provide broad clinician and consumer expertise. The Spinal Surgery Working Group was established in 2015 to review the existing schedule and assist in the creation of the revised schedule. Who was consulted on the changes to the spinal surgery schedule?
Significant variation from forecasted expenditure may warrant review and amendment of fees, and incorrect use of MBS items can result in penalties including the health professional being asked to repay monies that have been incorrectly received. Spinal Surgery items will be subject to MBS compliance processes and activities, including random and targeted audits which may require a provider to submit evidence about the services claimed. How will the new requirements be monitored? Patients should also no longer receive different Medicare rebates for the same operations as there should be less variation in the items claimed by different providers. Patients will receive Medicare rebates for spinal surgery services that are clinically appropriate and reflect modern clinical practice. How will the changes to MBS Spinal Surgery items affect patients? The changes to spinal surgery items will commence on 1 November 2018. When will the changes to Spinal Surgery items come into effect?
The complete list of new spinal surgery items is available in the Quick Reference Guide. The changes will also help to ensure the ongoing sustainability of the MBS by preventing inappropriate claiming of multiple MBS items. The revised spinal surgery listings better describe the procedures being performed by spinal surgeons, reflecting the contemporary practice of spinal surgery. The previous spinal surgery schedule was outdated and ambiguous. The revised spinal surgery listings were recommended by the independent MBS Review Taskforce, following a comprehensive review of the MBS items by clinicians, health system experts and consumers. The Government’s changes to the Medicare Benefits Schedule (MBS) items for spinal surgery were announced in the 2018-19 Budget. Why is the Government making these changes? Spine Surgery Case Example Guide (DOC 517 KB) Spine Surgery Case Example Guide (PDF 675 KB) Spine Surgery Quick reference guide (DOC 623 KB) Spine Surgery Quick reference guide (PDF 738 KB) Please note from 1 November 2019, there will be minor changes to MBS items for spinal surgery. Changes to MBS Items for Spinal Surgery Services - Frequently Asked Questions