Further Update - 1 July Changes to MBS Item Descriptors
As Members will be aware, USANZ previously communicated changes to MBS item descriptors for items 45566 and 45572.
We have since received further communication from the MBS Policy and Specialist Programs Branch, Department of Health and Aged Care. Members are advised of the information below regarding claiming restrictions when using treatments involving hydrogel injections.
1 July changes to MBS items descriptors for items 45566 and 45572 relevant to injection of hydrogel spacer for prostate cancer
On 1 July 2023, a range of changes to the Medicare Benefits Schedule came into effect reflecting the recommendations of the 2019 MBS Review Taskforce Report for Plastic and Reconstructive Surgery Items. More information about the changes can be found here, and the full MBS Taskforce report on Plastic and Reconstructive Surgery Items can be found here.
As part of these changes, the item descriptor for MBS tissue expansion item 45566 was amended to clarify indications for claiming of this item and assist clinicians in appropriate selection and claiming.
The new item descriptor for item 45566 is: “Insertion of a temporary prosthetic tissue expander which requires subsequent removal, including all attendances for subsequent expansion injections, not to be used for breast or post-mastectomy tissue expansion (Anaes.)(Assist.)”
The Department is aware that item 45566 has been claimed for injection of hydrogel spacer to protect the rectum during radiation therapy for prostate cancer and advises this does not meet the changing item descriptor requirements.
The item descriptor for MBS tissue expansion item 45572 also changed on 1 July 2023, and now reads: “Intra-operative tissue expansion using a prosthetic tissue expander, performed under general anaesthetic or intravenous sedation during an operation if combined with a service to which another item in Group T8 applies (including expansion injections), not to be used for breast tissue expansion (Anaes.)"
As long as all item requirements of the item are met, the Department considers that item 45572 may be appropriately claimed for injection of a hydrogel such as SpaceOAR or Barrigel into the pre-rectal space.