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New Medicare item number (42705) listed for MIGS

New Medicare item number (42705) listed for MIGS

Following continued discussions between RANZCO and the federal Department of Health, a new Medicare item number (42705) has been listed today for the implant of minimally invasive glaucoma surgery (MIGS) devices. The new item number is an interim measure only, with a current expiry date of 31 December 2017.

It follows the notification that as of 1 May the goniotomy item number 42758 cannot be used for the implant of MIGS devices. The new item number is specifically designed to allow the continued implant of devices whilst a full MSAC review is underway. It can only be done in conjunction with cataract surgery and does not provide a specific rebate for the surgical component other than the cataract element.

However, following the discussions with the Department of Health it should not be assumed that the restrictions applied now, including the implant in conjunction with cataract surgery, will be the same if the MSAC review is positive. RANZCO will continue to work with MSAC and the Department of Health as they undertake a full review with a result expected later this year.

The exact item number is:

Upcoming changes to Ophthalmology MBS items 1/5

From 1 May 2017, a number of changes to Ophthalmology procedural Medicare Benefits Schedule (MBS) items will take effect. These have been a product of ongoing discussions between the College and the Department of Health.

Please note that these changes are not part of the formal MBS Review process. The MBS Review Ophthalmology Committee is expected to be announced later this year. The College will continue to update Fellows on the MBS Review and other changes to Ophthalmology MBS items.

One significant change that Fellows should note is the limitation placed on MBS item 42758 (goniotomy). In practice, this change means that glaucoma stents cannot be billed for MBS rebate using this item. This change came about despite repeated advocacy efforts by the RANZCO Medicare Advisory Committee and the Australia and New Zealand Glaucoma Society to explain the impact of this change to the Department of Health. RANZCO will continue to advocate for the proper inclusion of stents into the MBS schedule.

The full list upcoming changes, effective 1 May, are detailed below. Changes to existing item wording are presented in underline.

  • MBS item 42725: VITRECTOMY via pars plana sclerotomies including the removal of vitreous, division of bands or removal of epiretinal membranes, and including capsulotomy if performed.
  • MBS item 42734: CAPSULOTOMY, other than by laser, not being an item associated with items 42725 or 42731.
  • MBS item 42758: GONIOTOMY for the treatment of primary congenital glaucoma, excluding the minimally invasive implantation of glaucoma drainage devices (H).
  • MBS item 42788: LASER CAPSULOTOMY – each treatment episode to 1 eye, to a maximum of 2 treatments to that eye in a 3 year period, not being an item associated with item 42702.
  • MBS item 42789: LASER CAPSULOTOMY – each treatment episode to one eye – if it can be demonstrated that a third or subsequent treatment to that eye (including any treatments to which item 42788 applies) is indicated in a 2 year period, not being an item associated with item 42702.
  • MBS item 42791: LASER VITREOLYSIS OR CONTRICOLYSIS OF LENS MATERIAL OR FIBRINOLYSIS, excluding vitreolysis in the posterior vitreous cavity – each treatment to 1 eye, to a maximum of 2 treatments to that eye in a 2 year period.
  • MBS item 42792: LASER VITREOLYSIS OR CORTICOLYSIS OF LENS MATERIAL OR FIBRINOLYSIS, excluding vitreolysis in the posterior vitreous cavity – each treatment to one eye – if it can be demonstrated that a third or subsequent treatment to that eye (including any treatments to which item 42791 applies) is indicated in a 2 year period.

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