Untitled document
Health Insurance (Section 3C General Medical Services—Transvaginal repair of pelvic organ prolapse and procedures for the excision of graft material) Determination 2018
I, NATASHA RYAN, delegate of the Minister for Health, make this Determination under subsection 3C(1) of the Health Insurance Act 1973.
Dated 1 June 2018
NATASHA RYAN
Assistant Secretary
MBS Policy and Specialist Services Branch
Medical Benefits Division
Department of Health
Contents
1. Name of Determination
2. Commencement
3. Authority
4. Definitions
5. Treatment of relevant services
6. Application of items 35581 and 35582
7. Application of provisions of the general medical services table
Schedule 1 – relevant services
Name of Determination
This Determination is the Health Insurance (Section 3C General Medical Services—Transvaginal repair of pelvic organ prolapse and procedures for the excision of graft material) Determination 2018.
Commencement
This Determination commences immediately after the commencement of the Health Insurance (General Medical Services Table) Regulations 2018.
Authority
This Determination is made under subsection 3C(1) of the Health Insurance Act 1973.
Definitions
In this Determination:
Act means the Health Insurance Act 1973.
relevant provisions means all provisions, of the Act and regulations made under the Act, and the National Health Act 1953 and regulations made under the National Health Act 1953, relating to medical services, professional services or items.
relevant service means a health service, as defined in subsection 3C(8) of the Act, that is specified in a Schedule.
Schedule means a Schedule to this Determination.
Note: The following terms are defined in subsection 3(1) of the Act:
·clinically relevant service
·item
·general medical services table
·professional service
(2) Unless the contrary intention appears, a reference in this Determination to a provision of the Act or the National Health Act 1953 or regulations made under the Act or under the National Health Act 1953 as applied, adopted or incorporated in relation to specifying a matter is a reference to those provisions as in force from time to time and any other reference to provisions of an Act or regulations is a reference to those provisions as in force from time to time.
Treatment of relevant services
For subsection 3C(1) of the Act a relevant service, provided in accordance with this Determination and as a clinically relevant service, is to be treated, for the relevant provisions, as if:
(a) it were both a professional service and a medical service; and
(b) there were an item in Group T8 of the general medical services table that:
(i) related to the service; and
(ii) specified for the service a fee in relation to each State, being the fee specified in the Schedule in relation to the service.
Application of items 35581 and 35582
For items 35581 and 35582 the size of the excised graft material must be histologically tested and confirmed.
Application of provisions of the general medical services table
(1) Clause 1.2.5 of the general medical services table shall have effect as if the items contained in the Schedule were also specified in clause 1.2.5(1).
(2) Clause 1.2.6 of the general medical services table shall have effect as if items contained in the Schedule were also specified in clause 1.2.6(1).
Schedule 1 – relevant services
| Group T8 – Surgical Operations | ||
| Subgroup 4—Gynaecological | ||
| Item | Service | Fee ($) |
| 35570 | Anterior vaginal compartment repair by vaginal approach for pelvic organ prolapse (involving repair of urethrocele and cystocele), using native tissue without graft, other than a service associated with a service to which item 35573, 35577 or 35578 applies (H) (Anaes.) (Assist.) | 553.85 |
| 35571 | Posterior vaginal compartment repair by vaginal approach for pelvic organ prolapse involving repair of one or more of the following: (a) perineum; (b) rectocoele; (c) enterocoele; using native tissue without graft, other than a service associated with a service to which item 35573, 35577 or 35578 applies (H) (Anaes.) (Assist.) | 553.85 |
| 35573 | Anterior and posterior vaginal compartment repair by vaginal approach for pelvic organ prolapse (involving anterior and posterior compartment defects), using native tissue without graft, other than a service associated with a service to which item 35577 or 35578 applies (H) (Anaes.) (Assist.) | 830.90 |
| 35577 | Manchester (Donald Fothergill) operation for pelvic organ prolapse (includes cervical amputation, anterior and posterior native tissue vaginal wall repairs without graft) (H) (Anaes.) (Assist.) | 674.50 |
| 35581 | Vaginal procedure for excision of graft material in symptomatic patients with graft related complications, including graft related pain or discharge and bleeding related to graft exposure, less than 2cm2 in its maximum area, either singly or in multiple pieces, other than a service associated with a service to which item 35582 or 35585 applies (H) (Anaes.) (Assist.) | 553.85 |
| 35582 | Vaginal procedure for excision of graft material in symptomatic patients with graft related complications, including graft related pain or discharge and bleeding related to graft exposure, more than 2cm2 in its maximum area, either singly or in multiple pieces, other than a service associated with a service to which item 35581 or 35585 applies (H) (Anaes.) (Assist.) | 830.90 |
| 35585 | Abdominal procedure either open, laparoscopic or robotic, for removal of graft material in patients symptomatic with graft related complications, including graft related pain or discharge and bleeding related to graft exposure or where the graft has penetrated adjacent organs such as the bladder (including urethra) or bowel, including retroperitoneal dissection and mobilisation of bladder and/or bowel, other than a service associated with a service to which item 35581 or 35582 applies (H) (Anaes.) (Assist.) | 1,473.20 |
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