Cosmetic and plastic surgery assessing rules in Medicare 011-42060070
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MBS Online - Plastic and reconstructive surgery MBS changes
MBS Online - Three new items relating to plastic and reconstructive surgery for nurse practitioners
FAQ from customers
Table 1: this table describes frequently asked questions about cosmetic surgery.
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Item |
Description |
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1 |
Question: If a patient has undergone previous cosmetic breast augmentation surgery and there have been complications (such as rupture, migration of prosthetic material, or capsule formation) can item numbers 45552 to 45555 be billed? + Read more ... Answer: Yes. The circumstances of the original implant, such as if it was for cosmetic reasons, do not affect eligibility for MBS rebates if removal and replacement is clinically relevant. |
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2 |
Question: Is treatment of hypomastia considered to be cosmetic? + Read more ... Answer: Yes, breast augmentation for hypomastia (under-developed breasts) is considered cosmetic. There is no MBS item number for surgical treatment of hypomastia. |
Table 2: this table describes frequently asked questions about the reduction of eyelids.
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Item |
Description |
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1 |
Question: Does a health professional need to provide photos when claiming items 45617, 45620, or 45623? + Read more ... Answer: No, however full clinical details must be documented in patient notes, including clear photographic evidence of the loss of visual field for audit purposes. |
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2 |
Question: Can the health professional claim items 45617 or 45620 twice? + Read more ... Answer: Yes the item is payable twice on the same day. The operator must check for text or notation for left or right eye. |
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3 |
Question: Can items 45617 and 45623 be claimed on the same occasion? + Read more ... Answer: Yes, if the health professional determines that the service is 'clinically relevant', Medicare benefits are payable. The operator must check for text/notation for left and right eye. |