Medicare Benefits Schedule - Item 31572

Search Results for Item 31572

View Associated Notes

Category 3 - THERAPEUTIC PROCEDURES

31572

31572 - Additional Information

Item Start Date:
01-Jul-2013
Description Updated:
01-Jul-2013
Schedule Fee Updated:
01-Jul-2022

Group
T8 - Surgical Operations
Subgroup
1 - General
Subheading
1 - Bariatric

Gastric bypass by Roux-en-Y including associated anastomoses, with or without crural repair taking 45 minutes or less, for a patient with clinically severe obesity not being associated with a service to which item 30515 applies

Multiple Operation Rule

(Anaes.) (Assist.)

Fee: $1,105.20 Benefit: 75% = $828.90

(See para TN.8.29 of explanatory notes to this Category)


Associated Notes

Category 3 - THERAPEUTIC PROCEDURES

TN.8.29

Bariatric Procedures - (Items 31569 to 31581, anaesthesia item 20791)

Items 31569 to 31581 and item 20791 provide for surgical treatment of clinically severe obesity and the accompanying anaesthesia service (or similar).  The term clinically severe obesity generally refers to a patient with a Body Mass Index (BMI) of 40kg/m2 or more, or a patient with a BMI of 35kg/m2 or more with other major medical co-morbidities (such as diabetes, cardiovascular disease, cancer).  The BMI values in different population groups may vary due, in part, to different body proportions which affect the percentage of body fat and body fat distribution.  Consequently, different ethnic groups may experience major health risks at a BMI that is below the 35-40 kg/m2 provided for in the definition.  The decision to undertake obesity surgery remains a matter for the clinical judgment of the surgeon. 

If crural repair taking 45 minutes or less is performed in association with the bariatric procedure, additional hernia repair items cannot be claimed for the same service.

Practitioners providing items 31569, 31572, 31575 and 31581 should be registered with and provide relevant data to the Bariatric Surgery Registry.

Related Items: 20791 31569 31572 31575 31578 31581


Legend

  • Assist - Addition/Deletion of (Assist.)
  • Amend - Amended Description
  • Anaes - Anaesthetic Values Amended
  • Emsn - EMSN Change
  • Fee - Fee Amended
  • Renum - Item Number Change (renumbered)
  • New - New Item
  • NewMin - New Item (previous Ministerial Determination)
  • Qfe - QFE Change