Medicare Benefits Schedule - Item 39126

Search Results for Item 39126

View Associated Notes

Category 3 - THERAPEUTIC PROCEDURES

39126

39126 - Additional Information

Item Start Date:
01-Jul-1993
Description Updated:
01-Mar-2022
Schedule Fee Updated:
01-Nov-2023

Group
T8 - Surgical Operations
Subgroup
7 - Neurosurgical
Subheading
2 - Pain Relief

All of the following:
(a) infusion pump, subcutaneous implantation or replacement of;
(b) connection of the pump to a spinal catheter;
(c) filling of reservoir with a therapeutic agent or agents;
with or without programming the pump, for the management of chronic pain, including cancer pain (H) 



Multiple Operation Rule

(Anaes.) (Assist.)

Fee: $398.30 Benefit: 75% = $298.75

(See para TN.8.244 of explanatory notes to this Category)


Associated Notes

Category 3 - THERAPEUTIC PROCEDURES

TN.8.244

Implanted device items

As with all interventions, implant procedures should be performed in the context of clinical best practice. This is of particular importance given the high cost of the devices. Current clinical best practice for use of these item numbers includes:

-          All procedures being performed in the context of a comprehensive pain management approach with a multidisciplinary team.

-          Patients should be appropriately selected for the procedure, including, but not limited to assessment of physical and psychological function prior to implantation with findings documented in the medical record.

-          Outcome evaluation pre and post implantation.

-          Appropriate follow up and ongoing management of implanted medical devices should be ensured.

Implantable devices require ongoing monitoring and management. If the person providing the implantation service is not the ongoing physician manager of the device, they are responsible for ensuring that appropriate ongoing management has been arranged.

Items 39130 and 39139 provide for the insertion of one or multiple leads. There is no intention to change current billing practices for these items, e.g. where more than one lead is inserted as part of an episode then the item can be billed once per lead.

Item 39133 can be billed twice per attendance where services are separate procedures. Accompanying text is required for these claims such as one item is for the removal of an infusion pump and one item is for the removal or repositioning of a spinal catheter.

Related Items: 14218 39125 39126 39127 39128 39130 39131 39133 39134 39135 39136 39137 39139 39141


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