Medicare Benefits Schedule - Item 49590

Search Results for Item 49590

View Associated Notes

Category 3 - THERAPEUTIC PROCEDURES

49590

49590 - Additional Information

Item Start Date:
01-Jul-2021
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Nov-2023

Group
T8 - Surgical Operations
Subgroup
15 - Orthopaedic
Subheading
12 - Knee

Excision of ganglion, cyst or bursa of knee, by open or arthroscopic means, performed as an independent procedure, other than a service associated with a service to which another item in this Group applies

Multiple Operation Rule

(Anaes.) (Assist.)

Fee: $408.95 Benefit: 75% = $306.75 85% = $347.65

(See para TN.8.117, TN.8.183 of explanatory notes to this Category)


Associated Notes

Category 3 - THERAPEUTIC PROCEDURES

TN.8.117

Autologous Chondrocyte Implantation in the Knee

The Medical Services Advisory Committee (MSAC) evaluated the available evidence and did not support public funding for matrix-induced autologous chondrocyte implantation (MACI) or autologous chondrocyte implantation (ACI) for the treatment of chondral defects in the knee and other joints, due to the increased cost compared to existing procedures and the lack of evidence showing short term or long-term improvements in clinical outcomes. Medicare benefits are not payable in association with this technology as per GN.13.33.

Related Items: 49500 49503 49506 49509 49512 49515 49516 49517 49518 49519 49521 49524 49525 49527 49530 49533 49534 49536 49542 49544 49548 49551 49554 49564 49565 49569 49570 49572 49574 49576 49578 49580 49582 49584 49586 49590

Category 3 - THERAPEUTIC PROCEDURES

TN.8.183

Procedure for arthroscopic knee surgery (Items 49570 - 49590)

  • Only a single arthroscopy item for each procedure may be utilised per knee.
  • This item must be for the most complex procedure undertaken and must not be utilised in conjunction with any other knee arthroscopy item. Refer to the Australian Orthopaedic Association guidelines for appropriate use.
  • Osteoarthritis is a progressive disease involving structural and compositional changes of the whole joint. Multiple clinical trials have demonstrated that knee arthroscopic procedures have no clinically meaningful benefit in patients with uncomplicated osteoarthritis.
  • Uncomplicated osteoarthritis is defined as a circumstance where the patient's symptoms or illness are not due to obstructive atraumatic chondral, meniscal or chondral lesions, or repairable menisci, sepsis, neoplasia or inflammatory disorders.
  • For patients with uncomplicated osteoarthritis, arthroscopy should only be performed in patients with surgeon-confirmed obstructive symptoms (locked or locking knee), or where the identified pathology is atraumatic chondral, meniscal or chondral lesions that are causative of the symptoms.
  • Patient selection for knee arthroscopy in the presence of osteoarthritis should conform to the October 2016 Position statement from the Australian Knee Society on arthroscopic surgery of the knee, including reference to the presence of osteoarthritis or degenerative joint disease, or such standards that supersede these.

Related Items: 49570 49572 49574 49576 49578 49580 49582 49584 49586 49590


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