Medicare Benefits Schedule - Note TN.8.123

Item 35533 is intended to cover the surgical repair of female genital mutilation or a major congenital anomaly of the uro-gynaecological tract which is not covered by existing MBS items. For example, this item would apply where a patient who has previously received treatment for cloacal extrophy, bladder exstrophy or congenital adrenal hyperplasia requires additional or follow-up treatment.

Item 35534 is intended to cover services for a structural abnormality causing significant functional impairment and is restricted to patients aged 18 years and over.

A detailed clinical history outlining the structural abnormality and the medical need for surgery of the vulva and/or labia must be included in patient notes, as this may be subject to audit.

Medicare benefits are not payable for non-therapeutic cosmetic services. 

Related Items: 35533 35534

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Multiple Operation Rule

Vulvoplasty or labioplasty, for repair of:

(a) female genital mutilation; or

(b) an anomaly associated with a major congenital anomaly of the uro-gynaecological tract

other than a service associated with a service to which item 35536, 37836, 37050, 37842, 37851 or 43882 applies

(Anaes.)

Fee: $385.05 Benefit: 75% = $288.80

(See para TN.8.123 of explanatory notes to this Category)

Multiple Operation Rule

Vulvoplasty or labioplasty, in a patient aged 18 years or more, performed by a specialist in the practice of the specialist's specialty, for a structural abnormality that is causing significant functional impairment, if the patient's labium extends more than 8 cm below the vaginal introitus while the patient is in a standing resting position

(Anaes.)

Fee: $385.05 Benefit: 75% = $288.80

(See para TN.8.123 of explanatory notes to this Category)