Medicare Benefits Schedule - Note TN.8.32

Under the Health Insurance (General Medical Services Table) Regulations, items 32500 to 32517 and 35321 do not apply to services mentioned in those items if the services are delivered by:

1. endovenous laser treatment (ELT); or
2. radiofrequency diathermy; or
3. radiofrequency ablation for varicose veins.

It is recommended that a practitioner who intends to bill ELT, radiofrequency diathermy or radiofrequency ablation for varicose veins on the same occasion as providing items 32500 to 32517 or 35321 contact the Services Australia provider information line on 132 150 to confirm requirements for correct itemisation of services on a single invoice.

The Department of Health monitors billing practices associated with MBS items. Services for ELT, radiofrequency diathermy or radiofrequency ablation for varicose veins provided on the same occasion as items 32500 to 32517 or 35321 must be itemised separately on the invoice, showing the full fees for each service separately to the fees billed against these MBS items.

Related Items: 32500 32504 32507 32508 32511 32514 32517 35321

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Multiple Operation Rule

PERIPHERAL ARTERIAL OR VENOUS CATHETERISATION to administer agents to occlude arteries, veins or arterio-venous fistulae or to arrest haemorrhage, (but not for the treatment of uterine fibroids or varicose veins) percutaneous or by open exposure, excluding associated radiological services or preparation, and excluding aftercare, not being a service associated with photodynamic therapy with verteporfin

(Anaes.) (Assist.)

Fee: $895.20 Benefit: 75% = $671.40 85% = $796.50

(See para TN.8.32 of explanatory notes to this Category)

Multiple Operation Rule

Varicose veins, multiple injections of sclerosant using continuous compression techniques, including associated consultation, one or both legs, if:

(a) proximal reflux of 0.5 seconds or longer has been demonstrated; and

(b) the service is not for cosmetic purposes; and

(c) the service is not associated with:

(i) any other varicose vein operation on the same leg (excluding aftercare); or

(ii) a service on the same leg (excluding aftercare) to which any of the following items apply:

(A) 35200;

(B) 59970 to 60078;

(C) 60500 to 60509;

(D) 61109

Applicable to a maximum of 6 treatments in a 12 month period

(Anaes.)

Fee: $120.85 Benefit: 75% = $90.65 85% = $102.75

(See para TN.8.4, TN.8.32, TN.8.33, TN.8.228 of explanatory notes to this Category)

Multiple Operation Rule

VARICOSE VEINS, multiple excision of tributaries, with or without division of 1 or more perforating veins - 1 leg - not being a service associated with a service to which item 32507, 32508, 32511, 32514 or 32517 applies on the same leg

(Anaes.)

Fee: $294.65 Benefit: 75% = $221.00 85% = $250.50

(See para TN.8.32 of explanatory notes to this Category)

Multiple Operation Rule

Varicose veins, sub‑fascial ligation of one or more incompetent perforating veins in one leg of a patient, if the service:

(a) is performed by open surgical technique (not including endoscopic ligation) and the patient has significant signs or symptoms (including one or more of the following signs or symptoms) attributable to venous reflux:

(i) ache;

(ii) pain;

(iii) tightness;

(iv) skin irritation;

(v) heaviness;

(vi) muscle cramps;

(vii) limb swelling;

(viii) discolouration;

(ix) discomfort;

(x) any other signs or symptoms attributable to venous dysfunction; and

(b) is not associated with:

(i) any other varicose vein operation on the same leg; or

(ii) a service (on the same leg) to which item 35200, 60072, 60075 or 60078 applies

(H)

(Anaes.) (Assist.)

Fee: $587.35 Benefit: 75% = $440.55

(See para TN.8.32, TN.8.33 of explanatory notes to this Category)

Multiple Operation Rule

Varicose veins, complete dissection at the sapheno‑femoral or sapheno‑popliteal junction, with or without either ligation or stripping, or both, of the great or small saphenous veins in one leg of a patient, for the first time on the same leg, including excision or injection of either tributaries or incompetent perforating veins, or both, if the patient has significant signs or symptoms (including one or more of the following signs or symptoms) attributable to venous reflux:

(a) ache;

(b) pain;

(c) tightness;

(d) skin irritation;

(e) heaviness;

(f) muscle cramps;

(g) limb swelling;

(h) discolouration;

(i) discomfort;

(j) any other signs or symptoms attributable to venous dysfunction

(H)

(Anaes.) (Assist.)

Fee: $587.35 Benefit: 75% = $440.55

(See para TN.8.32, TN.8.33 of explanatory notes to this Category)

Multiple Operation Rule

Varicose veins, complete dissection at the sapheno‑femoral and sapheno‑popliteal junction, with or without either ligation or stripping, or both, of the great or small saphenous veins in one leg of a patient, for the first time on the same leg, including excision or injection of either tributaries or incompetent perforating veins, or both, if the patient has significant signs or symptoms (including one or more of the following signs or symptoms) attributable to venous reflux:

(a) ache;

(b) pain;

(c) tightness;

(d) skin irritation;

(e) heaviness;

(f) muscle cramps;

(g) limb swelling;

(h) discolouration;

(i) discomfort;

(j) any other signs or symptoms attributable to venous dysfunction

(H)

(Anaes.) (Assist.)

Fee: $873.20 Benefit: 75% = $654.90

(See para TN.8.32, TN.8.33 of explanatory notes to this Category)

Multiple Operation Rule

Varicose veins, ligation of the great or small saphenous vein in the same leg of a patient, with or without stripping, by re‑operation for recurrent veins in the same territory—one leg—including excision or injection of either tributaries or incompetent perforating veins, or both, if the patient has significant signs or symptoms (including one or more of the following signs or symptoms) attributable to venous reflux:

(a) ache;

(b) pain;

(c) tightness;

(d) skin irritation;

(e) heaviness;

(f) muscle cramps;

(g) limb swelling;

(h) discolouration;

(i) discomfort;

(j) any other signs or symptoms attributable to venous dysfunction

(H)

(Anaes.) (Assist.)

Fee: $1,020.15 Benefit: 75% = $765.15

(See para TN.8.32, TN.8.33 of explanatory notes to this Category)

Multiple Operation Rule

Varicose veins, ligation of the great and small saphenous vein in the same leg of a patient, with or without stripping, by re‑operation for recurrent veins in either territory—one leg—including excision or injection of either tributaries or incompetent perforating veins, or both, if the patient has significant signs or symptoms (including one or more of the following signs or symptoms) attributable to venous reflux:

(a) ache;

(b) pain;

(c) tightness;

(d) skin irritation;

(e) heaviness;

(f) muscle cramps;

(g) limb swelling;

(h) discolouration;

(i) discomfort;

(j) any other signs or symptoms attributable to venous dysfunction

(H)

(Anaes.) (Assist.)

Fee: $1,313.60 Benefit: 75% = $985.20

(See para TN.8.32, TN.8.33 of explanatory notes to this Category)