Medicare Benefits Schedule - Note TN.8.101

Medicare benefits for liposuction are generally attracted under item 45584, that is for the treatment of post-traumatic pseudolipoma.  Such trauma must be significant and result in large haematoma and localised swelling.  Only on very rare occasions would benefits be payable for bilateral liposuction. 

Where liposuction is indicated for the treatment of Barraquer-Simons Syndrome, lymphoedema or macrodystrophia lipomatosa, or the reduction of buffalo hump, item 45585 applies.  One regional area is defined as one limb or trunk.  If liposuction is required on more than one limb, item 45585 can be claimed once per limb. 

Full clinical details must be documented in patient notes, including pre-operative photographic and / or diagnostic imaging evidence demonstrating the clinical need for the service as this may be subject to audit.

Related Items: 31346 45584 45585

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Multiple Operation Rule

Liposuction (suction assisted lipolysis) to one regional area (one limb or trunk), for treatment of post traumatic pseudolipoma, if photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes

(Anaes.)

Fee: $695.35 Benefit: 75% = $521.55

(See para TN.8.101 of explanatory notes to this Category)

Multiple Operation Rule

Liposuction (suction assisted lipolysis) to one regional area (one limb or trunk), other than a service associated with a service to which item 31525 or 31526 applies, if:

(a) the liposuction is for:

(i) the treatment of Barraquer-Simons syndrome, lymphoedema or macrodystrophia lipomatosa; or

(ii) the reduction of a buffalo hump that is secondary to an endocrine disorder or pharmacological treatment of a medical condition; and

(b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes

(H)

(Anaes.)

Fee: $695.35 Benefit: 75% = $521.55

(See para TN.8.101 of explanatory notes to this Category)

Multiple Operation Rule

Liposuction (suction assisted lipolysis) to one regional area for contour problems of abdominal, upper arm or thigh fat because of repeated insulin injections, if:

(a) the lesion is subcutaneous; and

(b) the lesion is 50 mm or more in diameter; and

(c) photographic and/or diagnostic imaging evidence demonstrating the need for this service is documented in the patient notes

(Anaes.)

Fee: $232.20 Benefit: 75% = $174.15 85% = $197.40

(See para TN.8.101 of explanatory notes to this Category)