Medicare Benefits Schedule - Note TN.8.32

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Category 3 - THERAPEUTIC PROCEDURES

TN.8.32

Varicose veins - (Items 32500 to 32517)

Claims for benefits under item 32501should be accompanied by full clinical details, including pre-operative colour photographs, to verify the need for additional services.

Where digital photographs are supplied, the practitioner must sign each photograph to certify that the digital photograph has not been altered. The claim and the additional information should be lodged with the Department of Human Services for referral to the National Office of the Department of Human Services for assessment by the Medicare Claims Review Panel (MCRP) and must be accompanied by sufficient clinical and/or photographic evidence to enable the Department of Human Services to determine the eligibility of the service for the payment of benefits.

Practitioners may also apply to the Department of Human Services for prospective approval for proposed surgery.

Applications for approval should be addressed in a sealed envelope marked 'Medical-in Confidence' to:

The MCRP Officer

PO Box 9822

SYDNEY NSW 2001

In relation to endovenous laser therapy (ELT) and/or radiofrequency diathermy/ablation, Rule 2.44.14 of the Health Insurance (General Medical Services Table) Regulations (GMST) means the following:

  • ELT and/or radiofrequency diathermy/ablation are not payable if they are billed under any varicose vein items (32500 to 32517) or vascular item 35321.
  • If ELT and/or radiofrequency diathermy/ablation are provided on the same occasion as these MBS items, the ELT and radiofrequency diathermy/ablation services must be itemised separately on the invoice, showing the full fees for each service separately to the fees billed against the MBS items.
  • We strongly recommend that a practitioner who intends to bill ELT and/or radiofrequency diathermy/ablation on the same occasion as providing MBS services contact Department of Human Services' provider information line on 132 150 to confirm the Department of Human Services' requirements for correct itemisation of MBS and non-MBS services on a single invoice.
  • The Department of Human Services monitors billing practices associated with MBS items and any billing which stands out as being out of line with most practitioners may warrant the attention of the Department of Human Services.
  • In light of the policy clarification of GMST Rule 2.44.14, with effect from 1 May 2009, ┬áthe Department of Human Services will be able to track any apparent cost-shifting (of ELT and/or radiofrequency diathermy/ablation) to the MBS items detailed in GMST Rule 2.44.14 or to other MBS items.

Related Items: 32500 32501 32504 32507 32508 32511 32514 32517


Related Items

Category 3 - THERAPEUTIC PROCEDURES

32500

32500 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-May-2003
Schedule Fee Start Date:
01-Nov-2012

VARICOSE VEINS where varicosity measures 2.5mm or greater in diameter, multiple injections of sclerosant using continuous compression techniques, including associated consultation - 1 or both legs - not being a service associated with any other varicose vein operation on the same leg (excluding after-care) - to a maximum of 6 treatments in a 12 month period

(Anaes.)

Fee: $109.80 Benefit: 75% = $82.35 85% = $93.35

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

Category 3 - THERAPEUTIC PROCEDURES

32501

32501 - Additional Information

Item Start Date:
01-Nov-1997
Description Start Date:
01-May-2003
Schedule Fee Start Date:
01-Nov-2012

VARICOSE VEINS where varicosity measures 2.5mm or greater in diameter, multiple injections of sclerosant using continuous compression techniques, including associated consultation - 1 or both legs - not being a service associated with any other varicose vein operation on the same leg, (excluding after-care) where it can be demonstrated that truncal reflux in the long or short saphenous veins has been excluded by duplex examination - and that a 7th or subsequent treatment (including any treatments to which item 32500 applies) is indicated in a 12 month period

Fee: $109.80 Benefit: 75% = $82.35 85% = $93.35

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

Category 3 - THERAPEUTIC PROCEDURES

32504

32504 - Additional Information

Item Start Date:
01-Nov-1994
Description Start Date:
01-Nov-2002
Schedule Fee Start Date:
01-Nov-2012

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: $267.65 Benefit: 75% = $200.75 85% = $227.55

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

Category 3 - THERAPEUTIC PROCEDURES

32507

32507 - Additional Information

Item Start Date:
01-Jul-1998
Description Start Date:
01-Nov-2002
Schedule Fee Start Date:
01-Nov-2012

VARICOSE VEINS, sub-fascial surgical exploration of one or more incompetent perforating veins - 1 leg - not being a service associated with a service to which item 32508, 32511, 32514 or 32517 applies on the same leg

(Anaes.) (Assist.)

Fee: $533.60 Benefit: 75% = $400.20 85% = $453.60

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

Category 3 - THERAPEUTIC PROCEDURES

32508

32508 - Additional Information

Item Start Date:
01-Nov-1994
Description Start Date:
01-Nov-2002
Schedule Fee Start Date:
01-Nov-2012

VARICOSE VEINS, complete dissection at the sapheno-femoral OR sapheno-popliteal junction - 1 leg - with or without either ligation or stripping, or both, of the long or short saphenous veins, for the first time on the same leg, including excision or injection of either tributaries or incompetent perforating veins, or both

(Anaes.) (Assist.)

Fee: $533.60 Benefit: 75% = $400.20

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

Category 3 - THERAPEUTIC PROCEDURES

32511

32511 - Additional Information

Item Start Date:
01-Nov-1994
Description Start Date:
01-Nov-2002
Schedule Fee Start Date:
01-Nov-2012

VARICOSE VEINS, complete dissection at the sapheno-femoral AND sapheno-popliteal junction - 1 leg - with or without either ligation or stripping, or both, of the long or short saphenous veins, for the first time on the same leg, including excision or injection of either tributaries or incompetent perforating veins, or both

(Anaes.) (Assist.)

Fee: $793.30 Benefit: 75% = $595.00

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

Category 3 - THERAPEUTIC PROCEDURES

32514

32514 - Additional Information

Item Start Date:
01-Nov-1994
Description Start Date:
01-Nov-2002
Schedule Fee Start Date:
01-Nov-2012

VARICOSE VEINS, ligation of the long or short saphenous vein on the same leg, with or without stripping, by re-operation for recurrent veins in the same territory - 1 leg - including excision or injection of either tributaries or incompetent perforating veins, or both

(Anaes.) (Assist.)

Fee: $926.80 Benefit: 75% = $695.10

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

Category 3 - THERAPEUTIC PROCEDURES

32517

32517 - Additional Information

Item Start Date:
01-Nov-1994
Description Start Date:
01-Nov-2002
Schedule Fee Start Date:
01-Nov-2012

VARICOSE VEINS, ligation of the long and short saphenous vein on the same leg, with or without stripping, by re-operation for recurrent veins in either territory - 1 leg - including excision or injection of either tributaries or incompetent perforating veins, or both

(Anaes.) (Assist.)

Fee: $1,193.40 Benefit: 75% = $895.05

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


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