Medicare Benefits Schedule - Item 49590

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.8.183 of explanatory notes to this Category)

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• 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