Medicare Benefits Schedule - Item 22032

Introduction of a plexus or nerve block to a peripheral nerve, perioperatively performed using an in‑situ catheter in association with anaesthesia and surgery, for post‑operative pain management (H)

(4 basic units)

Fee: $92.40 Benefit: 75% = $69.30

(See para TN.10.8, TN.10.17 of explanatory notes to this Category)

• Previous - Item 22031
• Next - Item 22036

Included in the RVG format are a number of additional or complementary services which may be provided in connection with anaesthesia such as blood pressure monitoring (item 22012) and intra-arterial cannulation (item 22025). 

These items (with the exception of peri-operative nerve blocks (22031-22042)) and perfusion services (22055-22075) have also been retained in the MBS in the non-RVG format, for use by practitioners who provide these services other than in association with anaesthesia. 

Item 22002

The amendment to item 22002 is for the transfusion of blood and/or for intraoperative transfusion of red cells collected by cell saver in association with administration of anaesthesia.

Items 22012 and 22014

Benefits are payable under items 22012 and 22014 only once for each type of pressure, up to a maximum of 4 pressures per patient per calendar day, and irrespective of the number of practitioners involved in monitoring the pressures.

Items 22012, 22014 and 22025

A patient who is categorised as having a high risk  of complications is one where clinical indications allow for the following items to be claimed (in conjunction with items 22012, 22014 and 22025) with item 25000, item 25005 or item 25010 modifiers, and/or item 25013, and/or item 25014, and/or items 25020, 25025 and/or when the basic surgical item value is 10 or more units, and/or is conjunction with items in group T10 Subgroup 13 (Shoulder and Axilla), or with items 23170 – 24136 (for procedures of greater than four hours duration) noting this is not an exhaustive list.

Item 22042

This item can be co-claimed with item 20142 (anaesthesia for lens surgery), when anaesthesia or sedation was also provided by the same anaesthetist.

Item 22042 cannot be co-claimed with item 20142, 20144, 20145 and 20147 when a general anaesthetic is the primary anaesthetic approach.

Related Items: 22002 22012 22014 22015 22020 22025 22032 22042 22052 22053 22054

Items 22031 to 22041

Benefits are only payable for intra-operative nerve or plexus blocks performed for the management of post-operative pain that are specifically catered for under items 22031 to 22041.

Items 22031 and 22036

For items 22031 and 22036, postoperative pain management means that the injected therapeutic substance is expected to prolong the analgesic effect of the epidural or intrathecal technique.

Item 22031 (initial intrathecal or epidural injection)

Benefits are payable under item 22031 for the initial intrathecal or epidural injection of a therapeutic substance/s, in association with anaesthesia and surgery, for the control of post-operative pain. Benefit is not payable for subsequent intra-operative intrathecal and epidural injection (item 22036) in the same anaesthetic episode. Where subsequent infusion is provided post operatively, to maintain analgesia, benefit would be payable under items 18222 or 18225.

Item 22032 (continuous nerve block)

Benefits are payable under item 22032 for perioperative introduction of a plexus or nerve block to a peripheral nerve, using an in situ catheter in association with anaesthesia and surgery, for continuous post operative pain management.

Benefit is not payable under this item for ultrasound guidance for injection or catheter insertion for anaesthesia.

Item 22036 (subsequent intrathecal or epidural injection)

Benefits are payable under item 22036  for subsequent intrathecal or epidural injection of a therapeutic substance/s, in association with anaesthesia and surgery, performed intra-operatively, for postoperative pain management, where the catheter is already in-situ. Benefits are not payable under this item where the initial injection was performed intra-operatively, under item 22031, in the same anaesthetic episode.

Item 22041 (plexus or nerve block)

Benefits are payable under item 22041 in addition to the general anaesthesia for the related procedure.

Related Items: 22031 22032 22036 22041