Medicare Benefits Schedule - Item 30475

Endoscopic dilatation of stricture of upper gastrointestinal tract (including the use of imaging intensification if clinically indicated) (H)

Multiple Operation Rule

(Anaes.)

Fee: $397.55 Benefit: 75% = $298.20

(See para TN.8.17, TN.8.133 of explanatory notes to this Category)

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The following are guidelines for appropriate minimum standards for the performance of GI endoscopy in relation to (a) cleaning, disinfection and sterilisation procedures, and (b) anaesthetic and resuscitation equipment.

These guidelines are based on the advice of the Gastroenterological Society of Australia, the Sections of HPB and Upper GI and of Colon and Rectal Surgery of the Royal Australasian College of Surgeons, and the Colorectal Surgical Society of Australia.

Cleaning, disinfection and sterilisation procedures
Endoscopic procedures should be performed in facilities where endoscope and accessory reprocessing protocols follow procedures outlined in:

1. Infection Control in Endoscopy, Gastroenterological Society of Australia and Gastroenterological Nurses College of Australia , 2011;
2. Australian Guidelines for the Prevention and Control of Infection in Healthcare (NHMRC, 2010);
3. Australian Standard AS 4187 2014 (and Amendments), Standards Association of Australia. 

Anaesthetic and resuscitation equipment
Where the patient is anaesthetised, anaesthetic equipment, administration and monitoring, and post-operative and resuscitation facilities should conform to the standards outlined in 'Guidelines on Sedation and/or Analgesia for Diagnostic and Interventional Medical, Dental or Surgical Procedures' (PS09), Australian & New Zealand College of Anaesthetists, Gastroenterological Society of Australia and Royal Australasian College of Surgeons.

Single operator, single use peroral cholangiopancreatoscopy (POCPS) item 30665

For the purposes of item 30665 a treatment cycle, for a patient, means a series of treatments for the patient that:

(a)  begins on the day of the initial failed attempt at biliary stone removal via endoscopic retrograde cholangiopancreatography (ERCP) extraction techniques; and
(b)  ends at the conclusion of the aftercare period for the procedure, being either the lithotripsy procedure or a definitive surgical management procedure, that has resulted in removal of the biliary stones.

Conjoint Committee

For the purposes of Items 32023, 30664 and 30665 the procedure is to be performed by a surgeon or gastroenterologist with ERCP training recognised by the Conjoint Committee for the Recognition of Training in Gastrointestinal Endoscopy.

Related Items: 30473 30475 30478 30479 30481 30484 30485 30490 30491 30494 30664 30665 30680 30682 30684 30686 30687 30688 30690 30692 30694 32023 32084 32087 32094 32095 32106 32222 32223 32224 32225 32226 32227 32228 32229 32232

Endoscopic upper GI stricture services 41819 and 41820 have been consolidated under item 30475.  This consolidated item will allow any endoscopic technique to be performed for oesophageal through to gastroduodenal procedures and will include imaging intensification if done. The fee is the same as item 41819 which higher than item 30475 but lower than 41820. 

Related Items: 30475