Medicare Benefits Schedule - Note TN.8.248

For the purposes of any item in which an endometriosis grading is referenced the equivalent grade under the American Fertility Society (rAFS) endometriosis classification system is as follows:
Minimal endometriosis is the equivalent of stage I.
Mild endometriosis is the equivalent stage II.
Moderate endometriosis is the equivalent to stage III.
Servere endometriosis is the equivalent stage IV or higher.

Related Items: 35631 35632 35637 35641

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Multiple Operation Rule

Operative laparoscopy, including any of the following:
(a) unilateral or bilateral ovarian cystectomy;
(b) salpingo-oophorectomy;
(c) salpingectomy for tubal pathology (including ectopic pregnancy by tubal removal or salpingostomy, but excluding sterilisation);
(d) excision of mild endometriosis;
not being a service associated with a service to which any other intraperitoneal or retroperitoneal procedure item (other than item 30724 or 30725) applies (H)

(Anaes.) (Assist.)

Fee: $810.60 Benefit: 75% = $607.95

(See para TN.1.4, TN.8.2, TN.8.229, TN.8.248 of explanatory notes to this Category)

Multiple Operation Rule

Complicated operative laparoscopy, including either or both of the following:
(a) excision of moderate endometriosis;
(b) laparoscopic myomectomy for a myoma of at least 4cm, including incision and repair of the uterus;
not being a service associated with a service to which any other intraperitoneal or retroperitoneal procedure item (other than item 30724 or 30725 or 35658) applies (H)

(Anaes.) (Assist.)

Fee: $1,013.15 Benefit: 75% = $759.90

(See para TN.1.4, TN.8.2, TN.8.229, TN.8.248 of explanatory notes to this Category)

Multiple Operation Rule

Operative laparoscopy, including any of the following:
(a) excision or ablation of minimal endometriosis;
(b) division of pathological adhesions;
(c) sterilisation by application of clips, division, destruction or removal of tubes;
not being a service associated with another laparoscopic procedure (H) 

NOTE: Strict legal requirements apply in relation to sterilisation procedures on minors. Medicare benefits are not payable for services not rendered in accordance with relevant Commonwealth and State and Territory law. Observe the explanatory note before submitting a claim.

(Anaes.) (Assist.)

Fee: $463.20 Benefit: 75% = $347.40

(See para TN.1.4, TN.8.46, TN.8.229, TN.8.248 of explanatory notes to this Category)

Multiple Operation Rule

Severe endometriosis, laparoscopic resection of, involving 2 of the following procedures:
(a) resection of the pelvic side wall including dissection of endometriosis or scar tissue from the ureter;
(b) resection of the Pouch of Douglas;
(c) resection of an ovarian endometrioma greater than 2 cm in diameter;
(d) dissection of bowel from uterus from the level of the endocervical junction or above (H)

(Anaes.) (Assist.)

Fee: $1,415.70 Benefit: 75% = $1,061.80

(See para TN.1.4, TN.8.229, TN.8.248 of explanatory notes to this Category)