Part 2 of Presentation - Medical Benefits Schedule (MBS) Review - An Obstetric Perspective

Page last updated: 25 February 2016

PDF version: Part 2 of Presentation - Medical Benefits Schedule (MBS) Review: An Obstetric Perspective (PDF 1726 KB)

Slide 1: Insights from the pilot reviews

Who? MBS Review – Obstetric Clinical Committee

  • Specialist O&Gs - incl MFM Subspecialist
  • General Practitioner O&Gs
  • Other Specialist (Epidemiologist)
  • Midwife
  • Community rep
  • Health Department support ++

Slide 2: Examples of Review Items

  • Knee arthroscopy
  • CT scans for lower back pain
  • Sleep studies
  • Ferritin and Iron studies
  • Adenoidectomy, tonsillectomy and grommets
  • Prenatal pathology tests

Slide 3: Early Clinical Committees

  • Diagnostic Imaging - Bone densiometry, PE and acute DVT, Knee Imaging
  • Top of page
  • Obstetrics
  • Ear, Nose and Throat
  • Haematology
  • Respiratory
  • Endoscopy / Colonoscopy

Slide 4-6: What should the Obstetric Group look at?

Prepregnancy and Antenatal pathology tests
  • Vitamin D, Ferritin, TSH
  • U&E, LFT, Cholesterol
  • Parvovirus ab, CMV ab, Toxoplasma ab
Possible change?
Should recommend “first antenatal visit blood tests” be grouped into a single item number?

Slide 7-8: What will the Obstetric Group target?

Ultrasound?
  • Widespread use of point of care ultrasound in obstetrics, but many smaller practices find the credentialing process difficult

Possible change?
Should point of care ultrasound billing be rolled into the antenatal visit item number?

Slide 9-11: What will the Obstetric Group target?

Antenatal visits?
  • Large variation in numbers of visits and practices increasingly using midwives to do some antenatal visits

Possible change?
Is there any value in going back to a single item number for all antenatal visits?
e.g. Assume an average of 10 visits for PG and 7 for MG? (NICE guideline)

Slide 12-13: What will the Obstetric Group target?

Pregnancy Planning and Management
  • 16590 (intends to manage birth - 324) and 16591 (not - 142)
    Many 16590 (esp in some states) who never deliver a baby

Possible change?
Restrict 16590 to only those with obstetric admitting privileges at the hospital where the patient is booked? Top of page

Slide 14-16: What will the Obstetric Group target?

Labour and Birth?
  • 16519 (non-comples) and 16522 (complex)?
    Substantial variation probably not due to clinical complexity

Possible change?
More objective descriptors
e.g. add morbid obesity, remove "serious condition endangering mother"

Slide 17: What will the Obstetric Group target?

Labour and Birth?
  • 16519 (non-comples) and 16522 (complex)?
    More work (less help) rurally

Possible change?
Rural Loading

Slide 18-19: What will the Obstetric Group target?

Mid-trimester miscarriage or termination of Pregnancy
  • Currently around of the 16519 yet mostly much more complex/difficult and extremely demanding in time and emotional support for the patient

Possible change?
Restructure the current mid-trimester item number for 16.0 to 22.9 weeks at a substantially higher rate

Slide 20-21: What will the Obstetric Group target?

Postnatal Care
  • More resources into Postnatal care?

Possible change?
Definitive item for a postnatal check that includes a mental health assessment


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