| Medicare Benefits Schedule Review Taskforce
First Report from the
Ear Nose and Throat (ENT) Surgery Clinical Committee - Tonsillectomy, Adenoidectomy & Insertion of Grommets
The views and recommendations in this review report from the clinical committee have been released for the purpose of seeking the views of stakeholders.
This report does not constitute the final position on these items which is subject to:
Consideration by the MBS Review Taskforce;
Then if endorsed
Consideration by the Minister for Health; and
Stakeholders should provide comment on the recommendations via the online consultation tool.
Confidentiality of comments:
If you want your feedback to remain confidential please mark it as such. It is important to be aware that confidential feedback may still be subject to access under freedom of information law.
Table of Contents
1.Executive Summary 5
2.About the Medicare Benefits Schedule (MBS) Review 9
3.About the ENT Committee 12
4.MBS Item Group 1 – ENT Therapeutic Procedures 13
6.Insertion of grommets 20
9.New item for Stroboscopy 32
10.MBS items which require no change 34
11.Items requiring no change 35
12.MBS Item Group 2 – Obsolete Items 35
13.Obsolete items 35
14.MBS Item Group 3 – Generic issues 37
15.Generic Issues 39
16.Recommendations Impact Statement 40
1.Acronyms and Abbreviations 42
20.MBS items, Descriptors and Explanatory Notes 44
21.Summary for consumers 69
22.Stroboscopy Review 77
23.Data for items requiring no change 89
The Medicare Benefits Schedule (MBS) Review Taskforce (the Taskforce) is undertaking a program of work that considers how more than 5,700 items on the MBS can be aligned with contemporary clinical evidence and practice and improves health outcomes for patients. The Taskforce will also seek to identify any services that may be unnecessary, outdated or potentially unsafe.
The Taskforce is committed to providing recommendations to the Minister that will allow the MBS to deliver on each of these four key goals:
Affordable and universal access
Best practice health services
Value for the individual patient
Value for the health system.
The Taskforce has endorsed a methodology whereby the necessary clinical review of MBS items is undertaken by Clinical Committees and Working Groups. The Taskforce has asked the Clinical Committees to undertake the following tasks:
Consider whether there are MBS items that are obsolete and should be removed from the MBS.
Consider identified priority reviews of selected MBS services.
Develop a program of work to consider the balance of MBS services within its remit and items assigned to the Committee.
Advise the Taskforce on relevant general MBS issues identified by the Committee in the course of its deliberations.
The recommendations from the Clinical Committees are released for stakeholder consultation. The Clinical Committees will consider feedback from stakeholders and then provide recommendations to the Taskforce in a Review Report. The Taskforce will consider the Review Report from Clinical Committees and stakeholder feedback before making recommendations to the Minister for consideration by Government.
The Ear, Nose and Throat (ENT) Surgery Clinical Committee (the Committee) was established in 2015 to undertake a review of relevant MBS items. Phase one of this review relied upon the clinical expertise of the members who sought advice from colleagues as necessary, as well as independent, targeted rapid evidence reviews of certain services.
1.1Areas of responsibility of the Ear, Nose and Throat Surgery Clinical Committee
The Taskforce identified 196 MBS items for review by the Committee (see Appendix A for full descriptions).
Otolaryngology and Audiology Diagnostic Procedures
11300 to 11339 (16 items)
General Surgery Items
30244 to 30259 (9 items) – procedures on the styloid process, parotid gland and associated structures, submandibular gland and associated structures
30265 to 30294 (12 items) – procedures on the salivary glands, tongue, intraoral tumours, branchial cysts and cervical esphagostomy
31400 to 31412 (5 items) – removal of tumours of the upper aerodigestive tract
Ear Nose and Throat Procedures
41500-41816, 41822, 41825, 41834- 41886, 41904, 41907, 41910 (145 items)
82300 to 82332 (9 items) – services by audiologists on request from ENT specialists
Phase one of the review prioritised the items relating to tonsillectomy, adenoidectomy, insertion of grommets and identification of obsolete items. The remaining items are likely to be reviewed during phase two of the ENT review.
Gastroenterologists are the main providers of items 41819 to 41820 and 41828 to 41832 for dilatation of stricture of upper gastro-intestinal tract and balloon dilatation of oesophagus (5 items). Therefore, these items were referred to the Gastroenterology Clinical Committee for review.
Thoracic medicine physicians are the main providers of items 41889 to 41898 and item 41905 for bronchoscopy (5 items). These items were referred to the Thoracic Medicine Clinical Committee for review.