Article

Report from the Gynaecology Clinical Committee (Now Closed)

Published 4 October 2018

Items reviewed

The Gynaecology Clinical Committee of the MBS Review Taskforce reviewed a total of 141 items in the following areas:

  1. Assisted Reproductive Technologies (ART) 
  2. General Gynaecology
  3. Urogynaecology
  4. Gynaecological Oncology

Proposed item changes

Proposed changes
No. items
Change descriptor
54
Consolidate
24
No change
18
Change descriptor, change schedule fee
17
Delete
17
New item (split)
16
New item
11
Split item, change descriptor
4
Split item, change schedule fee
3
Consolidate, Delete item
2
Split item, change descriptor and schedule fee
1
Consolidate, change schedule fee
1

Report recommendations

The Gynaecology Clinical Committee made a total of 76 recommendations, and are summarised below:

Assisted reproductive technologies

The Committee recommended:

  • Introducing restrictions to the number of ART stimulated cycle items that can be claimed by each consumer, and to the maximum consumer age up to which MBS funding will be provided for these items.
  • Providing MBS funding support to those undergoing an ART stimulated cycle as part of an altruistic (non-commercial) egg donation or surrogacy arrangement.
  • Enacting measures to improve consumers’ understanding of the potential benefits and costs of ART treatment, making greater use of detailed Australian ART data that is already being collected by ART industry bodies.
General gynaecology

The Committee recommended:

  • Consolidating the two existing items used for the insertion of an IUD into one item, no longer specifying the indication for insertion, and keeping endometrial biopsy as a separate item. In addition, the Committee recommended increasing the schedule fee for the item to promote IUD insertions by general practitioners (GPs), which is currently limited in Australia but has potential benefits for patient safety, convenience and access.
  • Consolidating the three existing items for diagnostic hysteroscopy procedures into two items, specifying that one item is for use in an outpatient.
  • Restructuring or splitting items relating to laparoscopic hysterectomy, complex laparoscopic surgery and hysteroscopic surgery.
Urogynaecology

  • In late 2017 the Therapeutic Goods Administration (TGA) removed mesh products whose sole use is the treatment of pelvic organ prolapse via transvaginal implantation from the Australian Register of Therapeutic Goods. The Committee aligned their recommendations with the actions of the TGA by allowing MBS funding of vaginal surgery for pelvic organ prolapse only when native tissue without graft (mesh) is used.

  • The Committee recommended introducing three new items describing the removal of mesh/graft for consumers who suffer severe mesh-related side effects.

    Gynaecological oncology

    The Committee recommended:

    • Amending or splitting the current items for ovarian cancer debulking, radical hysterectomy, lymph node dissection and biopsy, and cervical cone biopsy so that they better describe the differing extent and complexity of the surgery required.
    • Adding new surgical techniques and information from the latest Australian clinical guidelines to several items, as well as specifying that certain procedures should only be done after discussion with experienced clinicians.