What are the indications, fees and benefits associated with the new items?
|MBS item numbers||Health service||Fee|
|57362||Cone beam computed tomography – dental and temporo-mandibular joint imaging (without contrast medium) for diagnosis and management of any of the following:
Cone beam computed tomography – dental and temporo-mandibular joint imaging (without contrast medium) for diagnosis and management of any of the following:
What are the restrictions under the new items, and why have they been applied?As recommended by the Medical Services Advisory Committee (MSAC), the new items will be accompanied by a range of restrictions to encourage the judicious use of CBCT in order to optimise the safety and quality of services.
Multiple claiming during the same attendance
Claims for more than one CBCT per day are not permitted; claiming for two-dimensional imaging in the same attendance (items 57959 to 57969) and with CT in the same attendance (items 56001 to 57361) are also excluded.
Why? Data showed that there was a high level of claiming of CBCT items with other panoramic radiography services and additional CBCT scan/s during a single episode of care. Given safety concerns at the increased radiation exposure to patients, and the lack of a demonstrated clinical justification, MSAC recommended that claiming of multiple services should be precluded.
CBCT scans can be requested by Medicare-eligible medical practitioners and specialist dentists
General dentists can no longer request CBCT services under Medicare.
Why? MSAC concluded that CBCT should have the same restrictions that apply for CT items and should therefore be restricted to dental specialists. Medical practitioners can request any CT service.
Services performed on hybrid units are excluded under the new arrangements.
Why? MSAC noted that multiple scans are often required when CBCT services are performed on equipment with a fixed or narrow field of view, which is a common limitation of hybrid CBCT units. Given concerns at over-servicing and exposure of patients to unnecessary levels of radiation, MSAC recommended that hybrid CBCT units be excluded under the new arrangements.
CBCT services under Medicare can no longer be performed in practices that are not Diagnostic Imaging Accreditation Scheme (DIAS) accredited.
Why? Given the range of safety and quality issues associated with CBCT services MSAC recommended that claims for CBCT should be restricted to DIAS-accredited practices, noting that DIAS is the primary quality assurance scheme in diagnostic imaging.
The Diagnostic Imaging Accreditation Scheme (DIAS)DIAS is a mandatory scheme, established via a 2007 amendment to the Health Insurance Act 1973, that links accreditation to the payment of Medicare benefits for diagnostic imaging services. DIAS commenced operations in 2008, and is a key mechanism in Australia for ensuring minimum safety and quality standards in diagnostic imaging practices.
Further information about DIAS, and how practices can become accredited, is available at the Diagnostic Imaging Accreditation Scheme page on this website.