Split of MBS item 42587 for the treatment of trichiasis

Trichiasis Split of MBS item 42587 - Factsheet (PDF 157 KB)
Trichiasis Split of MBS item 42587- Factsheet (DOC 516 KB)

What are the changes?
From 1 November 2018, MBS item 42587 will be split into two items, 42587 and 42588. The intent of this change is to distinguish whether a patient’s trichiasis is due to trachoma, or non-trachomatous cause.

Why are the changes being made?
In line with the World Health Organization (WHO) requirements on the elimination of trachoma, Australia has agreed to report on a comprehensive set of strategies including demonstrating that Australia’s health system is able to identify and manage cases of trichiasis.

Currently, it is difficult to determine from the available MBS data whether a patient has had surgery for trachomatous or non-trachomatous trichiasis.

To allow more accurate data to be captured on trachoma-related trichiasis surgery the MSAC Executive has recommended splitting MBS Item 42587 into two items to distinguish whether the cause of the trichiasis is due to trachoma or other causes.

What does this mean for providers?
MBS item 42587 should continue to be claimed for the treatment of trichiasis due to causes other than trachoma. From 1 November 2018, for treatment of trichiasis due to trachoma, providers should use new MBS item 42588.

What does this mean for patients?
Eligible patients can continue to receive Medicare rebates when undergoing treatment of trachoma. There is no change to eligibility to receive this service, nor any changes to the Schedule fee or applicable rebate(s).

When will this change be reviewed?
The Department of Health regularly reviews the usage of new and amended MBS items in consultation with the profession.

All MBS items may be subject to compliance processes and activities, including random and targeted audits which may require a provider to submit information about the services claimed.

Significant variation from forecasted expenditure may warrant review and amendment of fees, and incorrect use of MBS items can result in penalties including the health professional being asked to repay monies that have been incorrectly received.

Where can I find more information?
The full item descriptor and information on other changes to the MBS can be found at the MBS Online website or by calling the Department of Human Services on 132 150.

Amended Item
(Draft wording of items to be finalised through regulatory amendments)