Skin Lesion Excision and Flap Repair M B S Item Restriction Guide

 

This list outlines M B S items that are, not payable in association with, only payable in association with or payable when patientís record is clearly annotated with clinical relevance of the procedure.

 

Items 4 5 2 0 0, 4 5 2 0 3, 4 5 2 0 6 and 4 5 2 0 7, not payable in association with

malignant skin lesion items, 3 1 3 5 6, 3 1 3 5 8, 3 1 3 5 9, 3 1 3 6 1, 3 1 3 6 3, 3 1 3 6 5, 3 1 3 6 7, 3 1 3 6 9.

non-malignant skin lesion items, 3 1 3 5 7, 3 1 3 6 0, 3 1 3 6 2, 3 1 3 6 4, 3 4 3 6 6, 3 1 3 6 8, 3 1 3 7 0.

malignant melanomas items, 3 1 3 7 1, 3 1 3 7 2, 3 1 3 7 3, 3 1 3 7 4, 3 1 3 7 5, 3 1 3 7 6.

 

Item 4 5 2 0 1, only payable in association with one of the following

Mohs micrographic surgery items, 3 1 0 0 0 to 3 1 0 0 5.

malignant skin lesion items, 3 1 3 5 8, 3 1 3 5 9, 3 1 3 6 3 or 3 1 3 6 9.

non-malignant skin lesion items, 3 1 3 6 0, 3 1 3 6 4 or 3 1 3 7 0.

malignant melanoma items, 3 1 3 7 1, 3 1 3 7 3 or 3 1 3 7 6.

 

Item 4 5 2 0 2, payable when the clinical relevance of the procedure is clearly annotated in the patientís record and either

item 4 5 2 0 1 applies to the first flap and additional flap repair is required for the same defect; or

item 4 5 2 0 1 doesnít apply, for example the excision performed isnít an item listed in the description 4 5 2 0 1, and either the patient has severe pre-existing scarring, severe skin atrophy or sclerodermoid changes, or the repair is contiguous with a free margin

 

Go to m b s online.gov . a u for more information.

 

This infographic is correct as at December 2020

Module code M B S M02 INFO8

 

Australian Government

Services Australia

Website, medicareaust.com/index