Bilateral Ureteroscopy

As Chair of the Australian and New Zealand Association of Urological Surgeons (ANZAUS), A/Prof Troy Gianduzzo has provided the following information to share with Members.

Billing Requirements for MBS Item 36822

In response to a member enquiry, ANZAUS has clarified billing requirements regarding item 36822. Specifically:

“Many MBS cystoscopy items specify whether they may be used unilaterally (for example, item descriptors for 36822, 36821 and 36823 or whether they may be used either unilaterally or bilaterally (for example, item descriptors for 36818, 36824). The Urology Committee of the MBS Review Taskforce noted that bilateral cystoscopy represents a complete repeat procedure, including insertion and removal of the cystoscope. As such, item 36822 specifies it is ‘unilateral’ deliberately. Where the procedure being undertaken is bilateral in nature and the requirement under (b) in the item descriptor is met for both ureters, this item may be appropriately co-claimed.”

In summary, as the descriptor uses the word “unilateral”, and where the cystoscope is withdrawn and then re-inserted, the item number can be co-claimed for bilateral procedures. I encourage members to check directly with the department regarding queries on MBS items. It is the responsibility of members to ensure that billing is compliant with the MBS item descriptors. Specific enquiries can be directed to the Department via the following email: SurgicalServices@health.gov.au