7.           MBS Item Group 3: X-ray of the knee

7.1        Items considered in this section

The items listed in Table 8 are considered in this section.

Table 8: Item descriptor

GROUP I3 – DIAGNOSTIC RADIOLOGY

SUBGROUP 1 – RADIOGRAPHIC EXAMINATION OF EXTREMITIES

Common MBS item descriptor

FOOT, ANKLE, LEG, KNEE OR FEMUR

Item

Specifier

Fee

57518

NR

Fee: $32.50 Benefit: 75% = $24.40 85% = $27.65

57521

R

Fee: $43.40 Benefit: 75% = $32.55 85% = $36.90

57535

NR NK

Fee: $37.85 Benefit: 75% = $28.40 85% = $32.20

57536

R NK

Fee: $65.75 Benefit: 75% = $49.35 85% = $55.90

Common MBS item descriptor

FOOT AND ANKLE, OR ANKLE AND LEG, OR LEG AND KNEE, OR KNEE AND FEMUR

Item

Specifier

Fee

57524

NR

Fee: $49.40 Benefit: 75% = $37.05 85% = $42.00

57527

R

Fee: $65.75 Benefit: 75% = $49.35 85% = $55.90

57538

NR NK

Fee: $24.70 Benefit: 75% = $18.55 85% = $21.00

57539

R NK

Fee: $32.90 Benefit: 75% = $24.70 85% = $28.00

7.2        Issues identified

Insufficient granularity of Medicare data items does not allow utilisation of plain radiography of the knee to be determined.

7.3        Recommendation 4

Separate the MBS items for the knee from the current X-ray items, which encompass foot, ankle, leg, knee or femur.

Table 9: New proposed item descriptor

Item descriptor

X-ray of the knee

7.3.1        Rationale

The recommendation focuses on obtaining granularity of Medicare data. It was based on the following observations:

 There are no specific MBS items for X-ray of the knee. Therefore it is not possible to identify the number of X-ray services performed specifically for the knee.

 The BEACH data9 indicated that the proportion of knee X-rays of the total services claimed against the MBS items for X-rays for foot, ankle, leg, knee and/or femur requested by GPs has remained stable before and after the introduction of GP-requested knee MRI (40% vs 38%)7.

7.4        Recommendations impact statement

Recommendation 4 is not expected to have any impact on patients.

Providers will be required to use a different MBS item for X-ray of the knee and are expected to be aware of this recommendation.