By Rhiannon Riches
Our advocacy work with the Department of Health has produced a win for members.
Medicare item 10944, for the removal of an embedded corneal foreign body, in the Optometry Schedule of the Medicare Benefits Schedule online Book will be amended to allow optometrists to choose the most appropriate item number to bill if the embedded foreign body has not been completely removed.
Previously, optometrists were mandated through the item descriptor to bill item 10916 for incomplete removal of the corneal foreign body.
Optometry Australia had previously raised the matter with the Department of Health and discussed it at a face to face meeting on 26 June 2017.
The department agreed that the administrative change was necessary because the item descriptor for item 10944 in the MBS online Book does not currently match the legislative wording in the Health Insurance (Optometric services) Determination 2016.
To ensure that the text for item 10944 in the MBS online Book aligns with that in the Health Insurance (Optometric services) Determination 2016, the following wording has been approved for publication in the MBS online Book, commencing 1 September 2017:
‘If the embedded foreign body has not been completely removed, benefits may be payable under item 10916.’
Previously it stated:
‘Where the embedded foreign body has not been completely removed, benefits are only payable under item 10916.’
Medicare item 10944 came into effect on 1 September 2015. It carries a full scheduled fee of $72.15 and enables optometrists to claim an 85 per cent MBS fee of $61.35 for the removal of an embedded foreign body from the cornea.
The introduction of this first procedural item for optometrists took eight years of advocacy by Optometry Australia to achieve and is recognition of the advances in the scope of practice in optometry.
‘The inclusion of this item number on the Medicare Benefits Schedule represents a win, not just for optometrists but for patients,’ national professional services manager Luke Arundel said. ‘In most locations in Australia, the local optometry practice is the most sensible place to go to have an embedded corneal foreign body removed.’