Rebates at stake as GP skin doctors, Medicare enter anatomical debate

The debate concerns the appropriate MBS item for a regional nerve block

An anatomical debate has erupted over the MBS item descriptors for regional anaesthetic, after three skin cancer doctors were investigated by the PSR over inappropriate claims.

All three cases involved a variety of items, mainly including GP attendances and skin cancer excisions, and the doctors were subsequently told to repay $1.2 million.

But the watchdog also questioned their claims for regional anaesthetics using MBS item 18234, and decided to ban them from that item for between six and 36 months.

According to its descriptor, 18234 is for “injection of an anaesthetic agent into a primary division of the trigeminal nerve”, with an out-of-hospital rebate of $107.85.

The Skin Cancer College Australasia, which argued the ban was unjust, said the doctors ended up in trouble because they were claiming the item for infraorbital nerve blocks during surgical operations to remove skin cancers on people