A change to an item on the MBS has made it more difficult to investigate patients with ischaemia with no obstructive cardiac arteries using pressure wires, cardiologists and patient advocates say.

The International Heart Spasms Alliance, a not-for-profit association which is supported by several Australian interventional cardiologists, argues that patients with ischaemia with no obstructive cardiac arteries (INOCA) are not being properly served by Medicare.

The change made on 1 July 2021 to MBS item number 38241 — use of a coronary pressure wire during selective coronary angiography — now allows claim of the $488.70 fee only if a coronary artery is at least 50% stenosed.

Before this, reimbursement was possible for lower degrees of stenosis, interventional cardiologist Adjunct Professor Jamie Layland told Cardiology Update.