Changes to melanoma services from 1 November 2022

Last updated 12 January 2023

An overview of changes to melanoma services from 1 November 2022

On 1 November 2022, seven new Medicare Benefits Schedule (MBS) items (31377 to 31383) will be introduced for the excisions of clinically suspected melanoma. Six existing definitive excision items (31371 to 31376) will be amended to ensure clarity regarding appropriate claiming for melanoma excision services.

Providers will be able to claim one of the seven new MBS items for clinically suspected melanoma services in the first instance, pending histological confirmation of malignancy. Once malignancy is confirmed the provider would then perform a wide excision and claim an existing definitive excision item.

The RACGP will be engaging with the Department of Health and Aged Care regarding the rebate values of the new items for clinically suspected melanoma, which represent a significant drop in value from previously claimed items. The new items have lower rebates than those for existing MBS items for benign lesions, which have a far lower risk profile and required skill level.

Full item descriptors and rebates are outlined below. Visit MBS Online for more information.

New items

Item number

Descriptor

Rebate

31377

Clinically suspected melanoma, surgical excision (other than by shave excision) and repair of, if:

  1. the lesion is excised from nose, eyelid, eyebrow, lip, ear, digit or genitalia, or from a contiguous area; and
  2. the necessary excision diameter is less than 6 mm; and
  3. the excised specimen is sent for histological examination;

not in association with a service to which item 45201 applies

(Anaes.)

$97.00

31378

Clinically suspected melanoma, surgical excision (other than by shave excision) and repair of, if:

  1. the lesion is excised from nose, eyelid, eyebrow, lip, ear, digit or genitalia, or from a contiguous area; and
  2. the necessary excision diameter is 6 mm or more; and
  3. the excised specimen is sent for histological examination

(Anaes.)

$148.60

31379

Clinically suspected melanoma, surgical excision (other than by shave excision) and repair of, if:

  1. the lesion is excised from face, neck, scalp, nipple-areola complex, distal lower limb (distal to, and including, the knee) or distal upper limb (distal to, and including, the ulnar styloid); and
  2. the necessary excision diameter is less than 14 mm; and
  3. the excised specimen is sent for histological examination;

not in association with a service to which item 45201 applies
(Anaes.)

$118.45

31380

Clinically suspected melanoma, surgical excision (other than by shave excision) and repair of, if:

  1. the lesion is excised from face, neck, scalp, nipple-areola complex, distal lower limb (distal to, and including, the knee) or distal upper limb (distal to, and including, the ulnar styloid); and
  2. the necessary excision diameter is 14 mm or more; and
  3. the excised specimen is sent for histological examination

(Anaes.)

$148.60

31381

Clinically suspected melanoma, surgical excision (other than by shave excision) and repair of, if:

  1. the lesion is excised from any part of the body not covered by item 31377, 31378, 31379 or 31380; and
  2. the necessary excision diameter is less than 15 mm; and
  3. the excised specimen is sent for histological examination;

not in association with a service to which item 45201 applies
(Anaes.)

$84.45

31382

Clinically suspected melanoma, surgical excision (other than by shave excision) and repair of, if:

  1. the lesion is excised from any part of the body not covered by item 31377, 31378, 31379 and 31380; and
  2. the necessary excision diameter is at least 15 mm but not more than 30mm; and
  3. the excised specimen is sent for histological examination;

not in association with a service to which item 45201 applies
(Anaes.)

$111.00

31383

Clinically suspected melanoma, surgical excision (other than by shave excision) and repair of, if:

  1. the lesion is excised from any part of the body not covered by item 31377, 31378, 31379 and 31380; and
  2. the necessary excision diameter is more than 30 mm; and
  3. the excised specimen is sent for histological examination

(Anaes.)

$127.00

Amended items

Item number

Descriptor

Rebate

31371

Malignant melanoma, appendageal carcinoma, malignant connective tissue tumour of skin or merkel cell carcinoma of skin, definitive surgical excision (other than by shave excision) and repair of, including excision of the primary tumour bed, if:

  1. the tumour is excised from nose, eyelid, eyebrow, lip, ear, digit or genitalia, or from a contiguous area; and
  2. the necessary excision diameter is 6 mm or more; and
  3. the excised specimen is sent of histological examination; and
  4. malignancy is confirmed from the excised specimen or previous biopsy

(Anaes.)

 

31372

Malignant melanoma, appendageal carcinoma, malignant connective tissue tumour of skin or merkel cell carcinoma of skin, definitive surgical excision (other than by shave excision) and repair of, including excision of the primary tumour bed, if:

  1. the tumour is excised from face, neck, scalp, nipple-areola complex, distal lower limb (distal to, and including, the knee) or distal upper limb (distal to, and including, the ulnar styloid); and
  2. the necessary excision diameter is less than 14 mm; and
  3. the excised specimen is sent for histological examination; and
  4. malignancy is confirmed from the excised specimen or previous biopsy;

not in association with a service to which item 45201 applies
(Anaes.)

 

31373

Malignant melanoma, appendageal carcinoma, malignant connective tissue tumour of skin or merkel cell carcinoma of skin, definitive surgical excision (other than by shave excision) and repair of, including excision of the primary tumour bed, if:

  1. the tumour is excised from face, neck, scalp, nipple-areola complex, distal lower limb (distal to, and including,the knee) or distal upper limb (distal to, and including, the ulnar styloid); and
  2. the necessary excision diameter is 14 mm or more; and
  3. the excised specimen is sent for histological examination; and
  4. malignancy is confirmed from the excised specimen or previous biopsy

(Anaes.)

 

31374

Malignant melanoma, appendageal carcinoma, malignant connective tissue tumour of skin or merkel cell carcinoma of skin, definitive surgical excision (other than by shave excision) and repair of, including excision of the primary tumour bed, if:

  1. the tumour is excised from any part of the body not covered by item 31371, 31372 or 31373; and
  2. the necessary excision diameter is less than 15 mm; and
  3. the excised specimen is sent for histological examination; and
  4. malignancy is confirmed from the excised specimen or previous biopsy;

not in association with a service to which item 45201 applies
(Anaes.)

 

31375

Malignant melanoma, appendageal carcinoma, malignant connective tissue tumour of skin or merkel cell carcinoma of skin, definitive surgical excision (other than by shave excision) and repair of, including excision of the primary tumour bed, if:

  1. the tumour is excised from any part of the body not covered by item 31371, 31372 or 31373; and
  2. the necessary excision diameter is at least 15 mm but not more than 30 mm; and
  3. the excised specimen is sent for histological examination; and
  4. malignancy is confirmed from the excised specimen or previous biopsy;

not in association with a service to which item 45201 applies
(Anaes.)

 

31376

Malignant melanoma, appendageal carcinoma, malignant connective tissue tumour of skin or merkel cell carcinoma of skin, definitive surgical excision (other than by shave excision) and repair of, including excision of the primary tumour bed, if:

  1. the tumour is excised from any part of the body not covered by item 31371, 31372 or 31373; and
  2. the necessary excision diameter is more than 30 mm; and
  3. the excised specimen is sent for histological examination; and
  4. malignancy is confirmed from the excised specimen or previous biopsy

(Anaes.)

 

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