INSIGHTS: Changes to Medicare Benefits Schedule Items for Spinal X-Ray Services – Why, how and what now?

On 1 November 2017 changes took effect that impact on rights of chiropractors practitioners to request spinal x-rays.

The Medicare Taskforce

With the view to improving health outcomes for patients, the Commonwealth Government established the Medicare Taskforce (Taskforce) in April 2015 to consider how more than 5,700 items on the Medicare Benefits Scheme (MBS) aligned with contemporary clinical evidence and practice.  The Taskforce was assisted by wide variety of clinical committees and working groups comprised of clinicians, consumers and health technology experts, including the ‘Diagnostic imaging’ committee which reviewed:

• diagnostic imaging;
• diagnostic procedures; and
• investigation and therapeutic procedures.

The committee found that in 2014-15 approximately 130,000 three region x-rays were performed, but that most presentations of low back pain did not require diagnostic imaging because this was unlikely to have changed the clinical management of the patient.  The committee also found that the evidence indicates that routine imaging of the lower back by whole spine x-rays (three and four regions) was not associated with sufficient clinical benefit and can lead to unnecessary doses of radiation.

Changes to the requesting rights of chiropractors’ practitioners

From 1 November 2017, chiropractors will not be able to request Medicare-rebateable three and four region spinal x-rays because historically, chiropractors have ordered the majority of these items.  However medical practitioners, physiotherapists and osteopaths may continue to do so.

All allied health practitioners (including chiropractors) will still be able to request one and two region spinal x-rays, providing that no more than one, for the same patient on the same day is requested.

The clinical history obtained from the patient and assessment provide valuable information to establish a diagnosis, treatment plan and the basis for a request for imaging.  The Taskforce will continue to monitor requests for whole spine x-rays.  This being the case, all health practitioners are reminded of the importance of ensuring that clinical records demonstrate the knowledge, assessment and clinical reasoning when requesting spinal x-rays.

Please contact Principal Scott Ames if you wish to discuss how these changes may impact on your practice.

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Disclaimer: This information is current as of December 2017. These articles do not constitute legal advice and do not give rise to any solicitor/client relationship between Meridian Lawyers and the reader. Professional legal advice should be sought before acting or relying upon the content of these articles.