Changes to MBS Items for Spinal Surgery Services – Claiming Examples Last updated: 12/10/2018 Effective from 1 November 2018 Lumbar microdiscectomy (or discectomy) including recurrent disc prolapse One motion segment: 51011 Group T8 – Surgical Operation Subgroup 17 – Spinal Surgery 51011 Spinal decompression or exposure via partial or total laminectomy, partial vertebrectomy or posterior spinal release, one motion segment, not being a service associated with a service to which item 51012, 51013, 51014 or 51015 applies (H) (Anaes.) (Assist.) TN.8.141 TN.8.142 Multiple operations rule Fee: $1,435.50 Benefit: 75% = $1,076.65 Two motion segments: 51012 Group T8 – Surgical Operation Subgroup 17 – Spinal Surgery 51012 Spinal decompression or exposure via partial or total laminectomy, partial vertebrectomy or posterior spinal release, 2 motion segments, not being a service associated with a service to which item 51011, 51013, 51014 or 51015 applies (H) (Anaes.) (Assist.) TN.8.141 TN.8.142 Multiple operations rule Fee: $1,913.80 Benefit: 75% = $1,435.35 Lumbar laminectomy or laminotomy for lumbar canal stenosis Stenosis at one motion segment: 51011 Group T8 – Surgical Operation Subgroup 17 – Spinal Surgery 51011 Spinal decompression or exposure via partial or total laminectomy, partial vertebrectomy or posterior spinal release, one motion segment, not being a service associated with a service to which item 51012, 51013, 51014 or 51015 applies (H) (Anaes.) (Assist.) TN.8.141 TN.8.142 Multiple operations rule Fee: $1,435.50 Benefit: 75% = $1,076.65
$847.30 + Group T8 – Surgical Operation Subgroup 17 – Spinal Surgery 51120 Bone graft, harvesting of autogenous graft, via separate incision or via subcutaneous approach, in conjunction with spinal fusion, other than for the purposes of bone graft obtained from the cervical, thoracic, lumbar or sacral spine (H) (Anaes.) TN.8.141 Multiple operations rule Fee: $235.50 Benefit: 75% = $176.65 Anterior lumbar interbody fusion (ALIF) with internal fixation, including XLIF or OLIF – single surgeon Fusion at one motion segment: 51021 + 51041 + 51160 (+ 51120) Group T8 – Surgical Operation Subgroup 17 – Spinal Surgery Fixation of motion segment with vertebral body screw, pedicle screw or hook instrumentation including sublaminar tapes or wires, one motion segment, not being a service associated with a service to which item 51020, 51022, 51023, 51024, 51025 or 51026 applies (H) (Anaes.) (Assist.) TN.8.141 TN.8.143 Multiple operations rule Fee: $1,281.20 Benefit: 75% = $960.90 + Group T8 – Surgical Operation Subgroup 17 – Spinal Surgery 51041 Spinal fusion, anterior column (anterior, direct lateral or posterior interbody), one motion segment, not being a service associated with a service to which item 51042, 51043, 51044 or 51045 applies (H) (Anaes.) (Assist.) TN.8.141 TN.8.145 Multiple operations rule Fee: $1,082.70 Benefit: 75% = $812.05 + Group T8 – Surgical Operation Subgroup 17 – Spinal Surgery 51160 Anterior exposure of thoracic or lumbar spine, one motion segment, not being a service to which item 51165 applies (H) (Anaes.) (Assist.) TN.8.141 TN.8.149 Multiple operations rule Fee: $1,150.00 Benefit: 75% = $862.50 + Group T8 – Surgical Operation Subgroup 17 – Spinal Surgery 51120 Bone graft, harvesting of autogenous graft, via separate incision or via subcutaneous approach, in conjunction with spinal fusion, other than for the Fee: $235.50 Benefit: