DoHAC details vitamin B12 testing changes

The Department of Health and Aged Care (DoHAC) has clarified exactly how changes to MBS items for vitamin B12 testing and urine examinations will affect GPs when they come into effect in July next year.
 
The changes were revealed in the 2024–25 Federal Budget earlier this year in a bid to reduce ‘unnecessary testing’.
 
They are back in the spotlight after GPs and healthcare professionals raised concerns last week about their potential to create additional red tape, calling for wider consultation.
 
The DoHAC has now provided additional details, telling newsGP its vitamin B12 testing changes, which will be made to existing MBS items, will include a frequency restriction applied to the second-line test under item 66839.
 
It says this restriction follows recommendations by the MBS Review Taskforce – Diagnostic Medicine Clinical Committee, which called for the aligning of the restriction for item 66839 to an existing one for item 66838.
 
‘In addition, the proposed new restriction is once every 11 months, which is slightly more relaxed than the Review recommendation of once every 12 months,’ the DoHAC said.
 
‘This is to allow MBS rebates to be payable to patients who might present slightly earlier.
 
‘To ensure that patients requiring more frequent testing due to their clinical conditions can access testing, a new exception item with no frequency restriction will be introduced.’
 
The amendments will also see clinicians given an option to request a test for holoTranscobalamin as a first-line test under MBS item 66838.
 
‘The inclusion of holoTranscobalamin, alongside total serum vitamin B12 as a first-line testing option, allows clinicians to request the most clinically relevant first-line test for their patients based on the clinical situation they are managing,’ the DoHAC said.
 
It will also make amendments to urine examination changes (MBS item 69333) to specify that urine testing is only required when symptoms of a urinary tract infection are present.
 
The DoHAC said there will be exceptions to allow testing of groups of asymptomatic patients, including pregnant women and those aged under 16.
 
Services Australia data shows that in the last financial year, MBS item 66839 was processed 4.7 million times, compared to 1.4 million for item 66838, and 4.6 million for item 69333.
 
Data is most recently available for October 2024, which shows item 66839 was processed 423,557 times, item 66838 119,048 times, and item 69333 was processed 378,511 times.
 
As well as reducing testing rates, the DoHAC said its amendments aim to ‘support clinically appropriate testing to improve patient outcomes’.
 
‘Medicare benefits will continue to be available for clinically appropriate services,’ it said.
 
‘Under MBS claiming arrangements, it is the responsibility of the healthcare professional claiming the service to ensure that all requirements of the relevant MBS item, as detailed in the item descriptor and associated explanatory notes, have been met and the service provided is clinically relevant and necessary for the appropriate treatment of the patient.’
 
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Federal Budget MBS Medicare Benefits Schedule pathology requests vitamin B12