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Multiple operation rule

If two or more operations, other than amputations (MBS Group T8, subgroup 12), are being performed on a patient on the one occasion, the multiple operation rule will apply when determining the fees payable.

In most cases, operations include pre-procedure, intra-procedure and post-procedure work. When multiple operations are performed on the one occasion, there will be overlap in this work. The multiple operation rule will account for this overlap.

The rule is applied as follows:

Surgical procedures:

Includes surgical procedures set out in MBS Group T8, subgroups 1 to 11, 13, 16 and 17

  • 100% for the item with the greatest WorkCover fee;
  • plus 50% for the item with the next greatest WorkCover fee;
  • plus 25% for each other item.

Orthopaedic procedures:

Includes orthopaedic procedures set out in MBS Group T8, subgroups 14 and 15

  • 100% for the item with the greatest WorkCover fee;
  • plus 75% for the item with the next greatest WorkCover fee;
  • plus 75% per cent of each other item.

Where a medical practitioner performs both surgical and orthopaedic services on the one occasion, each rule applies in its entirety to the relevant items. This will result in two items with fees at 100%.

The following table illustrates how the rule will be applied to multiple operations:

MBS SUB-GROUP100% OF FEEORTHOPAEDIC
100 / 75 / 75%
SURGICAL
100 / 50 / 25%
1 to 11
(Items 30001 - 44136)
  
12 - Amputations
(Items 44325 - 44376)
  
13 - Plastic and Recon Surgery
(Items 45000 - 45996) 
  
14 - Hand Surgery
(Items 46300 - 46534) 
  
15 - Orthopaedic
(Items 4700 - 50658) 
  
16 - Radiofrequency and Microwave Tissue Ablation  
17 - Spinal Surgery
(Items 51011 - 51171)