So let's unpack the new item number 139, created recently by the MBS for patients under 25 with Neurodevelopment disorders access to early intervention.
MBS Item Number 139/92142 (TH) relates to attendance services for eligible disabilities, specifically focusing on the intention, eligibility, assessment, referral, and treatment processes. The service is designed for patients under 25 years of age diagnosed with eligible disabilities and is carried out by general practitioners.
The basics:
45 minutes minimum consult time
Patient under 25
Not in hospital
Patients must have had prior attendances in which a diagnosis of an eligible condition is made (completed with general attendance item numbers such as 23, 36, 44)
Copy must be offered to patient and carers
Once a lifetime claim only
Who is eligible?
Eligible are those with any of the following conditions:
(a) sight impairment that results in vision of less than or equal to 6/18 vision or equivalent field loss in the better eye, with correction;
(b) hearing impairment that results in:
(i) a hearing loss of 40 decibels or greater in the better ear, across 4 frequencies; or
(ii) permanent conductive hearing loss and auditory neuropathy;
(c) deaf blindness;
(d) cerebral palsy;
(e) Down syndrome;
(f) Fragile X syndrome;
(g) Prader‑Willi syndrome;
(h) Williams syndrome;
(i) Angelman syndrome;
(j) Kabuki syndrome;
(k) Smith‑Magenis syndrome;
(l) CHARGE syndrome;
(m) Cri du Chat syndrome;
(n) Cornelia de Lange syndrome;
(o) microcephaly, if a child has:
(i) a head circumference less than the third percentile for age and sex; and
(ii) a functional level at or below 2 standard deviations below the mean for age on a standard development test or an IQ score of less than 70 on a Wechsler Intelligence Scale for Children (WISC) or the Wechsler Preschool and Primary Scale of Intelligence (WPPSI).
(p) Rett’s disorder;
(q) Fetal Alcohol Spectrum Disorder (FASD);
(r) Lesch‑Nyhan syndrome;
(s) 22q deletion syndrome.
The details:
If require assistance through Multidisciplinary team, GP can refer on to AH to help with assessment and diagnosis but not through the access of 139
139 covers the development of a treatment and management plan which includes
The confirmed diagnosis
Findings of any assessments performed that contribute to the diagnosis
Risk assessment
Treatment options
Treatment plan allows for the access of up to 20 Allied health sessions to a Psychologist, Speech Pathologist, Occupational Therapist, Audiologist, Optometrist, Orthoptist or Physiotherapist.
Each allied health member can provide up to 8 sessions per year but requires to provide the GP with a written, phone, case conference or secure messaging review after 4 to access the remaining 4
Allied health members can refer to each other with 139 Plan, however require approval of the GP to do so (no specific appointment is required)
Have you used 139 yet? How have you found it? How have you found using it in a consult lasting 45 minutes- is this something you can offer?
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