The old MBS system

This worked by having all items defined by a surgical item number. There were no separate items for anaesthesia. Instead, each surgical procedure had a separate anaesthetic unit value which determined the fee for the anaesthetic service. Each anaesthetic unit had a rebateable value. The anaesthetic fee was therefore tied to the surgical procedure and would be determined not by what the anaesthetist did, but by what the surgeon did. Both surgical and anaesthetic item numbers were required on accounts.

Access Anaesthetics operated under this system until it was superseded by the incorporation of the RVG into the Medicare schedule in November 2001. However, the system remains backward compatible, and can be forced to run using the earlier methods by attaching a pre-November 2001 items file. Do this from the File Management Menu. The surgical item column still exists on the Items page, but it is disabled unless a pre-RVG items file is attached.

The old Multiple Anaesthetic rule deemed that a second surgical procedure was discounted to 20% of its original fee, and the third and subsequent procedures were discounted to 10%. In the new system, the second and later anaesthetic procedures are discounted to 0%, since the time-based system compensates for additional work.

Also, because anaesthesia rebates are now calculated using actual, as opposed to estimated times, the prolonged anaesthesia rule no longer applies. The button which operates this function still remains in the system to allow backward compatibility. However, it will only perform the calculation correctly if a pre-November 2001 items file is attached to the system.