What is Urgent Elective Surgery? Limitations On Elective Surgery Due To Covid

Limitations On Elective Surgery COVID

Urgent Elective Surgery for Plastic Surgery Patients – What are Surgery Procedure Categories?

During the COVID Crisis, Hospital resources have been put under a lot of strain, because of this restrictions have been placed on Elective Surgery. Therefore, decisions must be made about what is Urgent Elective Surgery.

What Is Elective Surgery?

Elective surgery is surgery for which, in the opinion of the treating medical practitioner, admission can be delayed for at least 24 hours. The timing of elective surgery is based on either clinical need or urgency.

Therefore, your surgeon will assess your clinical need and then assign an urgency category for your condition.

The Victorian system has three urgency categories. Each category has a desirable time for treatment.

Category 1: Urgent cases

  • In the first category, treatment is required within 30 days, this is because the condition that has the potential to deteriorate quickly to the point that it might become an emergency.

Category 2: Semi-urgent cases

  • Treatment within 90 days is desirable for a condition that is causing pain, dysfunction or disability but which is not likely to deteriorate quickly or become an emergency.

Category 3: Non-urgent cases

  • Treatment at some time in the future is acceptable for a condition causing minimal or no pain, dysfunction or disability that is very unlikely to deteriorate quickly and does not have the potential to become an emergency. Treatment within 12 months is used as a guide.

How am I scheduled for Elective Surgery?

When you are assessed by a surgeon as requiring surgery, you will be placed on a hospital-based elective surgery list. It’s also important to remember that elective surgery lists are not simple queues managed on a ‘first come – first served’ basis. Either your surgeon or specialist will assess your condition according to the elective surgery categories and schedule you for surgery based on your medical needs.

Furthermore, you have a responsibility to attend all appointments that have been arranged for you. Failing to attend your scheduled surgery may impact the time it takes for the hospital to treat you.

Contact us to see if your surgery has an MBS Item Number or is classified as urgent.

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    What if I’m not ready for treatment?

    Elective surgery patients are regularly reviewed to ensure they are both ready and available to be admitted for surgery. The are many reasons why a patient may not be ready for elective surgery, you may require additional medical treatment before you can have your surgery, or you may choose to delay your surgery for work or other reasons, such as the unavailability of carer support.

    It is important to note that there are limits that apply to the length of time you can be unavailable for surgery for personal reasons and still remain on the hospital’s list.

    These are:

    • 30 days for Category 1 patients
    • 90 days for Category 2 patients
    • 180 days for Category 3 patients

    However, if you exceed the relevant limit the hospital will contact you to discuss your plan for surgery. If your circumstances change and you are once again available for surgery you should notify the hospital as soon as possible.

    The hospital will inform also advise you in writing of any changes in your care status, as well as, the reason for the change.

    What if my condition gets worse?

    Of course, if you feel your condition has changed you should contact your surgeon or GP for advice.

    What happens if the hospital postpones my treatment?

    Sometimes postponing elective surgery is unavoidable. This is because demand for emergency services is unpredictable and those patients who attend hospitals with life-threatening illnesses take priority over those requiring other surgery.

    Does private health insurance affect my time until treatment?

    Public hospitals treat both public and private patients and are required to treat patients according to clinical urgency. Moreover, private insurance or willingness to pay for your surgery will not reduce the time you wait for surgery in a public hospital. You may also be asked to choose whether you would like to use your private insurance at a public hospital. Private insurance allows you to choose your surgeon but there may be some costs involved. You should contact your hospital if you need further information about using your private insurance at a public hospital.

    Cosmetic Plastic Surgery Procedures without an item number are very restricted during the COVID Crisis

    This means elective procedures that are either deemed cosmetic or that can’t be claimed with an MBS item number are restricted.

    • Only procedures with an MBS item number are likely to be performed, in other words, if your surgical procedure DOES NOT have an associated MBS item number it will NOT be performed
    • No Combination surgeries, this includes both item number and non-item number procedures at the same time are NOT likely to be performed
    • Elective surgery has been reduced to limited activity – (based on not only the theatre capacity but also the number of patients, hours or procedures,  depending on the hospital administrator)
    • This Applies to all Metropolitan Melbourne Hospitals, as well as, Day Surgeries currently
    • Priority may also be based on Urgency as assessed by admitting surgeon or GP.

    Is your Elective Surgery Procedure Urgent?

    Priority Elective Surgery Categories

    When a patient is assessed by a surgeon as requiring elective surgery, they are categorised as urgent based on 3 categories.

    1. In cases of category one treatment is required within 30 days, in other words, the procedure is semi-urgent
    2. Treatment required within 90 days or non-urgent – condition causes either pain or disability
    3. Lastly, category three means treatment is required within 12 months.

    The different Australian State Governments, Surgeons and Hospital Administrators disagree over the exact category classifications of urgency during the Crisis.

    Surgeons must make an assessment of what is URGENT – but may be subject to peer review or over-ruled by the Hospital or Health Department.

     

    Common Plastic Surgery Procedures and their usual Urgency Category (selected from the pdf below)

    • Malignant skin lesion – excision of +/- grafting – Category 1
    • Breast prosthesis – removal of (for reasons other than cosmetic) – Category 2
    • Trigger finger/thumb release – Category 2
    • Breast reconstruction (for reasons other than cosmetic) Category 3
    • Breast reduction (for reasons other than cosmetic) Category 3
    • Cleft lip and palate – repair of – Category 3
    • Dupytrens contracture release – Category 3
    • Lipoma – excision of +/-grafting – Category 3
    • Lymphangioma – surgery for – Category 3
    • Rhinoplasty (for reasons other than cosmetic) – Category 3
    • Skin lesions, non-malignant – excision of – Category 3
    • Scar revision (for reasons other than cosmetic) – Category 3

    National Elective Surgery Urgency Categorisation Guideline – April 2015 (PDF, 1 MB)

    Urgent category 2 plastic surgery may also include procedures like the removal of a breast implant for non-cosmetic reasons like a rupture

    Our Coco Ruby Surgeons Operate in these Victorian Hospitals

    • St Vincents Kew

    • Ramsay Masada Balaclava, as well as, Ramsay Glenferrie Private

    • St John of God Berwick

    For more information about these Hospitals

    Each hospital administration is assessing the availability of their theatre lists for plastic surgery based on Health Department criteria, as well as their supplies and the impact of COVID in their location.

     

    Urgent Elective Surgery

    ELECTIVE SURGERY WITHOUT MBS ITEM NUMBER (NOT Primary Reconstructive)

    Medicare benefits are NOT payable for non-therapeutic cosmetic services.

    • ALL
      • Purely Cosmetic Procedures, in other words, no MBS item number applies
      • Fat Transfer to either the Breasts or Face and Liposuction
      • Liposuction
    • BODY
      • Cosmetic Abdominoplasty – where no Item number (e.g. post-pregnancy)
      • Cosmetic Labioplasty – where no item number applies (e.g. < 8 cm)
    • BREAST
      • Removal and Replacement of Implants – where no item number applies
      • Breast Augmentation – where it is just for aesthetic reasons, however, congenital deformation may have an MBS number
      • Breast Augmentation and Mastopexy – also known as a Breast Augmentation with Implants
      • Cosmetic Breast lift Mastopexy – no item number applies
      • Removal of implants where no MBS item number applies
      • Removal and replacement of Implants for Size change only
    • EYE
      • Upper or Lower Blepharoplasty – where no item number applies
    • FACE
      • Cosmetic Facelift/Necklift
    • NOSE
      • Cosmetic Rhinoplasty – where no item number applies
      • Cosmetic Septo-Rhinoplasty – where no item number applies

    Plastic Surgery Procedures with an MBS Item Number

    urgent elective surgery

    (NOTE – ALL the MBS Criteria must apply – see MBS Website below)

    Item Number with a Summary of Procedure (see specific qualification details below)

    • BREAST
      • 45060   Breast Asymmetry or Tubular breast surgery
      • 45520   Breast Reduction Surgery Unilateral, in other words, one breast
      • 45523   Breast Reduction Surgery Bilateral (where strict MBS criteria apply)
      • 45548   Removal of Breast Implant
      • 45551   Breast Implant Removal with capsule
      • 45553   Remove and Replace implants due to complication
      • 45554   Remove and replace implants due to complication
      • 45558   Breast lift Mastopexy with an item number
    • BODY
      • 30171   Lipectomy – a wedge of skin removal, either for an arm lift or thigh lift
      • 30172   Lipectomy – multiple wedges of skin removal after Weight loss (Tummy Tuck)
      • 30177   Lipectomy, Post Weight loss Tummy Tuck (Abdominoplasty)
      • 30179   Circumferential lipectomy (Belt lipectomy) for massive weight loss
      • 30403   Hernia Repair surgery
    • EYE
      • 42866   Entropion or ectropion, in other words, Eyelid tightening
      • 45617   Upper eyelid surgery for either obstruction or vision issues
      • 45623   Eyelid Lift for either obstruction or vision issues
      • 45624   Upper eyelid lift for either obstruction or vision issues
    • LABIA
      • 35534   either Labioplasty or Vulvoplasty (> 8cm)
    • NOSE
      • 41671   either Septoplasty or Septum surgery
      • 41672   Nasal septum reconstruction
      • 45641   Rhinoplasty for airway congestion
      • 45644   Rhinoplasty for an obstructed airway

    (It should be noted, that there are many other item numbers, however, these are the most popular procedures at our clinic)

    Download our Guide to both Medicare and Health Insurance for Plastic Surgery

    Medicare and Health Insurance Guide

    How to Find other MBS Item Numbers for other Surgery Procedures

    For other surgeries such as Skin Surgery, Cancer Surgery, Hand Surgery, and Breast Reconstruction. You can visit either the website, MBS Online or download the app on your mobile (Search for either Apple or Android)

    Want More Information about MBS Item Numbers?

    • You can request more information, or you can also DOWNLOAD A GUIDE about the procedure
    • Alternatively, you can book a Complimentary Consultation with a Nurse
    • You can also organise a phone call with the Patient Coordinator (FREE)  Click here.
    • Another option is for you to attend our Regular Practice FREE Events and hear from our Team of Plastic Surgeons along with their top support team.
    • We also have the option for you to speak with a past patient that has undergone the procedure you want. You can either call or contact us to find out more. 
    Last updated: 13/04/2022
    Author profile image
    David Staughton
    David Staughton is the Business Manager of Coco Ruby Plastic Surgery

    Coco Ruby’s Specialist Plastic and ENT Surgeons

    With a wealth of experience and training, our Specialist Plastic Surgeons are dedicated to best practice patient care and education, customising Breast Enlargement Surgery for each and every patient to best meet their needs and desired surgical outcomes.

    coco ruby specialist plastic surgeons 

    What to do next?

    Our Patient Liaison Team can assist with any questions you may have when considering a procedure. You can send in an enquiry form below or call our Melbourne Clinic between 9 am – 5 pm Monday to Friday.

    Phone 1300 264 811, Email us: enquiries@cocoruby.com.au or Book a FREE 15-minute Phone Chat with our Patient Liaison Manager or a Virtual Consultation with a Surgeon.


    Disclaimer: Results depend on individual patient circumstances and can vary significantly. Results may also be impacted by a variety of factors including your lifestyle, weight, nutritional intake and overall health. Consult your Specialist Plastic Surgeon for details. This information is general in nature and is not intended to be medical advice nor does it constitute a doctor-patient relationship. Surgery risks and complications will be covered in detail during a consultation with your Surgeon.