New endometriosis guidelines are now supported in the form of an AMA MBS draft.
Major progress has been made for Australian women’s health after new guidelines and a new MBS draft were released to make endometriosis care more accessible.
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists’ (RANZCOG) Australian Living Evidence Guideline: Endometriosis has been highly revered for how it could improve care in the sector.
Now endorsed by the RACGP, the guidelines have outlined the latest scientific evidence to assist in the detection diagnosis and management of endometriosis and adenomyosis.
A major part of the guideline was the recommendation to initiate earlier diagnoses of endometriosis via a pelvic ultrasound as the first-line investigation.
This element of guideline has seen support from the AMA with a recent MBS item draft submission aligning with the guideline recommendations.
The AMA has stated that this is “an issue exacerbated by years without indexation, and further compounded by ongoing under-indexation of the MBS”.
“The current structure of pelvic ultrasound imaging MBS items has created inequitable access for women compared to the broader population seeking general medical imaging.”
The current MBS item 55065 (pelvic ultrasound) has been flagged by the AMA as being too broad.
This can be attributed to how currently more complex procedures are billed under the same umbrella as standard 15-minute procedures.
Creation of an endometriosis-specific version of this item was welcomed by the AMA provided it was rebated at a time-proportionate rate for the ultrasound.
“One of the major changes with the national guidelines on endometriosis are that it acknowledges that primary care is best suited to manage, identify and manage suspected endometriosis,” RACGP women’s health expert Associate Professor Magdalena Simonis told The Medical Republic.
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“GPS are in a position now where we are expected to be equipped to assess our patients who have a range of symptoms that may well be related to endometriosis.
“The benefit of being able to do this as a first line investigation means that there’s going to be less of a delay from the presentation to further investigating patients with these symptoms.”
Per the AMA draft submission, the health body expects the newly proposed item to commence by 1 November 2025 along with further changes to ultrasound items to improve gender equity.
This change is also expected by the RACGP to assist rural communities with equitable access to pelvic ultrasounds via general practice.
“The inequity is a really big issue and the quality of the ultrasound determines the management and also helps explain to patients what’s going on,” Professor Simonis told TMR.
“I think this shift in the guidelines has shone the light on the significance of primary care in general practitioners who see women with pelvic pain and suspected endometriosis.
“We’re at the forefront of this now, which means that we’ll be able to do this confidently.”
