Level 4, 18 North Tce, Adelaide SA

A fantastic recent update in the push to reinstate a Medicare item number for the surgical repair of postpartum muscle separation

The Australian Society of Plastic Surgeons (ASPS) have confirmed that Australian women, who suffer the physical consequences of pregnancy, may be able to have reconstructive correctional surgery funded by Medicare later next year. Surgery to sew the abdominal muscles back together after pregnancy used to be covered by Medicare, but was removed from the Medicare Benefits Schedule (MBS) in 2016.

This is an issue everyone at Adelaide Plastic Surgery is passionate about supporting and advocating change. For those following this journey with us, you may remember we shared an online survey created by ASPS, gathering real-life responses from people living with postpartum muscle separation.

That information, along with extensive research and new clinical evidence, has meant the recent application from ASPS to reinstate the MBS item number has been supported by The Medical Services Advisory Committee (MSAC). MSAC is the authoritative body that advises the Minister for Health and the Commonwealth Department of Health on what procedures should be partially covered by Medicare (i.e. subsidised).

Although this endorsement from MSAC goes a long way to ensuring it’ll be back on the Medicare schedule there is still a way to go – these things take time! 

How do I know if I am eligible?

ASPS have provided us with the following information put forward in their proposal to MSAC. Given the Medicare item is subject to change if it passes the Federal Budget, we don’t yet have final eligibility criteria. However, MSAC supported the proposed item descriptor put forward by ASPS which included the following:

Cause – The rectus diastasis (tummy muscle split) was caused by pregnancy
Timing – The patient must be at least 12 months postpartum at the time of receiving the surgery
Gap measurement – The gap between abdominal muscles must be at least 3cm as evidenced by an ultrasound
Symptoms – The patient must have documented symptoms of pain or discomfort at the site and/or low back pain or urinary symptoms
Other treatment failed – The patient must have tried and failed to respond to non-surgical treatment options such as physiotherapy.
Other examples of non-surgical treatment may be: symptomatic management with pain medication, lower back braces, lifestyle changes, physiotherapy and/or exercise.

We will keep you posted on updates as they arise, and we eagerly await the decision from the Minister for Health to determine if this item will be approved fo consideration in next year’s federal budget. Once again, a huge thank you and congratulations to ASPS for their continued efforts to make this life-changing procedure accessible to all women – pregnancy induced muscle separation shouldn’t have to limit quality of life.

For further information and a detailed timeline of this journey you can visit ASPS dedicated page by clicking here.