Eight-year trends in the Australian surgical approach to pterygium removal.

Abstract

Pterygium is a very common disease in Australia but the statistical data on the provision of pterygium surgical services is poorly understood. This study evaluated the trends in the types of surgeries performed for pterygium in Australia over an eight period. Retrospective cross-sectional study. All surgeries performed for pterygium in Australia from 2005 to 2010 in the Medicare system. Eight years of Medicare data were analysed for services performed with pterygium removal. Concurrently used MBS item numbers 42 686 (pterygium removal) with 42 641 (conjunctival autograft) and also 42 686 with any other ophthalmic item number. Pterygium removal was undertaken together with conjunctival autografting in 73% of patients in 2005 rising to 88% in 2010. Five other non-related surgical procedures were performed simultaneously with pterygium removal in 10% of patients in 2005 decreasing to 5.9% in 2012. About 12% of pterygium surgeries are not combined with a conjunctival autograft. It is possible that these may have been used with an adjuvant such as mitomycin or radiotherapy, or performed as simple excision. Allowing for the possibility that billing errors may have occurred it is still likely that in 5.9% of patients, other procedures that would normally not be performed with pterygium surgery, are undertaken simultaneously and may have an adverse outcome on the inappropriate concurrent surgery and on the recurrence rate of the pterygium. The surgeon should carefully review billing codes before submitting them to Medicare.