Mbs reviews vitamin b12 testing report february 2014 table of contents section Page

3.2 Age and gender profile of patients

The pattern of use by age and gender for item numbers 66599 and 66602 is shown in Figure 3.4. Vitamin B12/folate testing claimed under MBS item numbers 66599 and 66602 is performed for both males and females; however, on average (across all age groups), the test is undertaken more frequently in females than males (1.8 times more frequently for MBS item 66599 and 1.9 times more frequently for MBS item 66602). For both MBS items, this difference is greatest in the 15-24 and 25-34 year age groups where females are over 3 times more likely to have a vitamin B12/folate test.
For both males and females, the number of tests being performed is higher in older age groups, particularly for MBS item 66599. This trend was slightly greater for males, with 76% of claims for MBS item 66599 being for those aged 45 years and over versus 64% for females. Similarly, for MBS item 66602, 71% of claims for males were aged 45 years and over versus 60% for females.
Figure 3.4: Use of the MBS items for vitamin B12/folate testing by age and gender (2008/09 to 2012/13)

Source: Department of Human Services – Medicare Australia

3.3 Frequency of testing by patient

An analysis of vitamin B12/folate testing frequency per patient was conducted. For item 66599, there was an increase⁴ in the overall number of patients tested for vitamin B12/folate, from 350,954 patients in 2008/09 to 502,547 patients in 2012/13 (+43%). As can be clearly seen from Figure 3.5, over the period 2008/09 to 2012/13 there has been very little change in the proportion of patients receiving either one test per year (92%), two tests per year (7.5%), or three or more tests per year (0.8%).
For item 66602, there was an increase in the overall number of patients tested for vitamin B12/folate, from 1,324,646 in 2008/09 to 1,706,258 in 2012/13 (+29%). The proportion of patients receiving only one test within a year was stable over the five-year timeframe (90%). Approximately 9% of patients received two tests per year and approximately 1% received three or more tests per year.
These data suggest that the majority of vitamin B12/folate testing services are being undertaken for the purposes of screening/testing rather than monitoring.
Figure 3.5: Frequency of claiming MBS items 66599 and 66602 per year by patient, 2008/09 to 2012/13*

Source: Department of Human Services – Medicare Australia

* Based on data processed to 31 May 2013; 2012/13 is therefore incomplete.

3.4 Profile of providers requesting vitamin B12/folate testing services

The profile of providers requesting vitamin B12/folate services was examined over time from 2008/09 to 2012/13 (Table 3.3). Over the five-year time period, there were no material changes in the pattern of requesting providers. General practitioners (GPs) and other medical practitioners (OMPs) accounted for approximately 71% of all providers requesting vitamin B12/folate testing services for item 66599. Internal medicine consultant physicians accounted for approximately 14% of all provider counts over the five-year time period, followed by general surgeons (specialist – subspecialties) and interns. There was a large variety of other providers requesting services, but they each accounted for less than 2% of provider counts.
The profile of providers requesting item 66602 was similar to that of item 66599. GPs and OMPs accounted for 67% of all providers requesting item 66602, followed by internal medicine consultant physicians (approximately 14%), psychiatrists, general surgeons (specialist – subspecialties) and interns.
Table 3.3: Number of providers requesting MBS items 66599 and 66602, 2008/09 to 2012/13

Source: Department of Human Services – Medicare Australia

^€ Data are incomplete for 2008/09 and 2009/10 because small provider counts were suppressed.

* Based on data processed to 31 May 2013; 2012/13 is therefore incomplete.

^# Other includes the following peer groups, which each accounted for <1% of the provider count: Dermatologist – specialist; Surgeon – non-specialist; Other medical specialist; IVF; Unclassified-miscellaneous-non-specialist; Anaesthetics – specialist; Dentist/orthodontist; Therapeutic radiologist/therapeutic nuclear medicine – specialist; Pathologist; Anaesthetics – non-specialist; Specialist physician – internal medicine; Diagnostic imagist – specialist; Diagnostic imagist – non-specialist; Acupuncture; Other, other allied health, abortion/fertility control; Unclassified-miscellaneous-specialist.

3.5 Frequency of requests for testing by provider

An analysis was conducted of requests for item 66599 and 66602 by frequency from any one provider. For both items, there was an increase over the period 2008/09 to 2012/13 in the overall number of providers requesting vitamin B12/folate testing. For item 66599, the majority of providers (97%) requested 100 or fewer tests per year. Approximately 2% of providers requested 101 to 200 tests, and the remaining providers requested more than 200 tests per year (Table 3.4). There were a small number of providers (ranging from 36 to 62 per year) that requested more than 400 tests per year.
From 2008/09 to 2012/13, approximately 88% of the providers requesting item 66602 requested 100 or fewer tests per year (Table 3.4). Approximately 7% of providers requested between 101 and 200 tests per year and 2.5% requested 201 to 300 tests per year. Between 2010/11 and 2012/13, over 500 providers requested more than 400 tests per year.
Table 3.4: Frequency of MBS items 66599 and 66602 requested per year by any provider, 2008/09 to 2012/13*

Source: Department of Human Services – Medicare Australia

* Based on data processed to 31 May 2013; 2012/13 is therefore incomplete.