SOP Bulletin No. 82

Decision Support Unit

8 — th Floor, 259 Queen St, Brisbane — 3 — rd Floor Blackburn House, 199 Grenfell St, Adelaide

Intranet site:  http://intranet/nat/comp/dp/Nop/dsu/dsudefault.htm

30 March 2004

THE FOLLOWING RMA SOPS ARE TO BE GAZETTED ON 31 MARCH, 2004

New SOPs	Osteomyelitis Endometriosis
Amendments	Ischaemic Heart Disease

IMPORTANT OPERATIONAL FEATURES

Osteomyelitis

New  – 5 & 6 of '04

• These are new SOPs, which finalise the investigations into osteomyelitis and Brodie's abscess.  Claims for these conditions can now be determined.
• Osteomyelitis is inflammation of bone caused by infection.  This condition has not been commonly claimed.  When coding diagnoses of osteomyelitis, the coding needs to be site specific, as there are site specific factors in these SOPs.

• There are factors in the SOPs for a number of conditions including:

• wound, laceration, injury or other disease disrupting the skin or mucosa at the site or adjacent to the site
• septicaemia, bacteraemia or systemic fungal infection;
• an invasive surgical procedure, and
• diabetes mellitus.

Endometriosis

New  – 7 & 8 of '04

• These are new SOPs, which finalise the investigation into Endometriosis.  Claims for Endometriosis can now be determined.
• There is a causal factor in RH only for the presence of serum 2,3,7,8,-TCDD level of at least 10 parts per trillion at the time of the clinical onset of endometriosis.  Serum dioxin analysis should only be performed when the requirements of all other SOP factors cannot be met in a particular case, and the success of the claim hinges on a veteran's exposure to this particular type of herbicide. 

• In these cases, the procedures for arranging serum dioxin analysis, which were developed for the dioxin factor in the Diabetes SOP, should be followed.  These procedures are described in CCPS Research and in DSU Bulletin No.29, available in CCPS Research.

• There are causal and worsening factors in both RH and BOP for hormone replacement therapy and tamoxifen therapy (with time requirements) for postmenopausal women.

• In both RH and BOP, there is a causal factor for having surgery or trauma involving the site at least 6 months before the clinical onset of endometriosis of the abdominal wall, cervix, vagina, vulva or perineum only.

Ischaemic Heart Disease

Amendment – 9 & 10 of '04 Amends 53 and 54 of '03

• This amendment returns the physical inactivity factor for worsening in the BOP SOP.  This factor was left out of the previous SOPs in error.  At the same time, the new wording for the physical inactivity factors in both SOPs has been introduced.

Remember! If you are having any problems with SOPs, or SOPs in CCPS, talk to us!