When and how to use secondary intention healing under new MBS changes

With recent updates to the MBS now in effect as of 1 November 2025, GPs and skin cancer doctors will notice some important wording changes in the surgical operation item numbers, particularly those relating to excision and repair.

In this episode of Life by A Thousand Cuts, A/Prof Tony Dicker explains what these amendments mean in real terms, unpacking the subtle but significant implications for everyday skin cancer surgery.

Plus, download your Medicare Skin Cancer Item Number Guide below.

One of the most notable clarifications is the recognition that repairs are “included if performed”, meaning cases managed with healing by secondary intention are now explicitly covered.

Through a detailed case study of a basal cell carcinoma near the inner canthus, A/Prof Dicker walks through the full clinical workflow from excision margins and wound care to patient follow-up and histology, illustrating how secondary intention can achieve excellent outcomes in the right anatomical contexts.

He also shares practical dressing choices, patient management tips, and key considerations for concave sites such as the inner canthus and conchal bowl, where grafts or flaps may not always be necessary.

If you are managing skin cancers in primary care or surgical practice, this discussion offers valuable insight into how legislative nuance translates to patient care and procedural decision-making.

Listen to the podcast

Prefer a visual format? Watch this podcast on the HealthCert Education YouTube channel.

Helpful resources

Download your quick-reference Medicare Skin Cancer Item Number Guide, updated November 2025. ➡️ Download now >

Life by a Thousand Cuts 

This podcast series is designed to help you enhance your clinical decision-making, procedural skills, and confidence in skin cancer management. Focus on real-world cases, surgical techniques and tips, journal article reviews, diagnostic and management insights, and guest interviews with GPs and specialists.

Listen to the previous episode: Can curettage alone be curative for skin cancer?

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Or explore more educational content in Skin Cancer Surgery.

About A/Prof Tony Dicker

Associate Professor (Skin Cancer) & Course Coordinator MMed (Skin Cancer), The University of Queensland

Tony Dicker has practised full-time Skin Cancer Medicine in Melbourne since 2004, and previously practised in Brisbane. He obtained his PhD from The University of Queensland in molecular biology of skin cancer with Professor Ian Frazer's group at Princess Alexandra Hospital. He then spent three years as a dermatology registrar at the Royal Brisbane and Princess Alexandra Hospitals.

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