Medicare Benefits Schedule - Item 15962

Complex insertion of any of the following kinds of brachytherapy device, with image guidance and if a radiation oncologist is in attendance at the initiation of the service:

(a) intrauterine tubes with or without ovoids, ring or cylinder;

(b) endocavity applicators;

(c) intraluminal catheters for treatment of bronchus, trachea, oesophagus, nasopharynx, bile duct;

(d) endovascular catheters for treatment of vessels;

including the removal of applicators, catheters or needles

(Anaes.)

Fee: $319.15 Benefit: 75% = $239.40 85% = $271.30

(See para TN.2.5, TN.2.7 of explanatory notes to this Category)

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For each course of treatment there may be multiple applicator insertions. Each insertion is considered a new attendance (or episode of care). For each attendance there may be a claim for the relevant descriptors for items 15958-15984, including:

(a)     insertion of the applicator;

(b)     simulation and dosimetry;

(c)     treatment;

(d)     verification; and

(e)     re-planning, if required.

Final dosimetry plans must be validated by both the radiation therapist and medical physicist, using quality assurance processes, with the plan approved by the radiation oncologist prior to the delivery, which must include ensuring data transfer is acceptable and validation checks are completed.

Related Items: 15958 15960 15962 15964 15966 15968 15970 15972 15974 15976 15978 15980 15982 15984

Multi-disciplinary team involvement may be required for items relating to applicator insertion (Items 15958-15968). This may include a:

(a)     Gynaecological oncologist; or

(b)     Urologist; or

(c)     Breast surgeon; or

(d)     Thoracic surgeon; or

(e)     Vascular surgeon; or

(f)      Gastro-intestinal surgeon; or

(g)     Plastic surgeon; or

(h)     General surgeon; or

(i)       Interventional radiologist; or

(j)       Ophthalmic surgeon.

Related Items: 15958 15960 15962 15964 15966 15968