Medicare Benefits Schedule - Item 15978

Complex level dosimetry for brachytherapy plans that contain multiple needles, catheters or radiation sources, calculated on the three‑dimensional volumetric dataset, if:

(a) the planning process is required to deliver a prescribed dose to a target volume relative to multiple channel delivery applicators, needles or catheters or radiation sources; and

(b) based on review and assessment by a radiation oncologist, the planning process requires the differential of doses between the target, organs at risk and normal tissue dose using avoidance strategies (which include the placement of sources and/or dwell times or tissue packing; and

(c) delineation of structures is required as part of the planning process, in order to produce a dose‑volume histogram to review and assess the plan; and

(d) dose calculations are performed on a personalised basis, which must include three‑dimensional dose calculation to target and organ at risk volumes; and

(e) dose calculations and the dose‑volume histogram are approved and recorded with the plan

Applicable once per course of treatment

Fee: $1,078.10 Benefit: 75% = $808.60 85% = $979.40

(See para TN.2.5 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