Medicare Benefits Schedule - Item 73338

Search Results for Item 73338

View Associated Notes

Category 6 - PATHOLOGY SERVICES

73338

73338 - Additional Information

Item Start Date:
01-Apr-2014
Description Updated:
01-Jan-2015
Schedule Fee Updated:
22-Aug-2016

Group
P7 - Genetics

A test of tumour tissue from a patient with metastatic colorectal cancer (stage IV), requested by a specialist or consultant physician, to determine if the requirements relating to rat sarcoma oncogene (RAS) gene mutation status for access to cetuximab or panitumumab under the Pharmaceutical Benefits Scheme (PBS) are fulfilled, if:

(a) the test is conducted for all clinically relevant mutations on KRAS exons 2, 3 and 4 and NRAS exons 2, 3, and 4; or

(b) a RAS mutation is found.

Fee: $362.60 Benefit: 75% = $271.95 85% = $308.25

(See para PN.0.26 of explanatory notes to this Category)


Associated Notes

Category 6 - PATHOLOGY SERVICES

PN.0.26

RAS gene mutation status (Item 73338)

Item 73338 provides for testing of RAS mutations to limit subsidy of anti-EGFR antibodies to only those patients demonstrated to have no RAS mutations. 

For a Medicare benefit to be payable, the test must be conducted for all clinically relevant mutations on KRAS exons 2, 3 and 4 and NRAS exons 2, 3 and 4, or until a RAS mutation is found. 

Enabling the requirements of the item descriptor to be met once any RAS mutation is found means that once the test indicates that the patient is not RAS wild-type and therefore not suitable for access to cetuximab and panitumumab under the PBS, a pathologist is not required to continue testing for other clinically relevant mutations.

Related Items: 73338


Legend

  • Assist - Addition/Deletion of (Assist.)
  • Amend - Amended Description
  • Anaes - Anaesthetic Values Amended
  • Emsn - EMSN Change
  • Fee - Fee Amended
  • Renum - Item Number Change (renumbered)
  • New - New Item
  • NewMin - New Item (previous Ministerial Determination)
  • Qfe - QFE Change