Medicare Benefits Schedule - Note PN.0.32

Only one of these histopathology examination items (72813, 72816, 72817, 72818, 72823, 72824, 72825, 72826, 72827, 72828, 72830, 72836 and 72838) can be claimed in a patient episode.

The remaining items (72844, 72846, 72847, 72848, 72849, 72850, 72851, 72852, 72855, 72856 and 72857) are add-on items, covering enzyme histochemistry and immunohistochemistry, electron microscopy and frozen sections, which can be claimed in addition to the main item.

The list of complexity levels by type of specimen are contained in Part 3 of Schedule 1 of the Health Insurance (Pathology Services Table) Regulations 2020, which is available at www.legislation.gov.au

Related Items: 72813 72816 72817 72818 72823 72824 72825 72826 72827 72828 72830 72836 72838

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Examination of complexity level 2 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions - 1 or more separately identified specimens

(Item is subject to rule 13)

Fee: $73.20 Benefit: 75% = $54.90 85% = $62.25

(See para PN.0.32, PN.1.2 of explanatory notes to this Category)

Examination of complexity level 3 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions - 1 separately identified specimen

(Item is subject to rule 13)

Fee: $88.40 Benefit: 75% = $66.30 85% = $75.15

(See para PN.0.32 of explanatory notes to this Category)

Examination of complexity level 3 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions - 2 to 4 separately identified specimens

(Item is subject to rule 13)

Fee: $99.10 Benefit: 75% = $74.35 85% = $84.25

(See para PN.0.32 of explanatory notes to this Category)

Examination of complexity level 3 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions - 5 or more separately identified specimens

(Item is subject to rule 13)

Fee: $109.60 Benefit: 75% = $82.20 85% = $93.20

(See para PN.0.32 of explanatory notes to this Category)

Examination of complexity level 4 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions - 1 separately identified specimen

(Item is subject to rule 13)

Fee: $99.50 Benefit: 75% = $74.65 85% = $84.60

(See para PN.0.32 of explanatory notes to this Category)

Examination of complexity level 4 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions - 2 to 4 separately identified specimens

(Item is subject to rule 13)

Fee: $144.75 Benefit: 75% = $108.60 85% = $123.05

(See para PN.0.32 of explanatory notes to this Category)

Examination of complexity level 4 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions - 5 to 7 separately identified specimens

(Item is subject to rule 13)

Fee: $184.60 Benefit: 75% = $138.45 85% = $156.95

(See para PN.0.32 of explanatory notes to this Category)

Examination of complexity level 4 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions - 8 to 11 separately identified specimens

(Item is subject to rule 13)

Fee: $199.25 Benefit: 75% = $149.45 85% = $169.40

(See para PN.0.32 of explanatory notes to this Category)

Examination of complexity level 4 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions - 12 to 17 separately identified specimens

(Item is subject to Rule 13)

Fee: $213.95 Benefit: 75% = $160.50 85% = $181.90

(See para PN.0.32 of explanatory notes to this Category)

Examination of complexity level 4 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions -  18 or more separately identified specimens

(Item is subject to Rule 13)

Fee: $228.65 Benefit: 75% = $171.50 85% = $194.40

(See para PN.0.32 of explanatory notes to this Category)

Examination of complexity level 5 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions - 1 or more separately identified specimens

(Item is subject to rule 13)

Fee: $280.75 Benefit: 75% = $210.60 85% = $238.65

(See para PN.0.32 of explanatory notes to this Category)

Examination of complexity level 6 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions - 1 or more separately identified specimens

(Item is subject to rule 13)

Fee: $427.20 Benefit: 75% = $320.40 85% = $363.15

(See para PN.0.32 of explanatory notes to this Category)

Examination of complexicity level 7 biopsy material with multiple tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions - 1 or more separately identified specimens.

(Item is subject to rule 13)

Fee: $478.05 Benefit: 75% = $358.55 85% = $406.35

(See para PN.0.32, PN.1.2 of explanatory notes to this Category)