Medicare Benefits Schedule - Item 37220

Prostate, radioactive seed implantation of, urological component, using transrectal ultrasound guidance:

(a) for a patient with:

(i) localised prostatic malignancy at clinical stages T1 (clinically inapparent tumour not palpable or visible by imaging) or T2 (tumour confined within prostate); and

(ii) a Gleason score of less than or equal to 7 (Grade Group 1 to Grade Group 3); and

(iii) a prostate specific antigen (PSA) of not more than 10ng/ml at the time of diagnosis; and

(b) performed by a urologist at an approved site in association with a radiation oncologist; and

(c) being a service associated with:

(i) services to which items 15338 and 55603 apply; and

(ii) a service to which item 60506 or 60509 applies

Multiple Operation Rule

(Anaes.)

Fee: $1,149.35 Benefit: 75% = $862.05

(See para TN.8.55 of explanatory notes to this Category)

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One of the requirements of item 37220 is that patients have a Gleason score of less than or equal to 7 (Grade Group 1-3). However, where the patient has a score of 7, comprising a primary score of 4 and a secondary score of 3 (ie. 4+3=7; Grade Group 3), it is recommended that low dose rate brachytherapy form part of a combined modality treatment.

Low dose rate brachytherapy of the prostate should be performed in patients, with favourable anatomy allowing adequate access to the prostate without pubic arch interference, and who have a life expectancy of greater than 10 years.

An 'approved site' for the purposes of this item is one at which radiation oncology services may be performed lawfully under the law of the State or Territory in which the site is located.

Related Items: 37220