Medicare Benefits Schedule - Item 37606

Open surgical sperm retrieval, unilateral, including the exploration of scrotal contents, with our without biopsy, for the purposes of intracytoplasmic sperm injection, for male factor infertility, performed in a hospital, excluding a service to which item  13218 or 37604 applies.

Multiple Operation Rule

(Anaes.)

Fee: $610.40 Benefit: 75% = $457.80 85% = $518.85

(See para TN.1.5, TN.8.59 of explanatory notes to this Category)

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Item 13251 provides for intracytoplasmic sperm injection for male factor infertility under the following circumstances:

-           where fertilisation with standard IVF is highly unlikely to be successful; or

-           where in a previous cycle of IVF, the fertilisation rate has failed due to low or no fertilisation. 

Item 13251 excludes a service to which item 13218 applies.  Sperm retrieval procedures associated with intracytoplasmic sperm injection are covered under items 37605 and 37606. 

Items 13251, 37605, 37606 do not include services provided in relation to artificial insemination using the husband's or donated sperm.

Related Items: 13218 13251 37605 37606

Item 37606 covers open sperm retrieval for the purposes of intracytoplasmic sperm injection (item 13251) for male factor infertility, in association with assisted reproductive technologies. Item 37606 provides for the procedure to be performed unilaterally. Where it is clinically necessary to perform the service bilaterally, the multiple operation rule would apply. 

Benefits for item 37606 may be claimed in conjunction with a service or services provided under item 37605, where an open approach is clinically necessary following an unsuccessful percutaneous approach. Likewise, such services would be subject to the multiple operation rule. 

Benefit is not payable for item 37606 in conjunction with item 37604.

Related Items: 37606