Medicare Benefits Schedule - Item 63564

Search Results for Item 63564

View Associated Notes

Category 5 - DIAGNOSTIC IMAGING SERVICES

63564

63564 - Additional Information

Item Start Date:
01-Mar-2023
Description Updated:
01-Mar-2023
Schedule Fee Updated:
01-Nov-2023

Group
I5 - Magnetic Resonance Imaging
Subgroup
19 - Scan Of Body - For Specified Conditions

Note: the requirements for services provided under item 63564 are detailed under note IN.5.4

MRI – whole body scan for the early detection of cancer:

a)       requested by a specialist or consultant physician in consultation with a clinical geneticist in a familial cancer or genetic clinic; and

b)       the request identifies that the patient has a high risk of developing cancer malignancy

due to heritable TP53 - related cancer (hTP53rc) syndrome

(R)

Bulk bill incentive

(Anaes.)

Fee: $1,561.75 Benefit: 75% = $1,171.35 85% = $1,463.05

(See para IN.5.4 of explanatory notes to this Category)


Associated Notes

Category 5 - DIAGNOSTIC IMAGING SERVICES

IN.5.4

Requirements for imaging under Item 63564

A service described under item 63564 applies only if the same patient has not received a service to which the same item applies within the preceding 12 months.

The use of this item is limited to individuals carrying a heritable germline or mosaic pathogenic or likely pathogenic mutation in the TP53 gene, ascertained by a clinical report from an accredited pathology laboratory.

Related Items: 63564


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