Medicare Benefits Schedule - Item 73296

Characterisation of germline gene variants, including copy number variation where appropriate, requested by a specialist or consultant physician:

(a) in genes associated with breast, ovarian, fallopian tube or primary peritoneal cancer, which must include at least:

(i) BRCA1 and BRCA 2 genes; and

(ii) one or more STK11, PTEN, CDH1, PALB2 and TP53 genes; and

(b) in a patient:

(i) with breast, ovarian, fallopian tube or primary peritoneal cancer; and

(ii) for whom clinical and family history criteria place the patient at greater than 10% risk of having a pathogenic or likely pathogenic gene associated with breast, ovarian, fallopian tube or primary peritoneal cancer

Once per cancer diagnosis

Fee: $1,200.00 Benefit: 75% = $900.00 85% = $1,101.30

(See para PN.0.23 of explanatory notes to this Category)

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Items 73297, 73300, 73305, 73334, 73339, 73340, 73393, 73394, 73417, 73418, 73440, 73441, 73442, 73443, and 73444

Prior to ordering these tests the ordering practitioner should ensure the patient (or approximate proxy) has given written informed consent. Testing should only be performed after genetic counselling. Appropriate genetic counselling should be provided to the patient either by the specialist treating practitioner, a genetic counselling service or a clinical geneticist on referral. Further counselling may be necessary upon receipt of the test results.

Items 73295, 73296, 73304, 73333, 73392, 73395, 73416 and 73419

Patients who are found to have any form of affected allele should be referred for post-test genetic counselling as there may be implications for other family members. Appropriate genetic counselling should be provided to the patient either by the specialist treating practitioner, a genetic counselling service or a clinical geneticist on referral.

Related Items: 73295 73296 73297 73300 73304 73305 73333 73334 73339 73340 73392 73393 73394 73395 73416 73417 73418 73419 73440 73441 73442 73443 73444