Medicare Benefits Schedule - Item 73296

Characterisation of germline gene variants:

(a) including copy number variation in:

(i) BRCA1 genes; and

(ii) BRCA2 genes; and

(iii) one or more of the genes STK11, PTEN, CDH1, PALB2 and TP53; and

(b) in a patient:

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

(ii) for whom clinical and family history criteria (as assessed, by the specialist or consultant physician who requests the service, using a quantitative algorithm) place the patient at greater than 10% risk of having a pathogenic or likely pathogenic gene variation identified in one or more of the genes specified in subparagraphs (a)(i), (ii) and (iii);

requested by a specialist or consultant physician

Fee: $1,200.00 Benefit: 75% = $900.00 85% = $1,112.10

(See para PN.0.27 of explanatory notes to this Category)

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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.

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