Medicare Benefits Schedule - Item 73459

Testing for diagnostic purposes of a pregnant patient, for detection in the fetus of a gene variant or variants present in the parents, if:

(a) the gene variant or variants are:

(i) a variant or variants in the mitochondrial genome identified in the oocyte donating parent; or

(ii) autosomal recessive variants identified in both biological parents within the same gene; or

(iii) an autosomal dominant or X-linked variant identified in either biological parent; or

(iv) identified in a biological sibling of the fetus; and

(b) the causative variant or variants for the condition of the fetus’ first-degree relative have been confirmed by laboratory findings; and

(c) the detection is requested by a specialist or consultant physician; and

(d) the service is not a service associated with a service to which item 73361, 73362, 73363 or 73462 applies

Fee: $1,600.00 Benefit: 75% = $1,200.00 85% = $1,501.30

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