Medicare Benefits Schedule - Note IN.5.3

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Category 5 - DIAGNOSTIC IMAGING SERVICES

IN.5.3

Item 63399 - temporary availability

Item 63399 has been introduced temporarily to diagnose myocarditis that may occur after vaccination with the mRNA COVID-19 vaccines Comirnaty (Pfizer) and Spikevax (Moderna).

The Medical Services Advisory Committee (MSAC) recommended a temporary item to allow time for a full health technology assessment on the use of cardiac MRI in diagnosing myocarditis more broadly to be considered.

Item 63399 is for use in patients where:

  • the patient has suspected myocarditis after receiving a mRNA COVID-19 vaccine; and
  • the patient had symptom onset within 21 days of a mRNA COVID-19 vaccine administration; and
  • myocarditis cannot be definitively diagnosed using conventional imaging and other diagnostic tests.

The item can be used once in a patient's lifetime after the first vaccine dose, second vaccine dose or booster dose.

The item commenced on 1 January 2022 and will be available until 31 December 2022, pending a full assessment by the MSAC.

This service is able to be performed on both partially and fully Medicare-eligible MRIs.

 


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