Medicare Benefits Schedule - Note PN.7.3

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Category 6 - PATHOLOGY SERVICES

PN.7.3

Cystic fibrosis gene testing

(1) For any particular patient, item 73345, 73347, 73348 and 73349 is applicable not more than once in a lifetime.

(2) For any particular patient, item 73346 and 73350 is applicable not more than once in a pregnancy.

(3) The testing laboratory used to undertake tests for items 73345, 73346, 73347, 73348, 73349 and 73350 must use a cystic fibrosis transmembrane conductance regulator methodology appropriate to the clinical setting with:

                (a) sufficient diagnostic range and sensitivity to detect at least 95% of pathogenic cystic fibrosis transmembrane conductance regulator variants likely to be present in the patient; and

                (b) with at least 25 of the most frequently encountered cystic fibrosis transmembrane conductance regulator variants in the Australian population. 

Related Items: 73345 73346 73347 73348 73349 73350


Related Items

Category 6 - PATHOLOGY SERVICES

73345

73345 - Additional Information

Item Start Date:
01-Jul-2018
Description Updated:
01-Jul-2018
Schedule Fee Updated:
01-Jul-2018

Testing of a patient for pathogenic cystic fibrosis transmembrane conductance regulator variants for the purpose of investigating, making or excluding a diagnosis of cystic fibrosis or a cystic fibrosis transmembrane conductance regulator related disorder when requested by a specialist or consultant physician who manages the treatment of the patient, not being a service associated with a service to which item 73347, 73348, or 73349 applies.

The patient must have clinical or laboratory findings suggesting there is a high probability suggestive of cystic fibrosis or a cystic fibrosis transmembrane conductance regulator related disorder.

Fee: $500.00 Benefit: 75% = $375.00 85% = $425.00

(See para PN.7.3, PN.7.16 of explanatory notes to this Category)

Category 6 - PATHOLOGY SERVICES

73346

73346 - Additional Information

Item Start Date:
01-Jul-2018
Description Updated:
01-Jul-2018
Schedule Fee Updated:
01-Jul-2018

Testing of a pregnant patient whose carrier status for pathogenic cystic fibrosis transmembrane conductance regulator variants, as well as their reproductive partner carrier status is unknown, for the purpose of determining whether pathogenic cystic fibrosis transmembrane conductance regulator variants are present in the fetus, in order to make or exclude a diagnosis of cystic fibrosis or a cystic fibrosis transmembrane conductance regulator related disorder in the fetus when requested by a specialist or consultant physician who manages the treatment of the patient, not being a service associated with a service to which item 73350 applies.

The fetus must have ultrasonic findings of echogenic gut, with unknown familial cystic fibrosis transmembrane conductance regulator variants.

Fee: $500.00 Benefit: 75% = $375.00 85% = $425.00

(See para PN.7.3, PN.7.16 of explanatory notes to this Category)

Category 6 - PATHOLOGY SERVICES

73347

73347 - Additional Information

Item Start Date:
01-Jul-2018
Description Updated:
01-Jul-2018
Schedule Fee Updated:
01-Jul-2018

Testing of a prospective parent for pathogenic cystic fibrosis transmembrane conductance regulator variants for the purpose of determining the risk of their fetus having pathogenic cystic fibrosis transmembrane conductance regulator variants. This is indicated when the fetus has ultrasonic evidence of echogenic gut when requested by a specialist or consultant physician who manages the treatment of the patient, not being a service associated with a service to which item 73345, 73348, or 73349 applies.

Fee: $500.00 Benefit: 75% = $375.00 85% = $425.00

(See para PN.7.3, PN.7.16 of explanatory notes to this Category)

Category 6 - PATHOLOGY SERVICES

73348

73348 - Additional Information

Item Start Date:
01-Jul-2018
Description Updated:
01-Jan-2020
Schedule Fee Updated:
01-Jul-2018

Testing of a patient with a laboratory-established family history of pathogenic cystic fibrosis transmembrane conductance regulator variants, for the purpose of determining whether the patient is an asymptomatic genetic carrier of the pathogenic cystic fibrosis transmembrane conductance regulator variants that have been laboratory established in the family history, not being a service associated with a service to which item 73345, 73347, or 73349 applies.

The patient must have a positive family history, confirmed by laboratory findings of pathogenic cystic fibrosis transmembrane conductance regulator variants, with a personal risk of being a heterozygous genetic carrier of at least 6%. (This includes family relatedness of: parents, children, full-siblings, half-siblings, grand-parents, grandchildren, aunts, uncles, first cousins, and first cousins once-removed, but excludes relatedness of second cousins or more distant relationships).

Fee: $250.00 Benefit: 75% = $187.50 85% = $212.50

(See para PN.7.3, PN.7.16 of explanatory notes to this Category)

Category 6 - PATHOLOGY SERVICES

73349

73349 - Additional Information

Item Start Date:
01-Jul-2018
Description Updated:
01-Jul-2018
Schedule Fee Updated:
01-Jul-2018

Testing of a patient for pathogenic cystic fibrosis transmembrane conductance regulator variants for the purpose of determining the reproductive risk of the patient with their reproductive partner because their reproductive partner is already known to have pathogenic cystic fibrosis transmembrane conductance regulator variants requested by a specialist or consultant physician who manages the treatment of the patient, not being a service associated with a service to which item 73345, 73347, or 73348 applies.

Fee: $500.00 Benefit: 75% = $375.00 85% = $425.00

(See para PN.7.3, PN.7.16 of explanatory notes to this Category)

Category 6 - PATHOLOGY SERVICES

73350

73350 - Additional Information

Item Start Date:
01-Jul-2018
Description Updated:
01-Jul-2018
Schedule Fee Updated:
01-Jul-2018

Testing of a pregnant patient, where one or both prospective parents are known to be a genetic carrier of pathogenic cystic fibrosis transmembrane conductance regulator variants for the purpose of determining whether pathogenic cystic fibrosis transmembrane conductance regulator variants are present in the fetus in order to make or exclude a diagnosis of cystic fibrosis or a cystic fibrosis transmembrane conductance regulator related disorder in the fetus, when requested by a specialist or consultant physician who manages the treatment of the patient, not being a service associated with a service to which item 73346 applies.

The fetus must be at 25% or more risk of cystic fibrosis or a cystic fibrosis transmembrane conductance regulator related disorder because of known familial cystic fibrosis transmembrane conductance regulator variants.   

Fee: $250.00 Benefit: 75% = $187.50 85% = $212.50

(See para PN.7.3, PN.7.16 of explanatory notes to this Category)


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