Medicare Benefits Schedule - Note TN.8.26

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Category 3 - THERAPEUTIC PROCEDURES

TN.8.26

Breast Biopsy Items – items 31533 (Fine Needle Aspiration) and 31548 (Mechanical Device Biopsy)

Breast abnormalities requiring biopsy should be assessed by core biopsy or vacuum-assisted core biopsy. If a service has access to high-quality cytology with immediate reporting, then fine needle aspiration (FNA) may be used in addition to mechanical device biopsy, but not instead of it. In exceptional cases, based on a clinician’s judgement, FNA may be used alone if mechanical device biopsy is not possible.

FNA is indicated for patients with a suspected breast abscess or a symptomatic simple breast cyst.

In relation to item 31533 (FNA) an impalpable lesion includes those lesions that clinically require definition by ultrasound or mammography for accurate or safe sampling, eg. lesions in association with breast prostheses or in areas of breast thickening.

 

Related Items: 31533 31548


Related Items

Category 3 - THERAPEUTIC PROCEDURES

31533

31533 - Additional Information

Item Start Date:
01-Nov-2002
Description Updated:
01-Nov-2002
Schedule Fee Updated:
01-Nov-2023

FINE NEEDLE ASPIRATION of an impalpable breast lesion detected by mammography or ultrasound, imaging guided - but not including imaging

(Anaes.)

Fee: $151.80 Benefit: 75% = $113.85 85% = $129.05

(See para TN.8.26 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

31548

31548 - Additional Information

Item Start Date:
01-Nov-2002
Description Updated:
01-May-2020
Schedule Fee Updated:
01-Nov-2023

Breast, biopsy of solid tumour or tissue of, using mechanical biopsy device, for histological examination, other than a service associated with a service to which item 31530 applies (Anaes.)

(Anaes.)

Fee: $220.15 Benefit: 75% = $165.15 85% = $187.15

(See para TN.8.26 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