Medicare Benefits Schedule - Note PN.0.23

Prior to ordering these tests (73297, 73300, 73305, 73334, 73339 and 73340) the ordering practitioner should ensure the patient (or approximate proxy) has given informed consent. Testing should only be performed after genetic counselling. 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. Further counselling may be necessary upon receipt of the test results.

Related Items: 73297 73300 73305 73334 73339 73340

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Characterisation of germline gene variants, including copy number variation:

1. in one or more of the following genes:
   1. BRCA1;
   2. BRCA2;
   3. STK11;
   4. PTEN;
   5. CDH1;
   6. PALB2;
   7. TP53; and
2. in a patient who:
   1. is a biological relative of a patient who has had a pathogenic or likely pathogenic gene variant identified in one or more of the genes mentioned in paragraph (a); and
   2. has not previously received a service to which item 73295, 73296 or 73302 applies;

requested by a specialist or consultant physician

Fee: $400.00 Benefit: 75% = $300.00 85% = $340.00

(See para PN.0.23 of explanatory notes to this Category)

Detection of mutation of the FMR1 gene where:

(a) the patient exhibits intellectual disability, ataxia, neurodegeneration, or premature ovarian failure consistent with an FMRI mutation; or

(b) the patient has a relative with a FMR1 mutation

1 or more tests

Fee: $101.30 Benefit: 75% = $76.00 85% = $86.15

(See para PN.0.23 of explanatory notes to this Category)

Detection of mutation of the FMR1 gene by Southern Blot analysis where the results in item 73300 are inconclusive

Fee: $202.65 Benefit: 75% = $152.00 85% = $172.30

(See para PN.0.23 of explanatory notes to this Category)

Detection of germline mutations of the von Hippel-Lindau (VHL) gene in biological relatives of a patient with a known mutation in the VHL gene

Fee: $340.00 Benefit: 75% = $255.00 85% = $289.00

(See para PN.0.23 of explanatory notes to this Category)

Detection of germline mutations in the RET gene in patients with a suspected clinical diagnosis of multiple endocrine neoplasia type 2 (MEN2) requested by a specialist or consultant physician who manages the treatment of the patient.

One test.  (Item is  subject to rule 25)

Fee: $400.00 Benefit: 75% = $300.00 85% = $340.00

(See para PN.0.23 of explanatory notes to this Category)

Detection of a known mutation in the RET gene in an asymptomatic relative of a patient with a documented pathogenic germline RET mutation requested by a specialist or consultant physician who manages the treatment of the patient.

One test.  (Item is subject to rule 25)

Fee: $200.00 Benefit: 75% = $150.00 85% = $170.00

(See para PN.0.23 of explanatory notes to this Category)