Medicare Benefits Schedule - Note PN.3.4

Before undertaking testing it is advisable to consult with a medical practitioner experienced in the management of tuberculosis.  Neither IGRA tests or the tuberculin skin test (Mantoux) can absolutely exclude latent tuberculosis and following close contact exposure preventative therapy should always be considered in young children and immunosuppressed patients.

IGRA testing for the diagnosis of latent tuberculosis should be requested in compliance with recommendations made by the National Tuberculosis Advisory Committee in 2016 or later. http://www.health.gov.au/internet/main/publishing.nsf/Content/cdna-ntac-pubs.htm including:

• IGRAs have no place in the initial investigation of active TB disease and cannot and should not be used to exclude suspected TB disease.
• IGRA should not be used for the purpose of screening prior to BCG vaccination.
• While IGRA tests can be used in children less than 5 years of age, there may be a higher proportion of indeterminate test results and tuberculin skin testing is preferred, unless there is a history of BCG.

At least eight weeks should elapse following last possible TB exposure before testing of a contact of a confirmed case of active tuberculosis – testing of contacts should be performed only after discussion with appropriate State or Territory public health authorities.

Related Items: 69471

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Test of cell‑mediated immune response in blood for the detection of latent tuberculosis by interferon gamma release assay (IGRA) in the following people:

(a) a person who has been exposed to a confirmed case of active tuberculosis;

(b) a person who is infected with human immunodeficiency virus;

(c) a person who is to commence, or has commenced, tumour necrosis factor (TNF) inhibitor therapy;

(d) a person who is to commence, or has commenced, renal dialysis;

(e) a person with silicosis;

(f) a person who is, or is about to become, immunosuppressed because of a disease, or a medical treatment, not mentioned in paragraphs (a) to (e)

Fee: $34.90 Benefit: 75% = $26.20 85% = $29.70

(See para PN.3.4 of explanatory notes to this Category)