Medicare Benefits Schedule - Note TN.8.12

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Category 3 - THERAPEUTIC PROCEDURES

TN.8.12

Sentinel Node Biopsy for Breast Cancer - (Items 30299 to 30303)

The Medical Services Advisory Committee (MSAC) evaluated the available evidence and found that sentinel lymph node biopsy is safe and effective in identifying sentinel lymph nodes, but that the long term outcomes of sentinel lymph node biopsy compared to lymph node clearance are uncertain.  As a result, interim Medicare funding is available for these items pending the outcome of clinical trials and further consideration by the MSAC. 

For items 30299 and 30300, both lymphoscintigraphy and lymphotropic dye injection must be used, unless the patient has an allergy to the lymphotropic dye. 

For the purposes of these items, the axillary lymph node levels referred to are as follows:

-                  Level I  - axillary lymph nodes up to the inferior border of pectoralis minor.

-                  Level II -axillary lymph nodes up to the superior border of pectoralis minor.

-                  Level III - axillary lymph nodes extending above the superior border of pectoralis minor.

 

Related Items: 30299 30300 30302 30303


Related Items

Category 3 - THERAPEUTIC PROCEDURES

30299

30299 - Additional Information

Item Start Date:
01-Nov-2005
Description Updated:
01-Nov-2005
Schedule Fee Updated:
01-Jul-2021

SENTINEL LYMPH NODE BIOPSY OR BIOPSIES for breast cancer, involving dissection in a level I axilla, using preoperative lymphoscintigraphy and lymphotropic dye injection, not being a service associated with a service to which item 30300, 30302 or 30303 applies

(Anaes.) (Assist.)

Fee: $663.25 Benefit: 75% = $497.45

(See para TN.8.12 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

30300

30300 - Additional Information

Item Start Date:
01-Nov-2005
Description Updated:
01-Nov-2005
Schedule Fee Updated:
01-Jul-2021

SENTINEL LYMPH NODE BIOPSY OR BIOPSIES for breast cancer, involving dissection in a level II/III axilla, using preoperative lymphoscintigraphy and lymphotropic dye injection, not being a service associated with a service to which item 30299, 30302 or 30303 applies

(Anaes.) (Assist.)

Fee: $795.90 Benefit: 75% = $596.95

(See para TN.8.12 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

30302

30302 - Additional Information

Item Start Date:
01-Nov-2005
Description Updated:
01-Nov-2005
Schedule Fee Updated:
01-Jul-2021

SENTINEL LYMPH NODE BIOPSY OR BIOPSIES for breast cancer, involving dissection in a level I axilla, using lymphotropic dye injection, not being a service associated with a service to which item 30299, 30300 or 30303 applies

(Anaes.) (Assist.)

Fee: $530.60 Benefit: 75% = $397.95

(See para TN.8.12 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

30303

30303 - Additional Information

Item Start Date:
01-Nov-2005
Description Updated:
01-Nov-2005
Schedule Fee Updated:
01-Jul-2021

SENTINEL LYMPH NODE BIOPSY OR BIOPSIES for breast cancer, involving dissection in a level II/III axilla, using lymphotropic dye injection, not being a service associated with a service to which item 30299, 30300 or 30302 applies

(Anaes.) (Assist.)

Fee: $636.65 Benefit: 75% = $477.50

(See para TN.8.12 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