Medicare Benefits Schedule - Note TN.8.161

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Category 3 - THERAPEUTIC PROCEDURES

TN.8.161

Urology Oncology: Prostatectomy - (Items 37210, 37211, 37213 and 37214)

Best practice prior to claiming for a 37210, 37211, 37213 and 37214 would be for the operating surgeon to have a long consult with the patient within 6 months prior to surgery to discuss and provide patients with written information about all guideline-endorsed treatment options for their condition. A thorough consult discussing all available treatment modalities, is required to ensure patients make well-informed decision about their treatment.

Multi-disciplinary management constitutes clinical best practice in patients with intermediate risk or advanced prostate cancer. As such, patients should ideally be reviewed by a multi-disciplinary team before a treatment decision is made. Multi-disciplinary teams involve radiation oncologists (for alternate radical treatments), medical oncologists (for adjuvant or therapeutic approaches) and other disciplines (e.g. urology nurses, exercise physiotherapists, exercise physiologists, physiotherapists, psychologists, pathologists, radiologists). Recommendations from multi-disciplinary reviews should be documented in writing and provided to the patient and referring GP.

Men in whom curative treatment for prostate cancer is recommended, should be offered and encouraged to discuss treatment options with a urologist and a radiation oncologist prior to any treatment, as part of fully informed decision making. A record of a patient’s decision not to accept a referral to a radiation oncologist (from the urologist or general practitioner) should be clearly documented in the patient’s medical record.

Related Items: 37210 37211 37213 37214


Related Items

Category 3 - THERAPEUTIC PROCEDURES

37210

37210 - Additional Information

Item Start Date:
01-Nov-1997
Description Updated:
01-Nov-2020
Schedule Fee Updated:
01-Jul-2020

Prostatectomy, radical, involving total excision of the prostate, sparing of nerves around the prostate (where clinically indicated) with or without bladder neck reconstruction, other than a service associated with a service to which item 30390, 30627, 35551, 36502 or 37375 applies

(Anaes.) (Assist.)

Fee: $1,643.20 Benefit: 75% = $1,232.40

(See para TN.8.161 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

37211

37211 - Additional Information

Item Start Date:
01-Nov-1997
Description Updated:
01-Nov-2020
Schedule Fee Updated:
01-Jul-2020

Prostatectomy, radical, involving total excision of the prostate, sparing of nerves around the prostate (where clinically indicated):

(a) with or without bladder neck reconstruction; and

(b) with pelvic lymphadenectomy;

other than a service associated with a service to which item 30390, 30627, 35551, 36502 or 37375 applies

(Anaes.) (Assist.)

Fee: $1,995.65 Benefit: 75% = $1,496.75

(See para TN.8.161 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

37213

37213 - Additional Information

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

Prostatectomy, radical, involving total excision of the prostate, sparing of nerves around the prostate (where clinically indicated):

(a) complicated by:

(i) previous radiation therapy (including brachytherapy) on the prostate; or

(ii) previous ablative procedures on the prostate; and

(b) with bladder neck reconstruction;

other than a service associated with a service to which item 30390, 30627, 35551, 36502 or 37375 applies

(Anaes.) (Assist.)

Fee: $2,464.65 Benefit: 75% = $1,848.50

(See para TN.8.161 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

37214

37214 - Additional Information

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

Prostatectomy, radical, involving total excision of the prostate, sparing of nerves around the prostate (where clinically indicated):

(a) complicated by:

(i) previous radiation therapy (including brachytherapy) on the prostate; or

(ii) previous ablative procedures on the prostate; and

(b) with bladder neck reconstruction and pelvic lymphadenectomy;

other than a service associated with a service to which item 30390, 30627, 35551, 36502 or 37375 applies

(Anaes.) (Assist.)

Fee: $2,993.70 Benefit: 75% = $2,245.30

(See para TN.8.161 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