Medicare Benefits Schedule - Note TN.8.7

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Category 3 - THERAPEUTIC PROCEDURES

TN.8.7

Biopsy for Diagnostic Purposes - (Items 30071 to 30094 and 30820)

Needle aspiration biopsy attracts benefits on an attendance basis and not under item 30078. 

Item 30071 (diagnostic biopsy of the skin) or 30072 (diagnostic biopsy of mucous membrane) should be used when a biopsy (including shave) of a lesion is required to confirm a diagnosis and would facilitate the appropriate management of that lesion. If the shave biopsy results in a definitive excision of the lesion, only 30071 or 30072 can be claimed. 

Items 30071-30094 and 30820 require that the specimen be sent for pathological examination. 

The aftercare period for item 30071 or 30072 is 2 days rather than the standard aftercare period for skin excision of 10 days.

 

Related Items: 30071 30072 30078 30081 30084 30087 30090 30093 30094 30820


Related Items

Category 3 - THERAPEUTIC PROCEDURES

30071

30071 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Nov-2016
Schedule Fee Updated:
01-Jul-2021

Diagnostic biopsy of skin, as an independent procedure, if the biopsy specimen is sent for pathological examination

(Anaes.)

Fee: $54.35 Benefit: 75% = $40.80 85% = $46.20

(See para TN.8.7 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

30072

30072 - Additional Information

Item Start Date:
01-Nov-2016
Description Updated:
01-Nov-2016
Schedule Fee Updated:
01-Jul-2021

Diagnostic biopsy of mucous membrane, as an independent procedure, if the biopsy specimen is sent for pathological examination

(Anaes.)

Fee: $54.35 Benefit: 75% = $40.80 85% = $46.20

(See para TN.8.7 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

30078

30078 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Nov-2019
Schedule Fee Updated:
01-Jul-2021

DIAGNOSTIC DRILL BIOPSY OF LYMPH NODE, DEEP TISSUE OR ORGAN, as an independent procedure, where the biopsy specimen is sent for pathological examination

(Anaes.)

Fee: $50.45 Benefit: 75% = $37.85 85% = $42.90

(See para TN.8.7 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

30081

30081 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Nov-2003
Schedule Fee Updated:
01-Jul-2021

DIAGNOSTIC BIOPSY OF BONE MARROW by trephine using open approach, where the biopsy specimen is sent for pathological examination

(Anaes.)

Fee: $114.30 Benefit: 75% = $85.75 85% = $97.20

(See para TN.8.7 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

30084

30084 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Jan-2014
Schedule Fee Updated:
01-Jul-2021

DIAGNOSTIC BIOPSY OF BONE MARROW by trephine using percutaneous approach where the biopsy is sent for pathological examination

(Anaes.)

Fee: $61.20 Benefit: 75% = $45.90 85% = $52.05

(See para TN.8.7 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

30087

30087 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Nov-2003
Schedule Fee Updated:
01-Jul-2021

DIAGNOSTIC BIOPSY OF BONE MARROW by aspiration or PUNCH BIOPSY OF SYNOVIAL MEMBRANE, where the biopsy is sent for pathological examination

(Anaes.)

Fee: $30.60 Benefit: 75% = $22.95 85% = $26.05

(See para TN.8.7 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

30090

30090 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Nov-2003
Schedule Fee Updated:
01-Jul-2021

DIAGNOSTIC BIOPSY OF PLEURA, PERCUTANEOUS 1 or more biopsies on any 1 occasion, where the biopsy is sent for pathological examination

(Anaes.)

Fee: $133.75 Benefit: 75% = $100.35 85% = $113.70

(See para TN.8.7 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

30093

30093 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Nov-2003
Schedule Fee Updated:
01-Jul-2021

DIAGNOSTIC NEEDLE BIOPSY OF VERTEBRA, where the biopsy is sent for pathological examination

(Anaes.)

Fee: $178.50 Benefit: 75% = $133.90 85% = $151.75

(See para TN.8.7 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

30094

30094 - Additional Information

Item Start Date:
01-Apr-1992
Description Updated:
01-Nov-2003
Schedule Fee Updated:
01-Jul-2021

DIAGNOSTIC PERCUTANEOUS ASPIRATION BIOPSY of deep organ using interventional imaging techniques - but not including imaging, where the biopsy is sent for pathological examination

(Anaes.)

Fee: $197.10 Benefit: 75% = $147.85 85% = $167.55

(See para TN.8.7 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

30820

30820 - Additional Information

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

Lymph node of neck, biopsy of, by open procedure, if the specimen excised is sent for pathological examination

(Anaes.)

Fee: $191.35 Benefit: 75% = $143.55 85% = $162.65

(See para TN.8.7 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