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Category 5 - DIAGNOSTIC IMAGING SERVICES

63464

63464 - Additional Information

Item Start Date:
01-Feb-2009
Description Start Date:
01-Jan-2014
Schedule Fee Start Date:
01-Feb-2009

Group
I5 - MAGNETIC RESONANCE IMAGING
Subgroup
19 - SCAN OF BODY - FOR SPECIFIED CONDITIONS

MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician and where:  

(a)     a dedicated breast coil is used; and

(b)     the request for scan identifies that the person is asymptomatic and is less than 50 years of age; and

(c)     the request for scan identifies either:

    (i)     that the patient is at high risk of developing breast cancer, due to 1 of the following:

    (A) 3 or more first or second degree relatives on the same side of the family diagnosed with breast or ovarian cancer;

    (B) 2 or more first or second degree relatives on the same side of the family diagnosed with breast or ovarian cancer,  if any of the following applies to at least 1 of the relatives:                                                              

        - has been diagnosed with bilateral breast cancer;

        - had onset of breast cancer before the age of 40 years;

        - had onset of ovarian cancer before the age of 50 years;

        - has been diagnosed with breast and ovarian cancer, at the same time or at different times;

        - has Ashkenazi Jewish ancestry;

        - is a male relative who has been diagnosed with breast cancer;


    (C) 1 first or second degree relative diagnosed with breast cancer at age 45 years or younger, plus another first or second degree relative on the same side of the family with bone or soft tissue sarcoma at age 45 years or younger; or


    (ii)    that genetic testing has identified the presence of a high risk breast cancer gene mutation.


Scan of both breasts for:


- detection of cancer (R)


NOTE: Benefits are payable on one occasion only in any 12 month period

Bulk bill incentive


(Anaes.)

Fee: $690.00 Benefit: 75% = $517.50 85% = $609.80

(See para DIQ of explanatory notes to this Category)

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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