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Category 5 - DIAGNOSTIC IMAGING SERVICES
Category 5 - DIAGNOSTIC IMAGING SERVICES
63541 - Additional Information
Multiparametric Magnetic Resonance Imaging scan of the prostate for the detection of cancer, if the patient is referred by an urologist, radiation oncologist, or medical oncologist and the request for the scan identifies:
that the patient is suspected of developing prostate cancer, due to one of the following:
(i) a digital rectal examination which is suspicious for prostate cancer; or
(ii) in a person under 70 years, at least two prostate specific antigen (PSA) tests performed within an interval of 1- 3 months are greater than 3.0 ng/ml, and the free/total PSA ratio is less than 25% or the repeat PSA exceeds 5.5 ng/ml; or
(iii) in a person under 70 years, whose risk of developing prostate cancer based on relevant family history is at least double the average risk, at least two PSA tests performed within an interval of 1- 3 months are greater than 2.0 ng/ml, and the free/total PSA ratio is less than 25%; or
(iv) in a person 70 years or older, at least two PSA tests performed within an interval of 1- 3 months are greater than 5.5ng/ml and the free/total PSA ratio is less than 25%.
using a standardised image acquisition protocol involving T2 Weighted Imaging, Diffusion Weighted Imaging, and Dynamic Contrast Enhancement (unless contraindicated)
(R)
Note: Benefits are payable on one occasion only in any 12 month period.
Relevant family history is a first degree relative with prostate cancer, or suspected of carrying a BRCA 1 or BRCA 2 mutation.
(Anaes.)
Fee: $450.00 Benefit: 75% = $337.50 85% = $382.50
(See para IN.0.19 of explanatory notes to this Category)
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