Medicare Benefits Schedule - Note IN.5.5

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Category 5 - DIAGNOSTIC IMAGING SERVICES

IN.5.5

Explanatory Note for Items 63539 and 63540

For Items 63539 and 63540, access to these items is for patients with a confirmed clinical and/or molecular diagnosis of a rare genetic disorder associated with an increased risk of developing renal tumours.

The following list is intended to support providers in determining who may be eligible for the service. If a disorder is not included in the list but does meet all the eligibility criteria as described in the item descriptor, the service can still be provided.

Examples of eligible disorders could include:

  • Tuberous sclerosis complex
  • Von Hippel Lindau syndrome
  • Birt-Hogg-Dube syndrome
  • Hereditary papillary renal carcinoma syndrome
  • Hereditary leiomyomatosis and renal cell carcinoma (HLRCC)
  • Cowden syndrome (PTEN Hamartoma Tumour Syndrome spectrum)
  • BAP1-associated cancer syndrome
  • SDH associated renal cancer (risk for phaeochromocytoma and paraganglioma)
  • Familial clear renal cell carcinoma with chromosome 3 translocation, or
  • other rare genetic disorders associated with an increased risk of developing renal tumours.


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