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Category 3 - THERAPEUTIC PROCEDURES
TN.8.280
Localisation of lesions in the breast and or axilla (items 31536 and 31537)
MBS item 31536 is for the preoperative insertion of a hookwire (or a similar device) into the breast or axilla to mark the site of a lesion, when the insertion is not associated with a breast biopsy. The hookwire (or similar device) is to be inserted under imaging which is billed under a separate MBS item.
MBS item 31537 is for the insertion of a marker clip (or tissue marker) into the breast and/or axilla, to mark the site of lesion that has been totally or almost removed at biopsy and requires localisation. It is intended that the schedule fee for this item is inclusive of all components in delivering the service.
In accordance with accepted clinical practice guidelines, marker clips (or tissue markers) are not required for every biopsy and the particular occasions where they should be inserted are listed in MBS item 31537 (a) – (f). Please note the requirement at d) includes where neoadjuvant therapy may occur prior to future interventions on the breast and there is potential lack of lesion conspicuity following completion of neoadjuvant therapy.
Providers are required to use imaging when inserting the marker clip(s), however, the appropriate imaging modality can be determined by the practitioner and the imaging component is to be claimed under the relevant diagnostic imaging item.
When it is clinically relevant to insert more than one marker clip, the Multiple Operation Rule (MOR) will apply. The MOR will apply to all clips that are inserted at breast biopsy, regardless of site. This means the MOR will apply to all clips that are inserted as part of the same patient episode.
For further information practitioners could refer to the accepted clinical guidance for the use of marker clips that is provided by BreastScreen Australia and Assessment Services.
Related Items
Category 3 - THERAPEUTIC PROCEDURES
31500 - Additional Information
BREAST, BENIGN LESION up to and including 50mm in diameter, including simple cyst, fibroadenoma or fibrocystic disease, open surgical biopsy or excision of, with or without frozen section histology
(Anaes.)
Fee: $296.20 Benefit: 75% = $222.15 85% = $251.80
(See para TN.8.25, TN.8.280 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
31503 - Additional Information
Category 3 - THERAPEUTIC PROCEDURES
31506 - Additional Information
Category 3 - THERAPEUTIC PROCEDURES
31509 - Additional Information
Category 3 - THERAPEUTIC PROCEDURES
31515 - Additional Information
Category 3 - THERAPEUTIC PROCEDURES
31536 - Additional Information
Breast, preoperative localisation of lesion of, by hookwire or similar device, using interventional imaging techniques, but not including imaging (Anaes.)
(Anaes.)
Fee: $215.80 Benefit: 75% = $161.85 85% = $183.45
(See para TN.8.280 of explanatory notes to this Category)
Category 3 - THERAPEUTIC PROCEDURES
31537 - Additional Information
Insertion of a marker clip into a breast, including axilla, following a breast biopsy and using imaging (but not including the associated imaging), if additional surgery, neoadjuvant systemic therapy, follow up imaging or radiation may be required and the insertion is for any of the following reasons:
(a) to mark the site of a lesion that has been totally or almost completely removed;
(b) to confirm biopsy site if multiple lesions are present;
(c) to confirm biopsy site of an ill-defined lesion;
(d) future surgery or preoperative localisation is considered to be potentially difficult due to lesion conspicuity;
(e) preoperative localisation is likely to be carried out using a modality different from the biopsy modality;
(f) for correlation across modalities for diagnostic reasons
(Anaes.)
Fee: $215.80 Benefit: 75% = $161.85 85% = $183.45
(See para TN.8.2, TN.8.280 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