Medicare Benefits Schedule - Item 73456

Search Results for Item 73456

Category 6 - PATHOLOGY SERVICES

73456

73456 - Additional Information

Item Start Date:
01-Nov-2023
Description Updated:
01-Nov-2023
Schedule Fee Updated:
01-Nov-2023

Group
P7 - Genetics

Characterisation by whole genome sequencing, or by either or both whole exome sequencing and mitochondrial DNA sequencing, of germline variants present in nuclear DNA and in mitochondrial DNA of a patient with a strong suspicion of a mitochondrial disease, if:

(a) the characterisation is requested by a specialist or consultant physician; and

(b) the characterisation is requested because of the onset of one or more clinical features indicative of mitochondrial disease, including at least one or more of the following:

            (i) meeting the clinical criteria of a probable indicator of 

                 mitochondrial disease on a relevant scoring system;

            (ii) evident mitochondrial dysfunction or decompensation;

            (iii) unexplained hypotonia or weakness, profound hypoglycaemia

                  or “failure to thrive” in the presence of a metabolic acidosis;

            (iv) unexplained single or multi-organ dysfunction or fulminant

                  failure (including, but not limited to, neuropathies,

                  myopathies, hepatopathy, pancreatic and/or bone marrow

                  failure);

            (v) refractory or atypical seizures, developmental delays or cognitive

                  regression, or progressive encephalopathy or progressive

                  encephalomyopathy; 

            (vi) cardiomyopathy and/or cardiac arrythmias;

            (vii) rapid hearing or painless visual loss or ptosis;

            (viii) stroke-like episodes or nonvasculitic strokes;

            (ix) ataxia, encephalopathy, seizures, muscle fatigue or weakness;

            (x) external ophthalmoplegia;

            (xi) hearing loss, diabetes, unexplained short stature, or

                   endocrinopathy;

            (xii) family history of mitochondrial disease, or any of the above;

                   and

(c) the service is not a service associated with a service to which item 73358, 73359 or 73457 applies

Applicable only once per lifetime

Fee: $2,100.00 Benefit: 75% = $1,575.00 85% = $1,997.60


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