Medicare Benefits Schedule - Item 73295

Detection of germline BRCA1 or BRCA2 pathogenic or likely pathogenic gene variants, requested by a specialist or consultant physician, to determine eligibility for treatment with a poly (adenosine diphosphate [ADP]-ribose) polymerase (PARP) inhibitor under the Pharmaceutical Benefits Scheme (PBS), in a patient with:

(a)    advanced (FIGO III-IV) high-grade serous or high-grade epithelial ovarian, fallopian tube or primary peritoneal cancer for whom testing of tumour tissue is not feasible; or

(b)    triple negative early breast cancer; or

(c)    hormone receptor positive, HER2-negative, early breast cancer with one or more high-risk characteristics.

Applicable once per lifetime. 

Fee: $1,200.00 Benefit: 75% = $900.00 85% = $1,101.30

(See para PN.0.23 of explanatory notes to this Category)

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Items 73297, 73300, 73305, 73334, 73339, 73340, 73393, 73394, 73417, 73418, 73440, 73441, 73442, 73443, and 73444

Prior to ordering these tests the ordering practitioner should ensure the patient (or approximate proxy) has given written informed consent. Testing should only be performed after genetic counselling. Appropriate genetic counselling should be provided to the patient either by the specialist treating practitioner, a genetic counselling service or a clinical geneticist on referral. Further counselling may be necessary upon receipt of the test results.

Items 73295, 73296, 73304, 73333, 73392, 73395, 73416 and 73419

Patients who are found to have any form of affected allele should be referred for post-test genetic counselling as there may be implications for other family members. Appropriate genetic counselling should be provided to the patient either by the specialist treating practitioner, a genetic counselling service or a clinical geneticist on referral.

Related Items: 73295 73296 73297 73300 73304 73305 73333 73334 73339 73340 73392 73393 73394 73395 73416 73417 73418 73419 73440 73441 73442 73443 73444