Medicare Benefits Schedule - Note TN.8.40

These items were introduced into the Schedule on an interim basis in May 2006 following a recommendation of the Medical Services Advisory Committee (MSAC) pending the outcome of clinical trials and further consideration by the MSAC. SIRT should not be performed in an outpatient or day patient setting to ensure patient and radiation safety requirements are met.

Related Items: 35404 35406 35408

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Multiple Operation Rule

DOSIMETRY, HANDLING AND INJECTION OF SIR-SPHERES for selective internal radiation therapy of hepatic metastases which are secondary to colorectal cancer and are not suitable for resection or ablation, used in combination with systemic chemotherapy using 5-fluorouracil (5FU) and leucovorin, not being a service to which item 35317, 35319, 35320 or 35321 applies

The procedure must be performed by a specialist or consultant physician recognised in the specialties of nuclear medicine or radiation oncology on an admitted patient in a hospital. To be claimed once in the patient's lifetime only.

Fee: $394.85 Benefit: 75% = $296.15

(See para TN.3.1, TN.8.40 of explanatory notes to this Category)

Multiple Operation Rule

Trans-femoral catheterisation of the hepatic artery to administer SIR-Spheres to embolise the microvasculature of hepatic metastases which are secondary to colorectal cancer and are not suitable for resection or ablation, for selective internal radiation therapy used in combination with systemic chemotherapy using 5-fluorouracil (5FU) and leucovorin, not being a service to which item 35317, 35319, 35320 or 35321 applies

excluding associated radiological services or preparation, and excluding aftercare

(Anaes.) (Assist.)

Fee: $926.55 Benefit: 75% = $694.95

(See para TN.3.1, TN.8.40 of explanatory notes to this Category)

Multiple Operation Rule

Catheterisation of the hepatic artery via a permanently implanted hepatic artery port to administer SIR-Spheres to embolise the microvasculature of hepatic metastases which are secondary to colorectal cancer and are not suitable for resection or ablation, for selective internal radiation therapy used in combination with systemic chemotherapy using 5-fluorouracil (5FU) and leucovorin, not being a service to which item 35317, 35319, 35320 or 35321 applies

excluding associated radiological services or preparation, and excluding aftercare

(Anaes.) (Assist.)

Fee: $695.00 Benefit: 75% = $521.25

(See para TN.3.1, TN.8.40 of explanatory notes to this Category)