Medicare Benefits Schedule - Note PN.7.11

Where a recessive variant has been identified using item 73434, reproductive partners should first be tested using item 73434, prior to gene sequencing under item 73427 where no relevant variant was detected by item 73434 and if considered appropriate, after genetic counselling.

Related Items: 73434

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Detection of pathogenic or likely pathogenic gene variants, requested by a specialist or consultant physician, for any of the following:

(a) a patient with a suspected neuromuscular disorder, being a neuromuscular disorder with signs and symptoms associated with variants that are not detectable by massively parallel sequencing;

(b) a relative of a patient with a pathogenic or likely pathogenic germline gene variant associated with a neuromuscular disorder (confirmed by laboratory findings);

(c) the reproductive partner of a patient with a recessive pathogenic or likely pathogenic germline gene variant associated with a neuromuscular disorder (confirmed by laboratory findings)

Applicable once per gene per lifetime

Fee: $392.00 Benefit: 75% = $294.00 85% = $333.20

(See para PN.7.11, PN.7.12 of explanatory notes to this Category)