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Category 5 - DIAGNOSTIC IMAGING SERVICES
63464 - Additional Information
MRI scan of both breasts for the detection of cancer in a patient, if:
(a) a dedicated breast coil is used; and
(b) the request for the scan identifies that the patient is asymptomatic and is younger than 60 years of age; and
(c) the request for the scan identifies that the patient is at high risk of developing breast cancer due to one or more of the following:
(i) genetic testing has identified the presence of a high risk breast cancer gene mutation in the patient or in a first degree relative of the patient;
(ii) both:
(A) one of the patient’s first or second degree relatives was diagnosed with breast cancer at age 45 years or younger; and
(B) another first or second degree relative on the same side of the patient’s family was diagnosed with bone or soft tissue sarcoma at age 45 years or younger;
(iii) the patient has a personal history of breast cancer before the age of 50 years;
(iv) the patient has a personal history of mantle radiation therapy;
(v) the patient has a lifetime risk estimation greater than 30% or a 10 year absolute risk estimation greater than 5% using a clinically relevant risk evaluation algorithm; and
(d) the service is not performed in conjunction with item 55076 or 55079
Applicable not more than once in a 12 month period (R) (Contrast)
(Anaes.)
Fee: $755.50 Benefit: 75% = $566.65 85% = $656.80
(See para IN.0.18, IN.0.19 of explanatory notes to this Category)
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- 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