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Related Items: 73337 73341 73344 73436 73437 73438 73439

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A test of tumour tissue from a patient with a new diagnosis of non‑small cell lung cancer, shown to have non-squamous histology or histology not otherwise specified, requested by, or on behalf of, a specialist or consultant physician, if the test is:

(a)   to determine if requirements relating to epidermal growth factor receptor (EGFR) gene status for access to an immunotherapy listed under the Pharmaceutical Benefits Scheme (PBS) are fulfilled; and

(b)   not associated with a service to which item 73437 or 73438 applies

Fee: $397.35 Benefit: 75% = $298.05 85% = $337.75

(See para PN.7.15 of explanatory notes to this Category)

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A test of tumour tissue from a patient with a new diagnosis of locally advanced or metastatic non-small cell lung cancer requested by, or on behalf of, a specialist or consultant physician, if the test is:

(a)   to determine if the requirements relating to MET proto-oncogene, receptor tyrosine kinase (MET) exon 14 skipping alterations (METex14sk) status for access to an immunotherapy listed under the Pharmaceutical Benefits Scheme (PBS) are fulfilled: and

(b)   not associated with a service to which item 73437 or 73438 applies

Fee: $397.35 Benefit: 75% = $298.05 85% = $337.75

(See para PN.1.2, PN.7.15 of explanatory notes to this Category)

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A nucleic acid-based multi-gene panel test of tumour tissue from a patient with a new diagnosis of non-small cell lung cancer requested by, or on behalf of, a specialist or consultant physician, if the test is:

(a)  to detect variants in at least EGFR, BRAF, KRAS and MET exon 14 to determine access to specific therapies relevant to these variants listed on the Pharmaceutical Benefits Scheme (PBS); and

(b)  to detect the fusion status of at least ALK, ROS1, RET, NTRK1, NTRK2 and NTRK3; and

          (i)   to determine access to specific therapies relevant to these variants listed on the PBS; or

         (ii)   determine if the requirements relating to EGFR, ALK and ROS1 status for access immunotherapies listed on the PBS are fulfilled; and

(c)  not associated with a service to which item 73438, 73439, 73337, 73341, 73344, 73436 or 73351 applies

Fee: $1,247.00 Benefit: 75% = $935.25 85% = $1,148.30

(See para PN.7.15 of explanatory notes to this Category)

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A DNA-based multi-gene panel test of tumour tissue from a patient with a new diagnosis of non-small cell lung cancer requested by, or on behalf of, a specialist or consultant physician, if the test is:

(a)   to detect variants in at least EGFR, BRAF, KRAS and MET exon 14; and

(b)   to determine access to specific therapies relevant to these variants listed on the Pharmaceutical Benefits Scheme (PBS); or

(c)   to determine if the requirements relating to EGFR status for access to immunotherapies listed on the PBS are fulfilled; and

(d)   not associated with a service to which item 73437, 73337, 73436 or 73351 applies

Fee: $682.35 Benefit: 75% = $511.80 85% = $583.65

(See para PN.7.15 of explanatory notes to this Category)

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