1.  The whole of this instrument

1 November 2021.

1 November 2021

14216

Professional attendance on a patient by a psychiatrist, who has undertaken training in Repetitive Transcranial Magnetic Stimulation (rTMS), for treatment mapping for rTMS, if the patient:

(a) has not previously received any prior transcranial magnetic stimulation therapy in a public or private setting; and

(b) is at least 18 years old; and

(c) is diagnosed with a major depressive episode; and

(d) has failed to receive satisfactory improvement for the major depressive episode despite the adequate trialling of at least 2 different classes of antidepressant medications, unless contraindicated, and all of the following apply:

(i) the patient’s adherence to antidepressant treatment has been formally assessed;

(ii) the trialling of each antidepressant medication has been at the recommended therapeutic dose for a minimum of 3 weeks;

(iii) where clinically appropriate, the treatment has been titrated to the maximum tolerated therapeutic dose; and

(e) has undertaken psychological therapy, if clinically appropriate

186.40

14217

Repetitive Transcranial Magnetic Stimulation (rTMS) treatment of up to 35 services provided by, or on behalf of, a psychiatrist who has undertaken training in rTMS, if the patient has previously received a service under item 14216—each service up to 35 services

160.00

14219

Professional attendance on a patient by a psychiatrist, who has undertaken training in Repetitive Transcranial Magnetic Stimulation (rTMS), for treatment mapping for rTMS, if the patient:

(a) is at least 18 years old; and

(b) is diagnosed with a major depressive episode; and

(c) has failed to receive satisfactory improvement for the major depressive episode despite the adequate trialling of at least 2 different classes of antidepressant medications, unless contraindicated, and all of the following apply:

(i) the patient’s adherence to antidepressant treatment has been formally assessed;

(ii) the trialling of each antidepressant medication has been at the recommended therapeutic dose for a minimum of 3 weeks;

(iii) where clinically appropriate, the treatment has been titrated to the maximum tolerated therapeutic dose; and

(d) has undertaken psychological therapy, if clinically appropriate; and

(e) has previously received an initial service under item 14217 and the patient:

(i) has relapsed after a remission following the initial service; and

(ii) has had a satisfactory clinical response to the service under item 14217 (which has been assessed by a validated major depressive disorder tool at least 4 months after receiving that service)

186.40

14220

Repetitive Transcranial Magnetic Stimulation (rTMS) treatment of up to 15 services provided by, or on behalf of, a psychiatrist who has undertaken training in rTMS, if the patient has previously received:

(a) a service under item 14217 (which was not provided in the previous 4 months); and

(b) a service under item 14219

Each service up to 15 services

160.00

30311

Sentinel lymph node biopsy or biopsies for cutaneous melanoma, using preoperative lymphoscintigraphy and lymphotropic dye injection, if:

(a) the primary lesion is greater than 1.0 mm in depth (or at least 0.8 mm in depth in the presence of ulceration); and

(b) appropriate excision of the primary melanoma has occurred; and

(c) the service is not associated with a service to which item 30075, 30078, 30299, 30300, 30302, 30303, 30329, 30332, 30618, 30820, 31423, 52025 or 52027 applies

Applicable to only one lesion per occasion on which the service is provided (H) (Anaes.) (Assist.)

647.65

32230

Endoscopic mucosal resection using electrocautery of a non‑invasive sessile or flat superficial colorectal neoplasm which is at least 25mm in diameter, if the service is:

(a) provided by a specialist gastroenterologist or surgical endoscopist; and

(b) supported by photographic evidence to confirm the size of the polyp in situ, and

(c) performed in association with a service to which item 32222, 32223, 32224, 32225, 32226 or 32228 applies.

Applicable only once per polyp (H) (Anaes.)

695.25

35401

Vertebroplasty, for one or more fractures in one or more vertebrae, performed by an interventional radiologist, for the treatment of a painful osteoporotic thoracolumbar vertebral compression fracture of the thoracolumbar spinal segment (T11, T12, L1 or L2), if:

(a) pain is severe (numeric rated pain score greater than or equal to 7 out of 10); and

(b) symptoms are poorly controlled by opiate therapy; and

(c) severe pain duration is 3 weeks or less; and

(d) there is MRI (or SPECT‑CT if MRI unavailable) evidence of acute vertebral fracture

Applicable only once for the same fracture, but is applicable for a new fracture of the same vertebra or vertebrae (H) (Anaes.)

710.50

45534

Autologous fat grafting, unilateral service (harvesting, preparation and injection of adipocytes) if:

(a) the autologous fat grafting is for one or more of the following purposes:

(i) the correction of defects arising from treatment and prevention of breast cancer in patients with contour defects, greater than or equal to 20% volume asymmetry, post‑treatment pain or poor prosthetic coverage;

(ii) the preparation of post mastectomy thin or irradiated skin flaps in patients intending to have breast reconstruction;

(iii) breast reconstruction in breast cancer patients;

(iv) the correction of developmental disorders of the breast; and

(b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes

Up to a total of 4 services per side (for total treatment of a single breast) (H) (Anaes.)

651.50

45535

Autologous fat grafting, bilateral service (harvesting, preparation and injection of adipocytes) if:

(a) the autologous fat grafting is for one or more of the following purposes:

(i) the correction of defects arising from treatment and prevention of breast cancer in patients with contour defects, greater than or equal to 20% volume asymmetry, post‑treatment pain or poor prosthetic coverage;

(ii) the preparation of post mastectomy thin or irradiated skin flaps in patients intending to have breast reconstruction;

(iii) breast reconstruction in breast cancer patients;

(iv) the correction of developmental disorders of the breast; and

(b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes

Up to a total of 4 services (H) (Anaes.)

1,140.15

45589

Autologous fat grafting (harvesting, preparation and injection of adipocytes) if:

(a) the autologous fat grafting is for either or both of the following purposes:

(i) the correction of asymmetry arising from volume and contour defects in craniofacial disorders—up to a total of 4 services if each service is provided at least 3 months after the previous service;

(ii) the treatment of burn scar or associated skin graft in the context of scar contracture, contour deformity or neuropathic pain, for patients who have undergone a minimum of 3 months of topical therapies, including silicone and pressure therapy, with an unsatisfactory or minimal level of improvement—up to a total of 4 services per region of the body (upper or lower limbs, trunk, neck or face) if each service provided per region of the body is provided at least 3 months after the previous such service; and

(b) both:

(i) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes; and

(ii) for craniofacial disorders, evidence of diagnosis of the qualifying craniofacial disorder is documented in the patient notes

(H) (Anaes.)

651.50

Correction of bilateral breast ptosis by mastopexy, if:

(a) at least two‑thirds of the breast tissue, including the nipple, lies inferior to the inframammary fold where the nipple is located at the most dependent, inferior part of the breast contour; and

(b) photographic evidence (including anterior, left lateral and right lateral views), with a marker at the level of the inframammary fold, demonstrating the clinical need for this service, is documented in the patient notes

Applicable only once per lifetime (H) (Anaes.) (Assist.)

11607

Continuous ambulatory blood pressure recording for 24 hours or more for a patient if:

(a) the patient has a clinic blood pressure measurement (using a sphygmomanometer or a validated oscillometric blood pressure monitoring device) of either or both of the following measurements:

(i) systolic blood pressure greater than or equal to 140 mmHg and less than or equal to 180 mmHg;

(ii) diastolic blood pressure greater than or equal to 90 mmHg and less than or equal to 110 mmHg; and

(b) the patient has not commenced anti‑hypertensive therapy; and

(c) the recording includes the patient’s resting blood pressure; and

(d) the recording is conducted using microprocessor‑based analysis equipment; and

(e) the recording is interpreted by a medical practitioner and a report is prepared by the same medical practitioner; and

(f) a treatment plan is provided for the patient; and

(g) the service:

(i) is not provided in association with ambulatory electrocardiogram recording, and

(ii) is not associated with a service to which any of the following items apply:

(A) 177;

(B) 224 to 228;

(C) 229 to 244;

(D) 699;

(E) 701 to 707;

(F) 721 to 732;

(G) 735 to 758.

Applicable only once in any 12 month period

Note: Items 177, 224 to 228, 229 to 244 and 699 are specified in determinations made under subsection 3C(1) of the Act.

107.20

32500

Varicose veins, multiple injections of sclerosant using continuous compression techniques, including associated consultation, one or both legs, if:

(a) proximal reflux of 0.5 seconds or longer has been demonstrated; and

(b) the service is not for cosmetic purposes; and

(c) the service is not associated with:

(i) any other varicose vein operation on the same leg (excluding aftercare); or

(ii) a service on the same leg (excluding aftercare) to which any of the following items apply:

(A) 35200;

(B) 59970 to 60078;

(C) 60500 to 60509;

(D) 61109

Applicable to a maximum of 6 treatments in a 12 month period (Anaes.)

114.20

32507

Varicose veins, sub‑fascial ligation of one or more incompetent perforating veins in one leg of a patient, if the service:

(a) is performed by open surgical technique (not including endoscopic ligation) and the patient has significant signs or symptoms (including one or more of the following signs or symptoms) attributable to venous reflux:

(i) ache;

(ii) pain;

(iii) tightness;

(iv) skin irritation;

(v) heaviness;

(vi) muscle cramps;

(vii) limb swelling;

(viii) discolouration;

(ix) discomfort;

(x) any other signs or symptoms attributable to venous dysfunction; and

(b) is not associated with:

(i) any other varicose vein operation on the same leg; or

(ii) a service (on the same leg) to which item 35200, 60072, 60075 or 60078 applies

(H) (Anaes.) (Assist.)

555.25

32508

Varicose veins, complete dissection at the sapheno‑femoral or sapheno‑popliteal junction, with or without either ligation or stripping, or both, of the great or small saphenous veins in one leg of a patient, for the first time on the same leg, including excision or injection of either tributaries or incompetent perforating veins, or both, if the patient has significant signs or symptoms (including one or more of the following signs or symptoms) attributable to venous reflux:

(a) ache;

(b) pain;

(c) tightness;

(d) skin irritation;

(e) heaviness;

(f) muscle cramps;

(g) limb swelling;

(h) discolouration;

(i) discomfort;

(j) any other signs or symptoms attributable to venous dysfunction

(H) (Anaes.) (Assist.)

555.25

32511

Varicose veins, complete dissection at the sapheno‑femoral and sapheno‑popliteal junction, with or without either ligation or stripping, or both, of the great or small saphenous veins in one leg of a patient, for the first time on the same leg, including excision or injection of either tributaries or incompetent perforating veins, or both, if the patient has significant signs or symptoms (including one or more of the following signs or symptoms) attributable to venous reflux:

(a) ache;

(b) pain;

(c) tightness;

(d) skin irritation;

(e) heaviness;

(f) muscle cramps;

(g) limb swelling;

(h) discolouration;

(i) discomfort;

(j) any other signs or symptoms attributable to venous dysfunction

(H) (Anaes.) (Assist.)

825.45

32514

Varicose veins, ligation of the great or small saphenous vein in the same leg of a patient, with or without stripping, by re‑operation for recurrent veins in the same territory—one leg—including excision or injection of either tributaries or incompetent perforating veins, or both, if the patient has significant signs or symptoms (including one or more of the following signs or symptoms) attributable to venous reflux:

(a) ache;

(b) pain;

(c) tightness;

(d) skin irritation;

(e) heaviness;

(f) muscle cramps;

(g) limb swelling;

(h) discolouration;

(i) discomfort;

(j) any other signs or symptoms attributable to venous dysfunction

(H) (Anaes.) (Assist.)

964.35

32517

Varicose veins, ligation of the great and small saphenous vein in the same leg of a patient, with or without stripping, by re‑operation for recurrent veins in either territory—one leg—including excision or injection of either tributaries or incompetent perforating veins, or both, if the patient has significant signs or symptoms (including one or more of the following signs or symptoms) attributable to venous reflux:

(a) ache;

(b) pain;

(c) tightness;

(d) skin irritation;

(e) heaviness;

(f) muscle cramps;

(g) limb swelling;

(h) discolouration;

(i) discomfort;

(j) any other signs or symptoms attributable to venous dysfunction

(H) (Anaes.) (Assist.)

1,241.80

32520

Varicose veins, abolition of venous reflux by occlusion of a primary or recurrent great or small saphenous vein (and major tributaries of saphenous veins as necessary) in one leg of a patient, using a laser probe introduced by an endovenous catheter, if all of the following apply:

(a) it is documented by duplex ultrasound that the great or small saphenous vein (whichever is to be treated) of the patient demonstrates reflux of 0.5 seconds or longer;

(b) the patient has significant signs or symptoms (including one or more of the following signs or symptoms) attributable to venous reflux:

(i) ache;

(ii) pain;

(iii) tightness;

(iv) skin irritation;

(v) heaviness;

(vi) muscle cramps;

(vii) limb swelling;

(viii) discolouration;

(ix) discomfort;

(x) any other signs or symptoms attributable to venous dysfunction;

(c) the service does not include radiofrequency diathermy, radiofrequency ablation or cyanoacrylate adhesive;

(d) the service is not associated with a service (on the same leg) to which any of the following items apply:

(i) 32500 to 32507;

(ii) 35200;

(iii) 59970 to 60078;

(iv) 60500 to 60509;

(v) 61109

The service includes all preparation and immediate clinical aftercare (including excision or injection of either tributaries or incompetent perforating veins, or both)

(Anaes.)

555.25

32522

Varicose veins, abolition of venous reflux by occlusion of a primary or recurrent great and small saphenous vein (and major tributaries of saphenous veins as necessary) in one leg of a patient, using a laser probe introduced by an endovenous catheter, if all of the following apply:

(a) it is documented by duplex ultrasound that the great and small saphenous veins of the patient demonstrate reflux of 0.5 seconds or longer;

(b) the patient has significant signs or symptoms (including one or more of the following signs or symptoms) attributable to venous reflux:

(i) ache;

(ii) pain;

(iii) tightness;

(iv) skin irritation;

(v) heaviness;

(vi) muscle cramps;

(vii) limb swelling;

(viii) discolouration;

(ix) discomfort;

(x) any other signs or symptoms attributable to venous dysfunction;

(c) the service does not include radiofrequency diathermy, radiofrequency ablation or cyanoacrylate adhesive;

(d) the service is not associated with a service (on the same leg) to which any of the following items apply:

(i) 32500 to 32507;

(ii) 35200;

(iii) 59970 to 60078;

(iv) 60500 to 60509;

(v) 61109

The service includes all preparation and immediate clinical aftercare (including excision or injection of either tributaries or incompetent perforating veins, or both)

(Anaes.)

825.45

32523

Varicose veins, abolition of venous reflux by occlusion of a primary or recurrent great or small saphenous vein (and major tributaries of saphenous veins as necessary) in one leg of a patient, using a radiofrequency catheter introduced by an endovenous catheter, if all of the following apply:

(a) it is documented by duplex ultrasound that the great or small saphenous vein (whichever is to be treated) demonstrates reflux of 0.5 seconds or longer;

(b) the patient has significant signs or symptoms (including one or more of the following signs or symptoms) attributable to venous reflux:

(i) ache;

(ii) pain;

(iii) tightness;

(iv) skin irritation;

(v) heaviness;

(vi) muscle cramps;

(vii) limb swelling;

(viii) discolouration;

(ix) discomfort;

(x) any other signs or symptoms attributable to venous dysfunction;

(c) the service does not include endovenous laser therapy or cyanoacrylate adhesive;

(d) the service is not associated with a service (on the same leg) to which any of the following items apply:

(i) 32500 to 32507;

(ii) 35200;

(iii) 59970 to 60078;

(iv) 60500 to 60509;

(v) 61109

The service includes all preparation and immediate clinical aftercare (including excision or injection of either tributaries or incompetent perforating veins, or both)

(Anaes.)

555.25

32526

Varicose veins, abolition of venous reflux by occlusion of a primary or recurrent great and small saphenous vein (and major tributaries of saphenous veins as necessary) in one leg of a patient, using a radiofrequency catheter introduced by an endovenous catheter, if all of the following apply:

(a) it is documented by duplex ultrasound that the great and small saphenous veins demonstrate reflux of 0.5 seconds or longer;

(b) the patient has significant signs or symptoms (including one or more of the following signs or symptoms) attributable to venous reflux:

(i) ache;

(ii) pain;

(iii) tightness;

(iv) skin irritation;

(v) heaviness;

(vi) muscle cramps;

(vii) limb swelling;

(viii) discolouration;

(ix) discomfort;

(x) any other signs or symptoms attributable to venous dysfunction;

(c) the service does not include endovenous laser therapy or cyanoacrylate adhesive;

(d) the service is not associated with a service (on the same leg) to which any of the following items apply:

(i) 32500 to 32507;

(ii) 35200;

(iii) 59970 to 60078;

(iv) 60500 to 60509;

(v) 61109

The service includes all preparation and immediate clinical aftercare (including excision or injection of either tributaries or incompetent perforating veins, or both)

(Anaes.)

825.45

32528

Varicose veins, abolition of venous reflux by occlusion of a primary or recurrent great or small saphenous vein (and major tributaries of saphenous veins as necessary) in one leg of a patient, using cyanoacrylate adhesive, if all of the following apply:

(a) it is documented by duplex ultrasound that the great or small saphenous vein (whichever is to be treated) demonstrates reflux of 0.5 seconds or longer;

(b) the patient has significant signs or symptoms (including one or more of the following signs or symptoms) attributable to venous reflux:

(i) ache;

(ii) pain;

(iii) tightness;

(iv) skin irritation;

(v) heaviness;

(vi) muscle cramps;

(vii) limb swelling;

(viii) discolouration;

(ix) discomfort;

(x) any other signs or symptoms attributable to venous dysfunction;

(c) the service does not include radiofrequency diathermy, radiofrequency ablation or endovenous laser therapy;

(d) the service is not associated with a service (on the same leg) to which any of the following items apply:

(i) 32500 to 32507;

(ii) 35200;

(iii) 59970 to 60078;

(iv) 60500 to 60509;

(v) 61109

The service include all preparation and immediate clinical aftercare (including excision or injection of either tributaries or incompetent perforating veins, or both)

(Anaes.)

555.25

32529

Varicose veins, abolition of venous reflux by occlusion of a primary or recurrent great and small saphenous vein (and major tributaries of saphenous veins as necessary) in one leg of a patient, using cyanoacrylate adhesive, if all of the following apply:

(a) it is documented by duplex ultrasound that the great and small saphenous veins demonstrate reflux of 0.5 seconds or longer;

(b) the patient has significant signs or symptoms (including one or more of the following signs or symptoms) attributable to venous reflux:

(i) ache;

(ii) pain;

(iii) tightness;

(iv) skin irritation;

(v) heaviness;

(vi) muscle cramps;

(vii) limb swelling;

(viii) discolouration;

(ix) discomfort;

(x) any other signs or symptoms attributable to venous dysfunction;

(c) the service does not include radiofrequency diathermy, radiofrequency ablation or endovenous laser therapy;

(d) the service is not associated with a service (on the same leg) to which any of the following items apply:

(i) 32500 to 32507;

(ii) 35200;

(iii) 59970 to 60078;

(iv) 60500 to 60509;

(v) 61109

The service includes all preparation and immediate clinical aftercare (including excision or injection of either tributaries or incompetent perforating veins, or both)

(Anaes.)

825.45

13207

Biopsy of an embryo, from a patient who is eligible for a service described in item 73384 under clause 2.7.3A of the pathology services table, for the purpose of providing a sample for pre‑implantation genetic testing—applicable to one or more tests performed in one assisted reproductive treatment cycle

115.00

38428

Bronchoscopy with dilatation of tracheal stricture (Anaes.)

256.50

47491

Combined anterior and posterior pelvic ring disruption, including sacroiliac joint disruption, treatment of fracture by open reduction and internal fixation of both anterior and posterior ring segments

(H) (Anaes.) (Assist.)

1,616.30

Computed tomography of the coronary arteries performed on a minimum of a 64 slice (or equivalent) scanner if:

(a) the request is made by a specialist or consultant physician; and

(b) the patient has stable or acute symptoms consistent with coronary ischaemia; and

(c) the patient is at low to intermediate risk of an acute coronary event, including having no significant cardiac biomarker elevation and no electrocardiogram changes indicating acute ischaemia (R) (Anaes.)

61560

FDG PET study of the brain, performed for the diagnosis of Alzheimer’s disease, if:

(a) clinical evaluation of the patient by a specialist, or in consultation with a specialist, is equivocal; and

(b) the service includes a quantitative comparison of the results of the study with the results of an FDG PET study of a normal brain from a reference database; and

(c) a service to which this item applies has not been performed on the patient in the previous 12 months; and

(d) a service to which item 61402 applies has not been performed on the patient in the previous 12 months for the diagnosis or management of Alzheimer’s disease

Applicable not more than 3 times per lifetime

605.05

15A

63541

12 months

1

63489

MRI—scan of one breast, performed in conjunction with a biopsy procedure on that breast and an ultrasound scan of that breast, if:

(a) the request for the MRI scan identifies that the patient has a suspicious lesion seen on MRI but not on conventional imaging; and

(b) the ultrasound scan is performed immediately before the MRI scan and confirms that the lesion is not amenable to biopsy guided by conventional imaging; and

(c) a dedicated breast coil is used (R) (Anaes.)

1,008.00

63541

Multiparametric MRI—scan of the prostate for the detection of cancer, requested by a specialist in the speciality of urology, radiation oncology or medical oncology:

(a) if the request for the scan identifies that the patient is suspected of developing prostate cancer:

(i) on the basis of a digital rectal examination; or

(ii) in the circumstances mentioned in clause 2.5.9A; and

(b) using a standardised image acquisition protocol involving:

(i) T2‑weighted imaging; and

(ii) diffusion‑weighted imaging; and

(iii) (unless contraindicated) dynamic contrast enhancement

(R) (Anaes)

450.00

63543

Multiparametric MRI—scan of the prostate for the assessment of cancer, requested by a specialist in the speciality of urology, radiation oncology or medical oncology:

(a) if the request for the scan identifies that the patient:

(i) is under active surveillance following a confirmed diagnosis of prostate cancer by biopsy histopathology; and

(ii) is not undergoing, or planning to undergo, treatment for prostate cancer; and

(b) using a standardised image acquisition protocol involving:

(i) T2‑weighted imaging; and

(ii) diffusion‑weighted imaging; and

(iii) (unless contraindicated) dynamic contrast enhancement

(R) (Anaes)

450.00

66522

Faecal calprotectin test for the diagnosis of inflammatory bowel disease, if all the following apply:

(a) the patient is under 50 years of age;

(b) the patient has gastrointestinal symptoms suggestive of inflammatory or functional bowel disease of more than 6 weeks’ duration;

(c) infectious causes have been excluded;

(d) the likelihood of malignancy has been assessed as low;

(e) no relevant clinical alarms are present

75.00

66523

Faecal calprotectin test for the diagnosis of inflammatory bowel disease, if all the following apply:

(a) the results of a service to which item 66522 applies were inconclusive for the patient (that is, the results showed a faecal calprotectin level of more than 50 μg/g but not more than 100 μg/g);

(b) the patient has ongoing gastrointestinal symptoms suggestive of inflammatory or functional bowel disease;

(c) the service is requested by a specialist or consultant physician practising as a specialist gastroenterologist;

(d) the request indicates that an endoscopic examination is not initially required;

(e) no relevant clinical alarms are present

75.00

71175

A test, requested by a specialist or consultant physician, to diagnose neuromyelitis optica spectrum disorder (NMOSD) or myelin oligodendrocyte glycoprotein antibody‑related demyelination (MARD), by the detection of one or more antibodies, for a patient:

(a) suspected of having NMOSD or MARD; and

(b) with any of the following:

(i) recurrent, bilateral or severe optic neuritis;

(ii) recurrent longitudinal extensive transverse myelitis (LETM);

(iii) area postrema syndrome (unexplained hiccups, nausea or vomiting);

(iv) acute brainstem syndrome;

(v) symptomatic narcolepsy or acute diencephalic clinical syndrome with typical NMOSD magnetic resonance imaging lesions;

(vi) symptomatic cerebral syndrome with typical NMOSD magnetic resonance imaging lesions;

(vii) monophasic neuromyelitis optica (no recurrence, and simultaneous or closely related optic neuritis and LETM within 30 days of each other);

(viii) acute disseminated encephalomyelitis;

(ix) aseptic meningitis and encephalomyelitis;

(x) poor recovery from multiple sclerosis relapses

Applicable not more than 4 times in 12 months

50.00

Characterisation of germline gene variants, including copy number variation:

(a) in one or more of the following genes:

(i) BRCA1;

(ii) BRCA2;

(iii) STK11;

(iv) PTEN;

(v) CDH1;

(vi) PALB2;

(vii) TP53; and

(b) in a patient who:

(i) is a biological relative of a patient who has had a pathogenic or likely pathogenic gene variant identified in one or more of the genes mentioned in paragraph (a); and

(ii) has not previously received a service to which item 73295, 73296 or 73302 applies;

requested by a specialist or consultant physician

Testing of a person (the person tested) for the detection of a single gene variant for diagnostic purposes, if:

(a) the person tested has a biological sibling (the sibling) with a known monogenic condition; and

(b) a service described in item 73358, 73359 or 73360 has identified the causative variant for the sibling’s condition; and

(c) the results of the testing performed for the sibling are made available for the purpose of providing the detection for the person tested; and

(d) the detection is:

(i) requested by a consultant physician practising as a clinical geneticist; or

(ii) requested by a consultant physician practising as a specialist paediatrician, following consultation with a clinical geneticist; and

(e) the detection is not performed in conjunction with a service to which item 73362 or 73363 applies

Applicable only once per variant per lifetime

Testing of a person (the person tested) for the detection of a single gene variant for the purpose of reproductive decision making, if:

(a) the person tested has a first‑degree relative (the relative) with a known monogenic condition; and

(b) a service described in item 73358, 73359 or 73360 has identified the causative variant for the relative’s condition; and

(c) the results of the testing performed for the relative are made available for the purpose of providing the detection for the person tested; and

(d) the detection is requested by a consultant physician or specialist; and

(e) the detection is not performed in conjunction with item 73359, 73361 or 73363

Applicable only once per variant per lifetime

Testing of a person (the person tested) for the detection of a single gene variant for segregation analysis in relation to another person (the patient), if:

(a) the patient has a known phenotype of a suspected monogenic condition; and

(b) a service described in item 73358 or 73360 has identified a potentially causative variant for the patient; and

(c) the person tested is a biological parent or other biological relative of the patient; and

(d) a sample from the person tested has not previously been tested in relation to the patient for a service to which item 73359 applies; and

(e) the results of the testing of the person tested for this service are made available for the purpose of providing the detection for the patient; and

(f) the detection is:

(i) requested by a consultant physician practising as a clinical geneticist; or

(ii) requested by a consultant physician practising as a specialist paediatrician, following consultation with a clinical geneticist; and

(g) the detection is not performed in conjunction with item 73361 or 73362

Applicable only once per variant per lifetime

73384

Genetic analysis, for a patient who is eligible for this service under clause 2.7.3A, of samples from the patient and (if relevant) the patient’s reproductive partner, for the purpose of providing an assay for pre‑implantation genetic testing, requested by a specialist or consultant physician

Applicable not more than once per patient episode per disorder (of a kind described in clause 2.7.3A) per reproductive relationship

1,736.00

73385

Genetic analysis, for a patient who is eligible for this service under clause 2.7.3A, of embryonic tissue from a sample from one embryo, if the analysis is:

(a) for the purpose of providing a pre‑implantation genetic test; and

(b) requested by a specialist or consultant physician; and

(c) performed in the assisted reproductive treatment cycle in which the embryo was produced

Applicable not more than once per embryo

635.00

73386

Genetic analysis, for a patient who is eligible for this service under clause 2.7.3A, of embryonic tissue from samples from 2 embryos, if the analysis is:

(a) for the purpose of providing a pre‑implantation genetic test; and

(b) requested by a specialist or consultant physician; and

(c) performed in the assisted reproductive treatment cycle in which the embryos were produced

Applicable not more than once per assisted reproductive treatment cycle, and not more than once for the 2 embryos tested

1,270.00

73387

Genetic analysis, for a patient who is eligible for this service under clause 2.7.3A, of embryonic tissue from samples from 3 or more embryos, if the analysis is:

(a) for the purpose of providing a pre‑implantation genetic test; and

(b) requested by a specialist or consultant physician; and

(c) performed in the assisted reproductive treatment cycle in which the embryos were produced

Applicable not more than once per assisted reproductive treatment cycle for the 3 or more embryos tested

1,905.00

73388

Analysis of chromosomes by genome‑wide microarray, of a sample from amniocentesis or chorionic villus sampling, including targeted assessment of specific regions for constitutional genetic abnormalities in diagnostic studies of a fetus, if

(a) one or more major fetal structural abnormalities have been detected on ultrasound; or

(b) nuchal translucency was greater than 3.5 mm

Applicable only once per fetus

589.90

73389

Analysis of products of conception from a patient with suspected hydatidiform mole for the characterisation of ploidy status

Applicable once per pregnancy

340.00

73391

Analysis of chromosomes by genome‑wide microarray in diagnostic studies of a patient with multiple myeloma

Applicable once per lifetime

589.90