Billing Codes — Australian Health Schedule Tracker

Showing 5251–5300 of 6045 Pg 106/121

	Item No.	Description	Category	Schedule Fee	100% Benefit
	73383	Analysis of tumour tissue, requested by a specialist or consultant physician, that: (a) is for the characterisation of either or both of the following: (i) TFE3 gene rearrangement; (ii) TFEB gene rearrangement; and (b) is for a patient with clinical or laboratory evidence, including morphological features, of renal cell carcinoma Applicable only once per lifetime Group P7	Category 6 — Pathology	$400.00	—
Item Number 73383 Schedule Fee $400.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.05.2020 Item from: 01.05.2020 Gov. Change Flags No changes flagged Full Description Analysis of tumour tissue, requested by a specialist or consultant physician, that: (a) is for the characterisation of either or both of the following: (i) TFE3 gene rearrangement; (ii) TFEB gene rearrangement; and (b) is for a patient with clinical or laboratory evidence, including morphological features, of renal cell carcinoma Applicable only once per lifetime Sign in to watch this code → Get an email alert when this item changes
	73384	Genetic analysis, for a patient who is eligible for this service under clause 2.7.3A of the pathology services table (see PR.7.1), 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 (PR.7.1)) per reproductive relationship Group P7	Category 6 — Pathology	$1736.00	—
Item Number 73384 Schedule Fee $1736.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.11.2021 Item from: 01.11.2021 Gov. Change Flags No changes flagged Full Description Genetic analysis, for a patient who is eligible for this service under clause 2.7.3A of the pathology services table (see PR.7.1), 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 (PR.7.1)) per reproductive relationship Sign in to watch this code → Get an email alert when this item changes
	73385	Genetic analysis, for a patient who is eligible for this service under clause 2.7.3A of the Pathology Services Table (see PR.7.1), of embryonic tissue from a sample from one embryo, if: (a) the analysis is: (i) requested by a specialist or consultant physician; and (ii) for the purpose of providing a pre‑implantation genetic test; and (iii) performed on an embryo that was produced in a single assisted reproductive treatment cycle; and (b) the service is not a service to which item 73386 or 73387 applies for the same assisted reproductive treatment cycle Applicable not more than once per embryo Group P7	Category 6 — Pathology	$635.00	—
Item Number 73385 Schedule Fee $635.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.11.2021 Item from: 01.11.2021 Gov. Change Flags No changes flagged Full Description Genetic analysis, for a patient who is eligible for this service under clause 2.7.3A of the Pathology Services Table (see PR.7.1), of embryonic tissue from a sample from one embryo, if: (a) the analysis is: (i) requested by a specialist or consultant physician; and (ii) for the purpose of providing a pre‑implantation genetic test; and (iii) performed on an embryo that was produced in a single assisted reproductive treatment cycle; and (b) the service is not a service to which item 73386 or 73387 applies for the same assisted reproductive treatment cycle Applicable not more than once per embryo Sign in to watch this code → Get an email alert when this item changes
	73386	Genetic analysis, for a patient who is eligible for this service under clause 2.7.3A of the Pathology Services Table (see PR.7.1), of embryonic tissue from samples from 2 embryos, if: (a) the analysis is: (i) requested by a specialist or consultant physician; and (ii) for the purpose of providing a pre‑implantation genetic test; and (iii) performed on embryos that were produced in a single assisted reproductive treatment cycle; and (b) the service is not a service to which item 73385 or 73387 applies for the same assisted reproductive treatment cycle Applicable not more than once per assisted reproductive treatment cycle for the 2 embryos tested Group P7	Category 6 — Pathology	$1270.00	—
Item Number 73386 Schedule Fee $1270.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.11.2021 Item from: 01.11.2021 Gov. Change Flags No changes flagged Full Description Genetic analysis, for a patient who is eligible for this service under clause 2.7.3A of the Pathology Services Table (see PR.7.1), of embryonic tissue from samples from 2 embryos, if: (a) the analysis is: (i) requested by a specialist or consultant physician; and (ii) for the purpose of providing a pre‑implantation genetic test; and (iii) performed on embryos that were produced in a single assisted reproductive treatment cycle; and (b) the service is not a service to which item 73385 or 73387 applies for the same assisted reproductive treatment cycle Applicable not more than once per assisted reproductive treatment cycle for the 2 embryos tested Sign in to watch this code → Get an email alert when this item changes
	73387	Genetic analysis, for a patient who is eligible for this service under clause 2.7.3A of the Pathology Services Table (see PR.7.1), of embryonic tissue from samples from 3 or more embryos, if: (a) the analysis is: (i) requested by a specialist or consultant physician; and (ii) for the purpose of providing a pre‑implantation genetic test; and (iii) performed on embryos that were produced in a single assisted reproductive treatment cycle; and (b) the service is not a service to which item 73385 or 73386 applies for the same assisted reproductive treatment cycle Applicable not more than once per assisted reproductive treatment cycle for the 3 or more embryos tested Group P7	Category 6 — Pathology	$1905.00	—
Item Number 73387 Schedule Fee $1905.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.11.2021 Item from: 01.11.2021 Gov. Change Flags No changes flagged Full Description Genetic analysis, for a patient who is eligible for this service under clause 2.7.3A of the Pathology Services Table (see PR.7.1), of embryonic tissue from samples from 3 or more embryos, if: (a) the analysis is: (i) requested by a specialist or consultant physician; and (ii) for the purpose of providing a pre‑implantation genetic test; and (iii) performed on embryos that were produced in a single assisted reproductive treatment cycle; and (b) the service is not a service to which item 73385 or 73386 applies for the same assisted reproductive treatment cycle Applicable not more than once per assisted reproductive treatment cycle for the 3 or more embryos tested Sign in to watch this code → Get an email alert when this item changes
	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 one or more major fetal structural abnormalities have been detected on ultrasound; or nuchal translucency was greater than 3.5 mm Applicable only once per fetus Group P7	Category 6 — Pathology	$589.90	—
Item Number 73388 Schedule Fee $589.90 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.11.2021 Item from: 01.11.2021 Gov. Change Flags No changes flagged Full Description 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 one or more major fetal structural abnormalities have been detected on ultrasound; or nuchal translucency was greater than 3.5 mm Applicable only once per fetus Sign in to watch this code → Get an email alert when this item changes
	73389	Analysis of products of conception from a patient with suspected hydatidiform mole for the characterisation of ploidy status Applicable once per pregnancy Group P7	Category 6 — Pathology	$340.00	—
Item Number 73389 Schedule Fee $340.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.11.2021 Item from: 01.11.2021 Gov. Change Flags No changes flagged Full Description Analysis of products of conception from a patient with suspected hydatidiform mole for the characterisation of ploidy status Applicable once per pregnancy Sign in to watch this code → Get an email alert when this item changes
	73391	Analysis of chromosomes by genome‑wide microarray in diagnostic studies of a patient with multiple myeloma Applicable once per lifetime Group P7	Category 6 — Pathology	$589.90	—
Item Number 73391 Schedule Fee $589.90 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.11.2021 Item from: 01.11.2021 Gov. Change Flags No changes flagged Full Description Analysis of chromosomes by genome‑wide microarray in diagnostic studies of a patient with multiple myeloma Applicable once per lifetime Sign in to watch this code → Get an email alert when this item changes
	73392	Characterisation of pathogenic or likely pathogenic germline gene variants, requested by a specialist or consultant physician: (a) in at least the following genes: (i) MYBPC3; (ii) MYH7; (iii) TNNI3; (iv) TNNT2; (v) TPM1; (vi) ACTC1; (vii) MYL2; (viii) MYL3; (ix) PRKAG2; (x) LAMP2; (xi) GLA; (xii) LMNA; (xiii) SCN5A; (xiv) TTN; (xv) RBM20; (xvi) PLN; (xvii) DSP; (xviii) DSC2; (xix) DSG2; (xx) JUP; (xxi) PKP2; (xxii) TMEM43; and (b) for a patient for whom clinical history, family history or laboratory findings suggest there is a high probability of one or more of the following heritable cardiomyopathies in the patient: (i) hypertrophic cardiomyopathy; (ii) dilated cardiomyopathy; (iii) arrhythmogenic cardiomyopathy Applicable once per lifetime Group P7	Category 6 — Pathology	$1200.00	—
Item Number 73392 Schedule Fee $1200.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2022 Item from: 01.07.2022 Gov. Change Flags No changes flagged Full Description Characterisation of pathogenic or likely pathogenic germline gene variants, requested by a specialist or consultant physician: (a) in at least the following genes: (i) MYBPC3; (ii) MYH7; (iii) TNNI3; (iv) TNNT2; (v) TPM1; (vi) ACTC1; (vii) MYL2; (viii) MYL3; (ix) PRKAG2; (x) LAMP2; (xi) GLA; (xii) LMNA; (xiii) SCN5A; (xiv) TTN; (xv) RBM20; (xvi) PLN; (xvii) DSP; (xviii) DSC2; (xix) DSG2; (xx) JUP; (xxi) PKP2; (xxii) TMEM43; and (b) for a patient for whom clinical history, family history or laboratory findings suggest there is a high probability of one or more of the following heritable cardiomyopathies in the patient: (i) hypertrophic cardiomyopathy; (ii) dilated cardiomyopathy; (iii) arrhythmogenic cardiomyopathy Applicable once per lifetime Sign in to watch this code → Get an email alert when this item changes
	73393	Characterisation of one or more pathogenic or likely pathogenic germline gene variants, requested by a specialist or consultant physician, if: (a) a service described in item 73392 has not previously been performed for the patient; and (b) the patient is a first-degree biological relative (or a second-degree biological relative if a first-degree biological relative is unavailable) of a person who has a pathogenic or likely pathogenic germline gene variant that is confirmed by laboratory findings; and (c) the service is performed for the purpose of assessing present or future risk of any of the following heritable cardiomyopathies in the patient: (i) hypertrophic cardiomyopathy; (ii) dilated cardiomyopathy; (iii) arrhythmogenic cardiomyopathy Applicable once per variant per lifetime Group P7	Category 6 — Pathology	$400.00	—
Item Number 73393 Schedule Fee $400.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2022 Item from: 01.07.2022 Gov. Change Flags No changes flagged Full Description Characterisation of one or more pathogenic or likely pathogenic germline gene variants, requested by a specialist or consultant physician, if: (a) a service described in item 73392 has not previously been performed for the patient; and (b) the patient is a first-degree biological relative (or a second-degree biological relative if a first-degree biological relative is unavailable) of a person who has a pathogenic or likely pathogenic germline gene variant that is confirmed by laboratory findings; and (c) the service is performed for the purpose of assessing present or future risk of any of the following heritable cardiomyopathies in the patient: (i) hypertrophic cardiomyopathy; (ii) dilated cardiomyopathy; (iii) arrhythmogenic cardiomyopathy Applicable once per variant per lifetime Sign in to watch this code → Get an email alert when this item changes
	73394	Characterisation of one or more recessive pathogenic or likely pathogenic germline genes, requested by a specialist or consultant physician, for the purpose of determining the reproductive risk of heritable cardiomyopathy in a patient: (a) who is a reproductive partner of a known carrier of a pathogenic or likely pathogenic germline gene that is confirmed by laboratory findings ; and (b) for whom carrier status of a pathogenic or likely pathogenic germline gene is unknown; and (c) who has a clinical history, family history or laboratory findings suggesting there is a low probability of heritable cardiomyopathy Applicable once per gene per lifetime Group P7	Category 6 — Pathology	$1200.00	—
Item Number 73394 Schedule Fee $1200.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2022 Item from: 01.07.2022 Gov. Change Flags No changes flagged Full Description Characterisation of one or more recessive pathogenic or likely pathogenic germline genes, requested by a specialist or consultant physician, for the purpose of determining the reproductive risk of heritable cardiomyopathy in a patient: (a) who is a reproductive partner of a known carrier of a pathogenic or likely pathogenic germline gene that is confirmed by laboratory findings ; and (b) for whom carrier status of a pathogenic or likely pathogenic germline gene is unknown; and (c) who has a clinical history, family history or laboratory findings suggesting there is a low probability of heritable cardiomyopathy Applicable once per gene per lifetime Sign in to watch this code → Get an email alert when this item changes
	73395	Re‑analysis of whole exome or genome data that is obtained in performing a service to which item 73392 applies, for characterisation of previously unreported germline gene variants related to the clinical phenotype, if: (a) the re-analysis is requested by a consultant physician practising as a clinical geneticist or a cardiologist; and (b) the patient is strongly suspected of having a heritable cardiomyopathy; and (c) the re-analysis is performed at least 18 months after a service to which item 73392 or this item applies is performed for the patient Applicable twice per lifetime Group P7	Category 6 — Pathology	$500.00	—
Item Number 73395 Schedule Fee $500.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2022 Item from: 01.07.2022 Gov. Change Flags No changes flagged Full Description Re‑analysis of whole exome or genome data that is obtained in performing a service to which item 73392 applies, for characterisation of previously unreported germline gene variants related to the clinical phenotype, if: (a) the re-analysis is requested by a consultant physician practising as a clinical geneticist or a cardiologist; and (b) the patient is strongly suspected of having a heritable cardiomyopathy; and (c) the re-analysis is performed at least 18 months after a service to which item 73392 or this item applies is performed for the patient Applicable twice per lifetime Sign in to watch this code → Get an email alert when this item changes
	73396	Characterisation of variants in the JAK2 exon 12 in the diagnostic work‑up of a patient with clinical and laboratory evidence of polycythaemia vera, requested by a specialist or consultant physician Group P7	Category 6 — Pathology	$90.00	—
Item Number 73396 Schedule Fee $90.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2022 Item from: 01.07.2022 Gov. Change Flags No changes flagged Full Description Characterisation of variants in the JAK2 exon 12 in the diagnostic work‑up of a patient with clinical and laboratory evidence of polycythaemia vera, requested by a specialist or consultant physician Sign in to watch this code → Get an email alert when this item changes
	73397	Characterisation of variants in both the CALR and MPL genes in the diagnostic work‑up of a patient with clinical and laboratory evidence of essential thrombocythaemia or primary myelofibrosis, requested by a specialist or consultant physician Group P7	Category 6 — Pathology	$200.00	—
Item Number 73397 Schedule Fee $200.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2022 Item from: 01.07.2022 Gov. Change Flags No changes flagged Full Description Characterisation of variants in both the CALR and MPL genes in the diagnostic work‑up of a patient with clinical and laboratory evidence of essential thrombocythaemia or primary myelofibrosis, requested by a specialist or consultant physician Sign in to watch this code → Get an email alert when this item changes
	73398	Characterisation of variants in at least 8 genes, which must include all of the following genes: (a) JAK2 (including exons 12 and 14); (b) CALR; (c) MPL; in the diagnostic work‑up of a patient with clinical and laboratory evidence of polycythaemia vera or essential thrombocythaemia, requested by a specialist or consultant physician Applicable to one test per diagnostic episode Group P7	Category 6 — Pathology	$420.00	—
Item Number 73398 Schedule Fee $420.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2022 Item from: 01.07.2022 Gov. Change Flags No changes flagged Full Description Characterisation of variants in at least 8 genes, which must include all of the following genes: (a) JAK2 (including exons 12 and 14); (b) CALR; (c) MPL; in the diagnostic work‑up of a patient with clinical and laboratory evidence of polycythaemia vera or essential thrombocythaemia, requested by a specialist or consultant physician Applicable to one test per diagnostic episode Sign in to watch this code → Get an email alert when this item changes
	73399	Characterisation of variants in at least 20 genes, which must include all of the following genes: (a) JAK2 (including exons 12 and 14); (b) CALR; (c) MPL; in the diagnostic work‑up of a patient, with clinical and laboratory evidence of primary myelofibrosis, who is eligible for a stem cell transplant, requested by a specialist or consultant physician Applicable to one test per diagnostic episode Group P7	Category 6 — Pathology	$700.00	—
Item Number 73399 Schedule Fee $700.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2022 Item from: 01.07.2022 Gov. Change Flags No changes flagged Full Description Characterisation of variants in at least 20 genes, which must include all of the following genes: (a) JAK2 (including exons 12 and 14); (b) CALR; (c) MPL; in the diagnostic work‑up of a patient, with clinical and laboratory evidence of primary myelofibrosis, who is eligible for a stem cell transplant, requested by a specialist or consultant physician Applicable to one test per diagnostic episode Sign in to watch this code → Get an email alert when this item changes
	73401	Characterisation, by whole exome or genome sequencing and analysis, of germline gene variants in one or more of the genes implicated in heritable cystic kidney disease, if: (a) the service is requested by a consultant physician practising as: (i) a clinical geneticist; or (ii) a specialist nephrologist; and (b) the patient has a renal abnormality and is strongly suspected of having a monogenic condition Applicable once per lifetime Group P7	Category 6 — Pathology	$2100.00	—
Item Number 73401 Schedule Fee $2100.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2022 Item from: 01.07.2022 Gov. Change Flags No changes flagged Full Description Characterisation, by whole exome or genome sequencing and analysis, of germline gene variants in one or more of the genes implicated in heritable cystic kidney disease, if: (a) the service is requested by a consultant physician practising as: (i) a clinical geneticist; or (ii) a specialist nephrologist; and (b) the patient has a renal abnormality and is strongly suspected of having a monogenic condition Applicable once per lifetime Sign in to watch this code → Get an email alert when this item changes
	73402	Characterisation, by whole exome or genome sequencing and analysis, of germline gene variants in one or more of the genes implicated in heritable kidney disease, if: (a) the service is requested by a consultant physician practising as: (i) a clinical geneticist; or (ii) a specialist nephrologist; and (b) the patient has chronic kidney disease (other than cystic disease or Alport syndrome) and is strongly suspected of having a monogenic condition Applicable once per lifetime Group P7	Category 6 — Pathology	$2100.00	—
Item Number 73402 Schedule Fee $2100.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2022 Item from: 01.07.2022 Gov. Change Flags No changes flagged Full Description Characterisation, by whole exome or genome sequencing and analysis, of germline gene variants in one or more of the genes implicated in heritable kidney disease, if: (a) the service is requested by a consultant physician practising as: (i) a clinical geneticist; or (ii) a specialist nephrologist; and (b) the patient has chronic kidney disease (other than cystic disease or Alport syndrome) and is strongly suspected of having a monogenic condition Applicable once per lifetime Sign in to watch this code → Get an email alert when this item changes
	73403	Re‑analysis of genetic data obtained in performing a service to which item 73401 or 73402 applies, for characterisation of previously unreported germline gene variants related to the clinical phenotype, if: (a) the re-analysis is requested by a consultant physician practising as a clinical geneticist or a specialist paediatrician; and (b) the patient has a strong clinical suspicion of a monogenic condition; and (c) a service to which item 73401, 73402 or this item applies has not been performed for the patient in the previous 18 months Applicable twice per lifetime Group P7	Category 6 — Pathology	$500.00	—
Item Number 73403 Schedule Fee $500.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2022 Item from: 01.07.2022 Gov. Change Flags No changes flagged Full Description Re‑analysis of genetic data obtained in performing a service to which item 73401 or 73402 applies, for characterisation of previously unreported germline gene variants related to the clinical phenotype, if: (a) the re-analysis is requested by a consultant physician practising as a clinical geneticist or a specialist paediatrician; and (b) the patient has a strong clinical suspicion of a monogenic condition; and (c) a service to which item 73401, 73402 or this item applies has not been performed for the patient in the previous 18 months Applicable twice per lifetime Sign in to watch this code → Get an email alert when this item changes
	73404	Detection of a single gene variant in a patient, if: (a) the service is requested by: (i) a clinical geneticist; or (ii) a specialist or consultant physician providing professional genetic counselling services; and (b) the patient has a first-degree relative with a known monogenic cause of kidney disease; and (c) a service described in item 73401, 73402, or 73403 has identified the causative variant for the disease for the relative Applicable once per variant per lifetime Group P7	Category 6 — Pathology	$400.00	—
Item Number 73404 Schedule Fee $400.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2022 Item from: 01.07.2022 Gov. Change Flags No changes flagged Full Description Detection of a single gene variant in a patient, if: (a) the service is requested by: (i) a clinical geneticist; or (ii) a specialist or consultant physician providing professional genetic counselling services; and (b) the patient has a first-degree relative with a known monogenic cause of kidney disease; and (c) a service described in item 73401, 73402, or 73403 has identified the causative variant for the disease for the relative Applicable once per variant per lifetime Sign in to watch this code → Get an email alert when this item changes
	73405	Detection of one or more variants of a single gene known to cause heritable kidney disease, for the purpose of reproductive decision making, if: (a) the detection is requested by a consultant physician practising as: (i) a clinical geneticist; or (ii) a specialist nephrologist; and (b) the patient is the reproductive partner of an individual known to be a carrier of a pathogenic variant that causes heritable kidney disease that has a recessive mode of inheritance; and (c) a service described in item 73401, 73402, 73403 or 73404 has identified the causative gene for the patient’s partner; and (d) the detection test methodology has sufficient diagnostic range and sensitivity to detect at least 95% of pathogenic variants likely to be present in the patient Group P7	Category 6 — Pathology	$1200.00	—
Item Number 73405 Schedule Fee $1200.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2022 Item from: 01.07.2022 Gov. Change Flags No changes flagged Full Description Detection of one or more variants of a single gene known to cause heritable kidney disease, for the purpose of reproductive decision making, if: (a) the detection is requested by a consultant physician practising as: (i) a clinical geneticist; or (ii) a specialist nephrologist; and (b) the patient is the reproductive partner of an individual known to be a carrier of a pathogenic variant that causes heritable kidney disease that has a recessive mode of inheritance; and (c) a service described in item 73401, 73402, 73403 or 73404 has identified the causative gene for the patient’s partner; and (d) the detection test methodology has sufficient diagnostic range and sensitivity to detect at least 95% of pathogenic variants likely to be present in the patient Sign in to watch this code → Get an email alert when this item changes
	73406	Testing of a pregnant patient, for the purpose of determining whether monogenic variants are present in the fetus, if: (a) the service is requested by a consultant physician practising as: (i) a clinical geneticist; or (ii) a specialist nephrologist; and (b) the patient or the patient’s reproductive partner (or both) are known to be affected by, or are carriers of, a known pathogenic variant that causes heritable kidney disease; and (c) the fetus is at risk, of at least 25%, of inheriting a monogenic variant known to cause kidney disease Group P7	Category 6 — Pathology	$400.00	—
Item Number 73406 Schedule Fee $400.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2022 Item from: 01.07.2022 Gov. Change Flags No changes flagged Full Description Testing of a pregnant patient, for the purpose of determining whether monogenic variants are present in the fetus, if: (a) the service is requested by a consultant physician practising as: (i) a clinical geneticist; or (ii) a specialist nephrologist; and (b) the patient or the patient’s reproductive partner (or both) are known to be affected by, or are carriers of, a known pathogenic variant that causes heritable kidney disease; and (c) the fetus is at risk, of at least 25%, of inheriting a monogenic variant known to cause kidney disease Sign in to watch this code → Get an email alert when this item changes
	73410	Deletion testing of HBA1 and HBA2 for: (a) the diagnosis of alpha thalassaemia in a patient of reproductive age: (i) who has abnormal red cell indices; and (ii) for whom thalassaemia screening was suggestive of thalassaemia; and (iii) who does not have a concurrent iron deficiency (or who, irrespective of iron status, is pregnant); and (iv) who has no historic normal cell indices; or (b) the determination of carrier status in a person: (i) who is a reproductive partner of a person with alpha thalassaemia; and (ii) who has abnormal red cell indices; and (iii) who does not have a concurrent iron deficiency; or (c) the determination of carrier status in a person: (i) who is a reproductive partner of a person with alpha thalassaemia and heterozygous 2‑gene deletion; and (ii) who has normal red cell indices Group P7	Category 6 — Pathology	$100.00	—
Item Number 73410 Schedule Fee $100.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2022 Item from: 01.07.2022 Gov. Change Flags No changes flagged Full Description Deletion testing of HBA1 and HBA2 for: (a) the diagnosis of alpha thalassaemia in a patient of reproductive age: (i) who has abnormal red cell indices; and (ii) for whom thalassaemia screening was suggestive of thalassaemia; and (iii) who does not have a concurrent iron deficiency (or who, irrespective of iron status, is pregnant); and (iv) who has no historic normal cell indices; or (b) the determination of carrier status in a person: (i) who is a reproductive partner of a person with alpha thalassaemia; and (ii) who has abnormal red cell indices; and (iii) who does not have a concurrent iron deficiency; or (c) the determination of carrier status in a person: (i) who is a reproductive partner of a person with alpha thalassaemia and heterozygous 2‑gene deletion; and (ii) who has normal red cell indices Sign in to watch this code → Get an email alert when this item changes
	73411	Sequencing of HBA1 or HBA2, if the results of deletion testing described in item 73410 were inconclusive and a less common or rare variant is suspected, either: (a) for the diagnosis of alpha thalassaemia in a patient of reproductive age; or (b) for the determination of carrier status in a reproductive partner of a person with alpha thalassaemia Applicable once per gene per lifetime Group P7	Category 6 — Pathology	$400.00	—
Item Number 73411 Schedule Fee $400.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2022 Item from: 01.07.2022 Gov. Change Flags No changes flagged Full Description Sequencing of HBA1 or HBA2, if the results of deletion testing described in item 73410 were inconclusive and a less common or rare variant is suspected, either: (a) for the diagnosis of alpha thalassaemia in a patient of reproductive age; or (b) for the determination of carrier status in a reproductive partner of a person with alpha thalassaemia Applicable once per gene per lifetime Sign in to watch this code → Get an email alert when this item changes
	73412	Deletion testing of HBA1 and HBA2, if the results of deletion testing described in item 73410 were inconclusive and a large deletion variant is suspected, either: (a) for the diagnosis of alpha thalassaemia in a patient of reproductive age; or (b) for the determination of carrier status in a reproductive partner of a person with alpha thalassaemia Group P7	Category 6 — Pathology	$250.00	—
Item Number 73412 Schedule Fee $250.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2022 Item from: 01.07.2022 Gov. Change Flags No changes flagged Full Description Deletion testing of HBA1 and HBA2, if the results of deletion testing described in item 73410 were inconclusive and a large deletion variant is suspected, either: (a) for the diagnosis of alpha thalassaemia in a patient of reproductive age; or (b) for the determination of carrier status in a reproductive partner of a person with alpha thalassaemia Sign in to watch this code → Get an email alert when this item changes
	73413	Non‑deletion testing of HBA1 and HBA2 using techniques other than sequencing, if the results of deletion testing described in item 73410 were inconclusive, either: (a) for the diagnosis of alpha thalassaemia in a patient of reproductive age ; or (b) for the determination of carrier status in a reproductive partner of a person with alpha thalassaemia Group P7	Category 6 — Pathology	$250.00	—
Item Number 73413 Schedule Fee $250.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2022 Item from: 01.07.2022 Gov. Change Flags No changes flagged Full Description Non‑deletion testing of HBA1 and HBA2 using techniques other than sequencing, if the results of deletion testing described in item 73410 were inconclusive, either: (a) for the diagnosis of alpha thalassaemia in a patient of reproductive age ; or (b) for the determination of carrier status in a reproductive partner of a person with alpha thalassaemia Sign in to watch this code → Get an email alert when this item changes
	73416	Detection of germline gene variants, including copy number variation, requested by a specialist or consultant physician: (a) in at least the following genes: (i) KCNQ1; (ii) KCNH2; (iii) SCN5A; (iv) KCNE1; (v) KCNE2; (vi) KCNJ2; (vii) CACNA1C; (viii) RYR2; (ix) CASQ2; (x) CAV3; (xi) SCN4B; (xii) AKAP9; (xiii) SNTA1; (xiv) KCNJ5; (xv) ALG10; (xvi) CALM1; (xvii) CALM2; (xviii) ANK2; (xix) TECRL; (xx) TRDN; and (b) for a patient for whom clinical or family history criteria is suggestive of inherited cardiac arrhythmias or channelopathies that place the patient at greater than 10% risk of having a pathogenic variant Applicable once per lifetime Group P7	Category 6 — Pathology	$1200.00	—
Item Number 73416 Schedule Fee $1200.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2022 Item from: 01.07.2022 Gov. Change Flags No changes flagged Full Description Detection of germline gene variants, including copy number variation, requested by a specialist or consultant physician: (a) in at least the following genes: (i) KCNQ1; (ii) KCNH2; (iii) SCN5A; (iv) KCNE1; (v) KCNE2; (vi) KCNJ2; (vii) CACNA1C; (viii) RYR2; (ix) CASQ2; (x) CAV3; (xi) SCN4B; (xii) AKAP9; (xiii) SNTA1; (xiv) KCNJ5; (xv) ALG10; (xvi) CALM1; (xvii) CALM2; (xviii) ANK2; (xix) TECRL; (xx) TRDN; and (b) for a patient for whom clinical or family history criteria is suggestive of inherited cardiac arrhythmias or channelopathies that place the patient at greater than 10% risk of having a pathogenic variant Applicable once per lifetime Sign in to watch this code → Get an email alert when this item changes
	73417	Characterisation of one or more pathogenic or likely pathogenic germline gene variants, requested by a specialist or consultant physician, if: (a) the patient is a first-degree or second‑degree biological relative of a person with a pathogenic or likely pathogenic germline gene variant that is confirmed by laboratory findings; and (b) the service is performed for the purpose of assessing present or future risk of a cardiac arrhythmia or channelopathy; and (c) a service to which item 73416 applies has not previously been performed for the patient Applicable once per variant per lifetime Group P7	Category 6 — Pathology	$400.00	—
Item Number 73417 Schedule Fee $400.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2022 Item from: 01.07.2022 Gov. Change Flags No changes flagged Full Description Characterisation of one or more pathogenic or likely pathogenic germline gene variants, requested by a specialist or consultant physician, if: (a) the patient is a first-degree or second‑degree biological relative of a person with a pathogenic or likely pathogenic germline gene variant that is confirmed by laboratory findings; and (b) the service is performed for the purpose of assessing present or future risk of a cardiac arrhythmia or channelopathy; and (c) a service to which item 73416 applies has not previously been performed for the patient Applicable once per variant per lifetime Sign in to watch this code → Get an email alert when this item changes
	73418	Characterisation of one or more recessive pathogenic or likely pathogenic germline genes, requested by a specialist or consultant physician, for the purpose of determining the reproductive risk of cardiac arrhythmia or channelopathy in a patient: (a) who is a reproductive partner of a person who is a known carrier of a pathogenic or likely pathogenic germline gene variant of a gene confirmed by laboratory findings; and (b) for whom a service to which item 73416 applies has not previously been performed; and (c) for whom carrier status of a pathogenic or likely pathogenic germline gene variant is unknown; and (d) who has a clinical history, family history or laboratory findings suggesting there is a low probability of cardiac arrhythmia or channelopathy Applicable once per gene per lifetime Group P7	Category 6 — Pathology	$1200.00	—
Item Number 73418 Schedule Fee $1200.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.11.2023 Item from: 01.07.2022 Gov. Change Flags No changes flagged Full Description Characterisation of one or more recessive pathogenic or likely pathogenic germline genes, requested by a specialist or consultant physician, for the purpose of determining the reproductive risk of cardiac arrhythmia or channelopathy in a patient: (a) who is a reproductive partner of a person who is a known carrier of a pathogenic or likely pathogenic germline gene variant of a gene confirmed by laboratory findings; and (b) for whom a service to which item 73416 applies has not previously been performed; and (c) for whom carrier status of a pathogenic or likely pathogenic germline gene variant is unknown; and (d) who has a clinical history, family history or laboratory findings suggesting there is a low probability of cardiac arrhythmia or channelopathy Applicable once per gene per lifetime Sign in to watch this code → Get an email alert when this item changes
	73419	Re‑analysis of whole exome or genome data that was obtained in performing a service to which item 73416 applies, for characterisation of previously unreported germline gene variants related to the clinical phenotype, if: (a) the re-analysis is requested by a consultant physician practising as a clinical geneticist or a cardiologist; and (b) the patient is strongly suspected of having inheritable cardiac arrhythmia or channelopathies; and (c) the service is performed at least 18 months after a service to which item 73416 or this item applies was performed for the patient Applicable twice per lifetime Group P7	Category 6 — Pathology	$500.00	—
Item Number 73419 Schedule Fee $500.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2022 Item from: 01.07.2022 Gov. Change Flags No changes flagged Full Description Re‑analysis of whole exome or genome data that was obtained in performing a service to which item 73416 applies, for characterisation of previously unreported germline gene variants related to the clinical phenotype, if: (a) the re-analysis is requested by a consultant physician practising as a clinical geneticist or a cardiologist; and (b) the patient is strongly suspected of having inheritable cardiac arrhythmia or channelopathies; and (c) the service is performed at least 18 months after a service to which item 73416 or this item applies was performed for the patient Applicable twice per lifetime Sign in to watch this code → Get an email alert when this item changes
	73420	Non‑invasive prenatal testing of blood from an RhD negative pregnant patient for the detection of the RHD gene from fetal DNA circulating in maternal blood, if the patient has not been previously alloimmunised against RhD Group P7	Category 6 — Pathology	$150.40	—
Item Number 73420 Schedule Fee $150.40 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.11.2024 Item from: 01.07.2022 Gov. Change Flags No changes flagged Full Description Non‑invasive prenatal testing of blood from an RhD negative pregnant patient for the detection of the RHD gene from fetal DNA circulating in maternal blood, if the patient has not been previously alloimmunised against RhD Sign in to watch this code → Get an email alert when this item changes
	73421	Non-invasive prenatal testing of blood from an RhD negative pregnant patient for the detection of the RHD gene from fetal DNA circulating in maternal blood, if the patient has been previously alloimmunised against RhD Group P7	Category 6 — Pathology	$550.00	—
Item Number 73421 Schedule Fee $550.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2022 Item from: 01.07.2022 Gov. Change Flags No changes flagged Full Description Non-invasive prenatal testing of blood from an RhD negative pregnant patient for the detection of the RHD gene from fetal DNA circulating in maternal blood, if the patient has been previously alloimmunised against RhD Sign in to watch this code → Get an email alert when this item changes
	73422	Characterisation of a gene variant or gene variants using a gene panel, in a patient presenting with clinical signs and symptoms suggestive of a genetic neuromuscular disorder (other than signs and symptoms associated with variants that are not detectable by massively parallel sequencing), if the service is requested: (a) by a specialist or consultant physician; and (b) after exclusion of non‑genetic causes Applicable once per lifetime Group P7	Category 6 — Pathology	$1200.00	—
Item Number 73422 Schedule Fee $1200.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.11.2022 Item from: 01.11.2022 Gov. Change Flags No changes flagged Full Description Characterisation of a gene variant or gene variants using a gene panel, in a patient presenting with clinical signs and symptoms suggestive of a genetic neuromuscular disorder (other than signs and symptoms associated with variants that are not detectable by massively parallel sequencing), if the service is requested: (a) by a specialist or consultant physician; and (b) after exclusion of non‑genetic causes Applicable once per lifetime Sign in to watch this code → Get an email alert when this item changes
	73423	Detection of a single identified gene variant, in a biological relative of a person with a germline gene variant for a neuromuscular disorder identified by a service described in item 73422, 73425 or 73426, if the service is requested by a specialist or consultant physician Applicable once per variant Group P7	Category 6 — Pathology	$500.00	—
Item Number 73423 Schedule Fee $500.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.11.2022 Item from: 01.11.2022 Gov. Change Flags No changes flagged Full Description Detection of a single identified gene variant, in a biological relative of a person with a germline gene variant for a neuromuscular disorder identified by a service described in item 73422, 73425 or 73426, if the service is requested by a specialist or consultant physician Applicable once per variant Sign in to watch this code → Get an email alert when this item changes
	73424	Prenatal detection of an actionable pathogenic familial gene variant or gene variants (including maternal cell contamination assessment), requested by a specialist or consultant physician, for a genetic neuromuscular disorder previously identified in an index person in the patient’s family as a result of a service described in item 73422, 73434 or 73435 Applicable once per pregnancy Group P7	Category 6 — Pathology	$1600.00	—
Item Number 73424 Schedule Fee $1600.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.11.2022 Item from: 01.11.2022 Gov. Change Flags No changes flagged Full Description Prenatal detection of an actionable pathogenic familial gene variant or gene variants (including maternal cell contamination assessment), requested by a specialist or consultant physician, for a genetic neuromuscular disorder previously identified in an index person in the patient’s family as a result of a service described in item 73422, 73434 or 73435 Applicable once per pregnancy Sign in to watch this code → Get an email alert when this item changes
	73425	Prenatal detection of unknown gene variants (including maternal cell contamination assessment) using a gene panel, if: (a) the service is requested: (i) by a specialist or consultant physician, for a suspected genetic neuromuscular disorder; and (ii) after exclusion of non‑genetic causes; and (b) the service is performed using a sample from the fetus; and (c) the service is not performed in conjunction with a service to which item 73426 applies Applicable once per pregnancy Group P7	Category 6 — Pathology	$1800.00	—
Item Number 73425 Schedule Fee $1800.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.11.2022 Item from: 01.11.2022 Gov. Change Flags No changes flagged Full Description Prenatal detection of unknown gene variants (including maternal cell contamination assessment) using a gene panel, if: (a) the service is requested: (i) by a specialist or consultant physician, for a suspected genetic neuromuscular disorder; and (ii) after exclusion of non‑genetic causes; and (b) the service is performed using a sample from the fetus; and (c) the service is not performed in conjunction with a service to which item 73426 applies Applicable once per pregnancy Sign in to watch this code → Get an email alert when this item changes
	73426	Prenatal detection of unknown gene variants (including maternal cell contamination assessment) using a gene panel, if: (a) the service is requested: (i) by a specialist or consultant physician; and (ii) for a suspected genetic neuromuscular disorder; and (iii) after exclusion of non‑genetic causes; and (b) the request states that singleton testing is inappropriate; and (c) the service is performed using a sample from the fetus and a sample from each of the fetus’s biological parents; and (d) the service is not performed in conjunction with a service to which item 73425 applies Applicable once per pregnancy Group P7	Category 6 — Pathology	$2400.00	—
Item Number 73426 Schedule Fee $2400.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.11.2022 Item from: 01.11.2022 Gov. Change Flags No changes flagged Full Description Prenatal detection of unknown gene variants (including maternal cell contamination assessment) using a gene panel, if: (a) the service is requested: (i) by a specialist or consultant physician; and (ii) for a suspected genetic neuromuscular disorder; and (iii) after exclusion of non‑genetic causes; and (b) the request states that singleton testing is inappropriate; and (c) the service is performed using a sample from the fetus and a sample from each of the fetus’s biological parents; and (d) the service is not performed in conjunction with a service to which item 73425 applies Applicable once per pregnancy Sign in to watch this code → Get an email alert when this item changes
	73427	Single gene testing for the characterisation of a germline gene variant or germline gene variants: (a) if requested by a specialist or consultant physician; and (b) within the same gene in which the patient’s reproductive partner has a documented pathogenic germline recessive gene variant for a neuromuscular disorder identified by a service described in: (i) item 73422, 73425 or 73426; or (ii) item 73434, if the patient has been provided a service described in item 73434 and that service has not identified a relevant variant Applicable once per gene Group P7	Category 6 — Pathology	$1200.00	—
Item Number 73427 Schedule Fee $1200.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.11.2022 Item from: 01.11.2022 Gov. Change Flags No changes flagged Full Description Single gene testing for the characterisation of a germline gene variant or germline gene variants: (a) if requested by a specialist or consultant physician; and (b) within the same gene in which the patient’s reproductive partner has a documented pathogenic germline recessive gene variant for a neuromuscular disorder identified by a service described in: (i) item 73422, 73425 or 73426; or (ii) item 73434, if the patient has been provided a service described in item 73434 and that service has not identified a relevant variant Applicable once per gene Sign in to watch this code → Get an email alert when this item changes
	73428	Re‑analysis of whole genome or exome data obtained in performing a service described in item 73422, 73425 or 73426, for characterisation of previously unreported gene variants related to the clinical phenotype, if the re‑analysis is requested by: (a) a consultant physician practicing as a clinical geneticist; or (b) a consultant physician practising as a specialist paediatrician, following consultation with a clinical geneticist Applicable twice per lifetime Group P7	Category 6 — Pathology	$500.00	—
Item Number 73428 Schedule Fee $500.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.11.2022 Item from: 01.11.2022 Gov. Change Flags No changes flagged Full Description Re‑analysis of whole genome or exome data obtained in performing a service described in item 73422, 73425 or 73426, for characterisation of previously unreported gene variants related to the clinical phenotype, if the re‑analysis is requested by: (a) a consultant physician practicing as a clinical geneticist; or (b) a consultant physician practising as a specialist paediatrician, following consultation with a clinical geneticist Applicable twice per lifetime Sign in to watch this code → Get an email alert when this item changes
	73429	Genetic testing (including characterisation of single nucleotide variants, structural variants, fusions and copy number alterations) in a gene panel, requested by a specialist or consultant physician, for a patient with clinical or laboratory evidence of a glioma, glioneuronal tumour or glioblastoma, to aid diagnosis and classification of the relevant tumour, including assessments of at least the following kinds: (a) IDH1, IDH2—variant testing; (b) 1p/19q—co‑deletion assessment; (c) H3F3A—variant status; (d) TERT—promoter variant status; (e) EGFR—amplification; (f) CDKN2A/B—deletion; (g) BRAF—variants Applicable to one test per diagnostic episode Group P7	Category 6 — Pathology	$887.90	—
Item Number 73429 Schedule Fee $887.90 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2023 Item from: 01.07.2023 Gov. Change Flags No changes flagged Full Description Genetic testing (including characterisation of single nucleotide variants, structural variants, fusions and copy number alterations) in a gene panel, requested by a specialist or consultant physician, for a patient with clinical or laboratory evidence of a glioma, glioneuronal tumour or glioblastoma, to aid diagnosis and classification of the relevant tumour, including assessments of at least the following kinds: (a) IDH1, IDH2—variant testing; (b) 1p/19q—co‑deletion assessment; (c) H3F3A—variant status; (d) TERT—promoter variant status; (e) EGFR—amplification; (f) CDKN2A/B—deletion; (g) BRAF—variants Applicable to one test per diagnostic episode Sign in to watch this code → Get an email alert when this item changes
	73430	Fluorescence in-situ hybridisation (FISH) test of tumour tissue from a patient with locally advanced or metastatic solid tumour, if: (a) the tumour is at risk of being caused by a neurotrophic receptor tyrosine kinase (NTRK) gene fusion as determined by either: (i) occurring in a child less than 18 years of age; or (ii) being mammary analogue secretory carcinoma of the salivary gland; or (iii) being secretory breast carcinoma; and (b) the test is requested by a specialist or consultant physician to determine if requirements relating to NTRK gene fusion status for access to a tropomyosin receptor kinase (Trk) inhibitor under the Pharmaceutical Benefits Scheme are fulfilled This item cannot be claimed if item 73433 has been claimed for the same patient during the same cancer diagnosis Applicable only once per cancer diagnosis Group P7	Category 6 — Pathology	$400.00	—
Item Number 73430 Schedule Fee $400.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: D Fee: N Benefit: C Effective Dates Fee from: 01.07.2022 Item from: 01.07.2022 Gov. Change Flags No changes flagged Full Description Fluorescence in-situ hybridisation (FISH) test of tumour tissue from a patient with locally advanced or metastatic solid tumour, if: (a) the tumour is at risk of being caused by a neurotrophic receptor tyrosine kinase (NTRK) gene fusion as determined by either: (i) occurring in a child less than 18 years of age; or (ii) being mammary analogue secretory carcinoma of the salivary gland; or (iii) being secretory breast carcinoma; and (b) the test is requested by a specialist or consultant physician to determine if requirements relating to NTRK gene fusion status for access to a tropomyosin receptor kinase (Trk) inhibitor under the Pharmaceutical Benefits Scheme are fulfilled This item cannot be claimed if item 73433 has been claimed for the same patient during the same cancer diagnosis Applicable only once per cancer diagnosis Sign in to watch this code → Get an email alert when this item changes
	73431	Two tests described in item 73430 Group P7	Category 6 — Pathology	$533.00	—
Item Number 73431 Schedule Fee $533.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: D Fee: N Benefit: C Effective Dates Fee from: 01.07.2022 Item from: 01.07.2022 Gov. Change Flags No changes flagged Full Description Two tests described in item 73430 Sign in to watch this code → Get an email alert when this item changes
	73432	Three or more tests described in item 73430 Group P7	Category 6 — Pathology	$667.00	—
Item Number 73432 Schedule Fee $667.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: D Fee: N Benefit: C Effective Dates Fee from: 01.07.2022 Item from: 01.07.2022 Gov. Change Flags No changes flagged Full Description Three or more tests described in item 73430 Sign in to watch this code → Get an email alert when this item changes
	73433	Next generation sequencing (NGS) test for neurotrophic receptor tyrosine kinase (NTRK1, NTRK2, NTRK3) fusions by RNA or DNA in tumour tissue from a patient with locally advanced or metastatic solid tumour, if: (a) the tumour is at risk of being caused by an NTRK gene fusion as determined by either: (i) occurring in a child less than 18 years of age; or (ii) being mammary analogue secretory carcinoma of the salivary gland; or (iii) being secretory breast carcinoma; (b) the test is requested by a specialist or consultant physician to determine if requirements relating to NTRK gene fusion status for access to a tropomyosin receptor kinase (Trk) inhibitor under the Pharmaceutical Benefits Scheme are fulfilled This item cannot be claimed if item 73430 has been claimed for the same patient during the same cancer diagnosis Applicable only once per cancer diagnosis Group P7	Category 6 — Pathology	$1000.00	—
Item Number 73433 Schedule Fee $1000.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: D Fee: N Benefit: C Effective Dates Fee from: 01.07.2022 Item from: 01.07.2022 Gov. Change Flags No changes flagged Full Description Next generation sequencing (NGS) test for neurotrophic receptor tyrosine kinase (NTRK1, NTRK2, NTRK3) fusions by RNA or DNA in tumour tissue from a patient with locally advanced or metastatic solid tumour, if: (a) the tumour is at risk of being caused by an NTRK gene fusion as determined by either: (i) occurring in a child less than 18 years of age; or (ii) being mammary analogue secretory carcinoma of the salivary gland; or (iii) being secretory breast carcinoma; (b) the test is requested by a specialist or consultant physician to determine if requirements relating to NTRK gene fusion status for access to a tropomyosin receptor kinase (Trk) inhibitor under the Pharmaceutical Benefits Scheme are fulfilled This item cannot be claimed if item 73430 has been claimed for the same patient during the same cancer diagnosis Applicable only once per cancer diagnosis Sign in to watch this code → Get an email alert when this item changes
	73434	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 Group P7	Category 6 — Pathology	$392.00	—
Item Number 73434 Schedule Fee $392.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2023 Item from: 01.07.2023 Gov. Change Flags No changes flagged Full Description 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 Sign in to watch this code → Get an email alert when this item changes
	73435	Detection of pathogenic or likely pathogenic DUX4 gene variants, requested by a specialist or consultant physician, for: (a) a patient with a suspected neuromuscular disorder; or (b) a relative of a patient with a pathogenic or likely pathogenic germline gene variant associated with a neuromuscular disorder (confirmed by laboratory findings) Applicable once per gene per lifetime Group P7	Category 6 — Pathology	$1000.00	—
Item Number 73435 Schedule Fee $1000.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: S Fee: N Benefit: C Effective Dates Fee from: 01.07.2023 Item from: 01.07.2023 Gov. Change Flags No changes flagged Full Description Detection of pathogenic or likely pathogenic DUX4 gene variants, requested by a specialist or consultant physician, for: (a) a patient with a suspected neuromuscular disorder; or (b) a relative of a patient with a pathogenic or likely pathogenic germline gene variant associated with a neuromuscular disorder (confirmed by laboratory findings) Applicable once per gene per lifetime Sign in to watch this code → Get an email alert when this item changes
	73436	A 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) for MET proto-oncogene, receptor tyrosine kinase (MET) exon 14 skipping alterations (METex14sk) status to determine eligibility for access to a relevant treatment under the Pharmaceutical Benefits Scheme; and (b) not associated with a service to which item 73437 or 73438 applies Group P7	Category 6 — Pathology	$397.35	—
Item Number 73436 Schedule Fee $397.35 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: D Fee: N Benefit: C Effective Dates Fee from: 01.11.2022 Item from: 01.11.2022 Gov. Change Flags No changes flagged Full Description A 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) for MET proto-oncogene, receptor tyrosine kinase (MET) exon 14 skipping alterations (METex14sk) status to determine eligibility for access to a relevant treatment under the Pharmaceutical Benefits Scheme; and (b) not associated with a service to which item 73437 or 73438 applies Sign in to watch this code → Get an email alert when this item changes
	73437	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 eligibility for a relevant treatment under the Pharmaceutical Benefits Scheme; and (b) to detect the fusion status of at least ALK, ROS1, RET, NTRK1, NTRK2 and NTRK3 to determine eligibility for a relevant treatment under the PBS; and (c) not associated with a service to which item 73438, 73439, 73337, 73341, 73344, 73436 or 73351 applies Group P7	Category 6 — Pathology	$1247.00	—
Item Number 73437 Schedule Fee $1247.00 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: D Fee: N Benefit: C Effective Dates Fee from: 01.11.2023 Item from: 01.11.2023 Gov. Change Flags No changes flagged Full Description 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 eligibility for a relevant treatment under the Pharmaceutical Benefits Scheme; and (b) to detect the fusion status of at least ALK, ROS1, RET, NTRK1, NTRK2 and NTRK3 to determine eligibility for a relevant treatment under the PBS; and (c) not associated with a service to which item 73438, 73439, 73337, 73341, 73344, 73436 or 73351 applies Sign in to watch this code → Get an email alert when this item changes
	73438	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 eligibility for a relevant treatment under the Pharmaceutical Benefits Scheme; and (c) not associated with a service to which item 73437, 73337, 73436 or 73351 applies Group P7	Category 6 — Pathology	$682.35	—
Item Number 73438 Schedule Fee $682.35 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: D Fee: N Benefit: C Effective Dates Fee from: 01.11.2023 Item from: 01.11.2023 Gov. Change Flags No changes flagged Full Description 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 eligibility for a relevant treatment under the Pharmaceutical Benefits Scheme; and (c) not associated with a service to which item 73437, 73337, 73436 or 73351 applies Sign in to watch this code → Get an email alert when this item changes
	73439	A nucleic acid-based multi-gene panel test of tumour tissue from a patient with a new diagnosis of non-small cell lung cancer and with documented absence of activating variants of the EGFR gene, KRAS, BRAF and MET exon14, requested by, or on behalf of, a specialist or consultant physician, if the test is: (a) for fusion status of at least ALK, ROS1, RET, NTRK1, NTRK2, and NTRK3 to determine eligibility for a relevant treatment under the Pharmaceutical Benefits Scheme; and (b) not associated with a service to which item 73437, 73341, 73344 or 73351 applies Group P7	Category 6 — Pathology	$682.35	—
Item Number 73439 Schedule Fee $682.35 Category Category 6 — Pathology Group / Subheading Group P7 Type Codes Item: D Fee: N Benefit: C Effective Dates Fee from: 01.11.2023 Item from: 01.11.2023 Gov. Change Flags No changes flagged Full Description A nucleic acid-based multi-gene panel test of tumour tissue from a patient with a new diagnosis of non-small cell lung cancer and with documented absence of activating variants of the EGFR gene, KRAS, BRAF and MET exon14, requested by, or on behalf of, a specialist or consultant physician, if the test is: (a) for fusion status of at least ALK, ROS1, RET, NTRK1, NTRK2, and NTRK3 to determine eligibility for a relevant treatment under the Pharmaceutical Benefits Scheme; and (b) not associated with a service to which item 73437, 73341, 73344 or 73351 applies Sign in to watch this code → Get an email alert when this item changes

Fee From

01.05.2020

Category

Category 6 — Pathology

Description

Analysis of tumour tissue, requested by a specialist or consultant physician, that: (a) is for the characterisation of either or both of the following: (i) TFE3 gene rearrangement; (ii) TFEB gene rearrangement; and (b) is for a patient with clinical or laboratory evidence, including morphological features, of renal cell carcinoma Applicable only once per lifetime

Fee From

01.11.2021

Category

Category 6 — Pathology

Description

Genetic analysis, for a patient who is eligible for this service under clause 2.7.3A of the pathology services table (see PR.7.1), 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 (PR.7.1)) per reproductive relationship

Fee From

01.11.2021

Category

Category 6 — Pathology

Description

Genetic analysis, for a patient who is eligible for this service under clause 2.7.3A of the Pathology Services Table (see PR.7.1), of embryonic tissue from a sample from one embryo, if: (a) the analysis is: (i) requested by a specialist or consultant physician; and (ii) for the purpose of providing a pre‑implantation genetic test; and (iii) performed on an embryo that was produced in a single assisted reproductive treatment cycle; and (b) the service is not a service to which item 73386 or 73387 applies for the same assisted reproductive treatment cycle Applicable not more than once per embryo

Fee From

01.11.2021

Category

Category 6 — Pathology

Description

Genetic analysis, for a patient who is eligible for this service under clause 2.7.3A of the Pathology Services Table (see PR.7.1), of embryonic tissue from samples from 2 embryos, if: (a) the analysis is: (i) requested by a specialist or consultant physician; and (ii) for the purpose of providing a pre‑implantation genetic test; and (iii) performed on embryos that were produced in a single assisted reproductive treatment cycle; and (b) the service is not a service to which item 73385 or 73387 applies for the same assisted reproductive treatment cycle Applicable not more than once per assisted reproductive treatment cycle for the 2 embryos tested

Fee From

01.11.2021

Category

Category 6 — Pathology

Description

Genetic analysis, for a patient who is eligible for this service under clause 2.7.3A of the Pathology Services Table (see PR.7.1), of embryonic tissue from samples from 3 or more embryos, if: (a) the analysis is: (i) requested by a specialist or consultant physician; and (ii) for the purpose of providing a pre‑implantation genetic test; and (iii) performed on embryos that were produced in a single assisted reproductive treatment cycle; and (b) the service is not a service to which item 73385 or 73386 applies for the same assisted reproductive treatment cycle Applicable not more than once per assisted reproductive treatment cycle for the 3 or more embryos tested

Fee From

01.11.2021

Category

Category 6 — Pathology

Description

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 one or more major fetal structural abnormalities have been detected on ultrasound; or nuchal translucency was greater than 3.5 mm Applicable only once per fetus

Fee From

01.11.2021

Category

Category 6 — Pathology

Description

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

Fee From

01.11.2021

Category

Category 6 — Pathology

Description

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

Fee From

01.07.2022

Category

Category 6 — Pathology

Description

Characterisation of pathogenic or likely pathogenic germline gene variants, requested by a specialist or consultant physician: (a) in at least the following genes: (i) MYBPC3; (ii) MYH7; (iii) TNNI3; (iv) TNNT2; (v) TPM1; (vi) ACTC1; (vii) MYL2; (viii) MYL3; (ix) PRKAG2; (x) LAMP2; (xi) GLA; (xii) LMNA; (xiii) SCN5A; (xiv) TTN; (xv) RBM20; (xvi) PLN; (xvii) DSP; (xviii) DSC2; (xix) DSG2; (xx) JUP; (xxi) PKP2; (xxii) TMEM43; and (b) for a patient for whom clinical history, family history or laboratory findings suggest there is a high probability of one or more of the following heritable cardiomyopathies in the patient: (i) hypertrophic cardiomyopathy; (ii) dilated cardiomyopathy; (iii) arrhythmogenic cardiomyopathy Applicable once per lifetime

Fee From

01.07.2022

Category

Category 6 — Pathology

Description

Characterisation of one or more pathogenic or likely pathogenic germline gene variants, requested by a specialist or consultant physician, if: (a) a service described in item 73392 has not previously been performed for the patient; and (b) the patient is a first-degree biological relative (or a second-degree biological relative if a first-degree biological relative is unavailable) of a person who has a pathogenic or likely pathogenic germline gene variant that is confirmed by laboratory findings; and (c) the service is performed for the purpose of assessing present or future risk of any of the following heritable cardiomyopathies in the patient: (i) hypertrophic cardiomyopathy; (ii) dilated cardiomyopathy; (iii) arrhythmogenic cardiomyopathy Applicable once per variant per lifetime

Fee From

01.07.2022

Category

Category 6 — Pathology

Description

Characterisation of one or more recessive pathogenic or likely pathogenic germline genes, requested by a specialist or consultant physician, for the purpose of determining the reproductive risk of heritable cardiomyopathy in a patient: (a) who is a reproductive partner of a known carrier of a pathogenic or likely pathogenic germline gene that is confirmed by laboratory findings ; and (b) for whom carrier status of a pathogenic or likely pathogenic germline gene is unknown; and (c) who has a clinical history, family history or laboratory findings suggesting there is a low probability of heritable cardiomyopathy Applicable once per gene per lifetime

Fee From

01.07.2022

Category

Category 6 — Pathology

Description

Re‑analysis of whole exome or genome data that is obtained in performing a service to which item 73392 applies, for characterisation of previously unreported germline gene variants related to the clinical phenotype, if: (a) the re-analysis is requested by a consultant physician practising as a clinical geneticist or a cardiologist; and (b) the patient is strongly suspected of having a heritable cardiomyopathy; and (c) the re-analysis is performed at least 18 months after a service to which item 73392 or this item applies is performed for the patient Applicable twice per lifetime

Fee From

01.07.2022

Category

Category 6 — Pathology

Description

Characterisation of variants in the JAK2 exon 12 in the diagnostic work‑up of a patient with clinical and laboratory evidence of polycythaemia vera, requested by a specialist or consultant physician

Fee From

01.07.2022

Category

Category 6 — Pathology

Description

Characterisation of variants in both the CALR and MPL genes in the diagnostic work‑up of a patient with clinical and laboratory evidence of essential thrombocythaemia or primary myelofibrosis, requested by a specialist or consultant physician

Fee From

01.07.2022

Category

Category 6 — Pathology

Description

Characterisation of variants in at least 8 genes, which must include all of the following genes: (a) JAK2 (including exons 12 and 14); (b) CALR; (c) MPL; in the diagnostic work‑up of a patient with clinical and laboratory evidence of polycythaemia vera or essential thrombocythaemia, requested by a specialist or consultant physician Applicable to one test per diagnostic episode

Fee From

01.07.2022

Category

Category 6 — Pathology

Description

Characterisation of variants in at least 20 genes, which must include all of the following genes: (a) JAK2 (including exons 12 and 14); (b) CALR; (c) MPL; in the diagnostic work‑up of a patient, with clinical and laboratory evidence of primary myelofibrosis, who is eligible for a stem cell transplant, requested by a specialist or consultant physician Applicable to one test per diagnostic episode

Fee From

01.07.2022

Category

Category 6 — Pathology

Description

Characterisation, by whole exome or genome sequencing and analysis, of germline gene variants in one or more of the genes implicated in heritable cystic kidney disease, if: (a) the service is requested by a consultant physician practising as: (i) a clinical geneticist; or (ii) a specialist nephrologist; and (b) the patient has a renal abnormality and is strongly suspected of having a monogenic condition Applicable once per lifetime

Fee From

01.07.2022

Category

Category 6 — Pathology

Description

Characterisation, by whole exome or genome sequencing and analysis, of germline gene variants in one or more of the genes implicated in heritable kidney disease, if: (a) the service is requested by a consultant physician practising as: (i) a clinical geneticist; or (ii) a specialist nephrologist; and (b) the patient has chronic kidney disease (other than cystic disease or Alport syndrome) and is strongly suspected of having a monogenic condition Applicable once per lifetime

Fee From

01.07.2022

Category

Category 6 — Pathology

Description

Re‑analysis of genetic data obtained in performing a service to which item 73401 or 73402 applies, for characterisation of previously unreported germline gene variants related to the clinical phenotype, if: (a) the re-analysis is requested by a consultant physician practising as a clinical geneticist or a specialist paediatrician; and (b) the patient has a strong clinical suspicion of a monogenic condition; and (c) a service to which item 73401, 73402 or this item applies has not been performed for the patient in the previous 18 months Applicable twice per lifetime

Fee From

01.07.2022

Category

Category 6 — Pathology

Description

Detection of a single gene variant in a patient, if: (a) the service is requested by: (i) a clinical geneticist; or (ii) a specialist or consultant physician providing professional genetic counselling services; and (b) the patient has a first-degree relative with a known monogenic cause of kidney disease; and (c) a service described in item 73401, 73402, or 73403 has identified the causative variant for the disease for the relative Applicable once per variant per lifetime

Fee From

01.07.2022

Category

Category 6 — Pathology

Description

Detection of one or more variants of a single gene known to cause heritable kidney disease, for the purpose of reproductive decision making, if: (a) the detection is requested by a consultant physician practising as: (i) a clinical geneticist; or (ii) a specialist nephrologist; and (b) the patient is the reproductive partner of an individual known to be a carrier of a pathogenic variant that causes heritable kidney disease that has a recessive mode of inheritance; and (c) a service described in item 73401, 73402, 73403 or 73404 has identified the causative gene for the patient’s partner; and (d) the detection test methodology has sufficient diagnostic range and sensitivity to detect at least 95% of pathogenic variants likely to be present in the patient

Fee From

01.07.2022

Category

Category 6 — Pathology

Description

Testing of a pregnant patient, for the purpose of determining whether monogenic variants are present in the fetus, if: (a) the service is requested by a consultant physician practising as: (i) a clinical geneticist; or (ii) a specialist nephrologist; and (b) the patient or the patient’s reproductive partner (or both) are known to be affected by, or are carriers of, a known pathogenic variant that causes heritable kidney disease; and (c) the fetus is at risk, of at least 25%, of inheriting a monogenic variant known to cause kidney disease

Fee From

01.07.2022

Category

Category 6 — Pathology

Description

Deletion testing of HBA1 and HBA2 for: (a) the diagnosis of alpha thalassaemia in a patient of reproductive age: (i) who has abnormal red cell indices; and (ii) for whom thalassaemia screening was suggestive of thalassaemia; and (iii) who does not have a concurrent iron deficiency (or who, irrespective of iron status, is pregnant); and (iv) who has no historic normal cell indices; or (b) the determination of carrier status in a person: (i) who is a reproductive partner of a person with alpha thalassaemia; and (ii) who has abnormal red cell indices; and (iii) who does not have a concurrent iron deficiency; or (c) the determination of carrier status in a person: (i) who is a reproductive partner of a person with alpha thalassaemia and heterozygous 2‑gene deletion; and (ii) who has normal red cell indices

Fee From

01.07.2022

Category

Category 6 — Pathology

Description

Sequencing of HBA1 or HBA2, if the results of deletion testing described in item 73410 were inconclusive and a less common or rare variant is suspected, either: (a) for the diagnosis of alpha thalassaemia in a patient of reproductive age; or (b) for the determination of carrier status in a reproductive partner of a person with alpha thalassaemia Applicable once per gene per lifetime

Fee From

01.07.2022

Category

Category 6 — Pathology

Description

Deletion testing of HBA1 and HBA2, if the results of deletion testing described in item 73410 were inconclusive and a large deletion variant is suspected, either: (a) for the diagnosis of alpha thalassaemia in a patient of reproductive age; or (b) for the determination of carrier status in a reproductive partner of a person with alpha thalassaemia

Fee From

01.07.2022

Category

Category 6 — Pathology

Description

Non‑deletion testing of HBA1 and HBA2 using techniques other than sequencing, if the results of deletion testing described in item 73410 were inconclusive, either: (a) for the diagnosis of alpha thalassaemia in a patient of reproductive age ; or (b) for the determination of carrier status in a reproductive partner of a person with alpha thalassaemia

Fee From

01.07.2022

Category

Category 6 — Pathology

Description

Detection of germline gene variants, including copy number variation, requested by a specialist or consultant physician: (a) in at least the following genes: (i) KCNQ1; (ii) KCNH2; (iii) SCN5A; (iv) KCNE1; (v) KCNE2; (vi) KCNJ2; (vii) CACNA1C; (viii) RYR2; (ix) CASQ2; (x) CAV3; (xi) SCN4B; (xii) AKAP9; (xiii) SNTA1; (xiv) KCNJ5; (xv) ALG10; (xvi) CALM1; (xvii) CALM2; (xviii) ANK2; (xix) TECRL; (xx) TRDN; and (b) for a patient for whom clinical or family history criteria is suggestive of inherited cardiac arrhythmias or channelopathies that place the patient at greater than 10% risk of having a pathogenic variant Applicable once per lifetime

Fee From

01.07.2022

Category

Category 6 — Pathology

Description

Characterisation of one or more pathogenic or likely pathogenic germline gene variants, requested by a specialist or consultant physician, if: (a) the patient is a first-degree or second‑degree biological relative of a person with a pathogenic or likely pathogenic germline gene variant that is confirmed by laboratory findings; and (b) the service is performed for the purpose of assessing present or future risk of a cardiac arrhythmia or channelopathy; and (c) a service to which item 73416 applies has not previously been performed for the patient Applicable once per variant per lifetime

Fee From

01.11.2023

Category

Category 6 — Pathology

Description

Characterisation of one or more recessive pathogenic or likely pathogenic germline genes, requested by a specialist or consultant physician, for the purpose of determining the reproductive risk of cardiac arrhythmia or channelopathy in a patient: (a) who is a reproductive partner of a person who is a known carrier of a pathogenic or likely pathogenic germline gene variant of a gene confirmed by laboratory findings; and (b) for whom a service to which item 73416 applies has not previously been performed; and (c) for whom carrier status of a pathogenic or likely pathogenic germline gene variant is unknown; and (d) who has a clinical history, family history or laboratory findings suggesting there is a low probability of cardiac arrhythmia or channelopathy Applicable once per gene per lifetime

Fee From

01.07.2022

Category

Category 6 — Pathology

Description

Re‑analysis of whole exome or genome data that was obtained in performing a service to which item 73416 applies, for characterisation of previously unreported germline gene variants related to the clinical phenotype, if: (a) the re-analysis is requested by a consultant physician practising as a clinical geneticist or a cardiologist; and (b) the patient is strongly suspected of having inheritable cardiac arrhythmia or channelopathies; and (c) the service is performed at least 18 months after a service to which item 73416 or this item applies was performed for the patient Applicable twice per lifetime

Fee From

01.11.2024

Category

Category 6 — Pathology

Description

Non‑invasive prenatal testing of blood from an RhD negative pregnant patient for the detection of the RHD gene from fetal DNA circulating in maternal blood, if the patient has not been previously alloimmunised against RhD

Fee From

01.07.2022

Category

Category 6 — Pathology

Description

Non-invasive prenatal testing of blood from an RhD negative pregnant patient for the detection of the RHD gene from fetal DNA circulating in maternal blood, if the patient has been previously alloimmunised against RhD

Fee From

01.11.2022

Category

Category 6 — Pathology

Description

Characterisation of a gene variant or gene variants using a gene panel, in a patient presenting with clinical signs and symptoms suggestive of a genetic neuromuscular disorder (other than signs and symptoms associated with variants that are not detectable by massively parallel sequencing), if the service is requested: (a) by a specialist or consultant physician; and (b) after exclusion of non‑genetic causes Applicable once per lifetime

Fee From

01.11.2022

Category

Category 6 — Pathology

Description

Detection of a single identified gene variant, in a biological relative of a person with a germline gene variant for a neuromuscular disorder identified by a service described in item 73422, 73425 or 73426, if the service is requested by a specialist or consultant physician Applicable once per variant

Fee From

01.11.2022

Category

Category 6 — Pathology

Description

Prenatal detection of an actionable pathogenic familial gene variant or gene variants (including maternal cell contamination assessment), requested by a specialist or consultant physician, for a genetic neuromuscular disorder previously identified in an index person in the patient’s family as a result of a service described in item 73422, 73434 or 73435 Applicable once per pregnancy

Fee From

01.11.2022

Category

Category 6 — Pathology

Description

Prenatal detection of unknown gene variants (including maternal cell contamination assessment) using a gene panel, if: (a) the service is requested: (i) by a specialist or consultant physician, for a suspected genetic neuromuscular disorder; and (ii) after exclusion of non‑genetic causes; and (b) the service is performed using a sample from the fetus; and (c) the service is not performed in conjunction with a service to which item 73426 applies Applicable once per pregnancy

Fee From

01.11.2022

Category

Category 6 — Pathology

Description

Prenatal detection of unknown gene variants (including maternal cell contamination assessment) using a gene panel, if: (a) the service is requested: (i) by a specialist or consultant physician; and (ii) for a suspected genetic neuromuscular disorder; and (iii) after exclusion of non‑genetic causes; and (b) the request states that singleton testing is inappropriate; and (c) the service is performed using a sample from the fetus and a sample from each of the fetus’s biological parents; and (d) the service is not performed in conjunction with a service to which item 73425 applies Applicable once per pregnancy

Fee From

01.11.2022

Category

Category 6 — Pathology

Description

Single gene testing for the characterisation of a germline gene variant or germline gene variants: (a) if requested by a specialist or consultant physician; and (b) within the same gene in which the patient’s reproductive partner has a documented pathogenic germline recessive gene variant for a neuromuscular disorder identified by a service described in: (i) item 73422, 73425 or 73426; or (ii) item 73434, if the patient has been provided a service described in item 73434 and that service has not identified a relevant variant Applicable once per gene

Fee From

01.11.2022

Category

Category 6 — Pathology

Description

Re‑analysis of whole genome or exome data obtained in performing a service described in item 73422, 73425 or 73426, for characterisation of previously unreported gene variants related to the clinical phenotype, if the re‑analysis is requested by: (a) a consultant physician practicing as a clinical geneticist; or (b) a consultant physician practising as a specialist paediatrician, following consultation with a clinical geneticist Applicable twice per lifetime

Fee From

01.07.2023

Category

Category 6 — Pathology

Description

Genetic testing (including characterisation of single nucleotide variants, structural variants, fusions and copy number alterations) in a gene panel, requested by a specialist or consultant physician, for a patient with clinical or laboratory evidence of a glioma, glioneuronal tumour or glioblastoma, to aid diagnosis and classification of the relevant tumour, including assessments of at least the following kinds: (a) IDH1, IDH2—variant testing; (b) 1p/19q—co‑deletion assessment; (c) H3F3A—variant status; (d) TERT—promoter variant status; (e) EGFR—amplification; (f) CDKN2A/B—deletion; (g) BRAF—variants Applicable to one test per diagnostic episode

Fee From

01.07.2022

Category

Category 6 — Pathology

Description

Fluorescence in-situ hybridisation (FISH) test of tumour tissue from a patient with locally advanced or metastatic solid tumour, if: (a) the tumour is at risk of being caused by a neurotrophic receptor tyrosine kinase (NTRK) gene fusion as determined by either: (i) occurring in a child less than 18 years of age; or (ii) being mammary analogue secretory carcinoma of the salivary gland; or (iii) being secretory breast carcinoma; and (b) the test is requested by a specialist or consultant physician to determine if requirements relating to NTRK gene fusion status for access to a tropomyosin receptor kinase (Trk) inhibitor under the Pharmaceutical Benefits Scheme are fulfilled This item cannot be claimed if item 73433 has been claimed for the same patient during the same cancer diagnosis Applicable only once per cancer diagnosis

Fee From

01.07.2022

Category

Category 6 — Pathology

Description

Two tests described in item 73430

Fee From

01.07.2022

Category

Category 6 — Pathology

Description

Three or more tests described in item 73430

Fee From

01.07.2022

Category

Category 6 — Pathology

Description

Next generation sequencing (NGS) test for neurotrophic receptor tyrosine kinase (NTRK1, NTRK2, NTRK3) fusions by RNA or DNA in tumour tissue from a patient with locally advanced or metastatic solid tumour, if: (a) the tumour is at risk of being caused by an NTRK gene fusion as determined by either: (i) occurring in a child less than 18 years of age; or (ii) being mammary analogue secretory carcinoma of the salivary gland; or (iii) being secretory breast carcinoma; (b) the test is requested by a specialist or consultant physician to determine if requirements relating to NTRK gene fusion status for access to a tropomyosin receptor kinase (Trk) inhibitor under the Pharmaceutical Benefits Scheme are fulfilled This item cannot be claimed if item 73430 has been claimed for the same patient during the same cancer diagnosis Applicable only once per cancer diagnosis

Fee From

01.07.2023

Category

Category 6 — Pathology

Description

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 From

01.07.2023

Category

Category 6 — Pathology

Description

Detection of pathogenic or likely pathogenic DUX4 gene variants, requested by a specialist or consultant physician, for: (a) a patient with a suspected neuromuscular disorder; or (b) a relative of a patient with a pathogenic or likely pathogenic germline gene variant associated with a neuromuscular disorder (confirmed by laboratory findings) Applicable once per gene per lifetime

Fee From

01.11.2022

Category

Category 6 — Pathology

Description

A 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) for MET proto-oncogene, receptor tyrosine kinase (MET) exon 14 skipping alterations (METex14sk) status to determine eligibility for access to a relevant treatment under the Pharmaceutical Benefits Scheme; and (b) not associated with a service to which item 73437 or 73438 applies

Fee From

01.11.2023

Category

Category 6 — Pathology

Description

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 eligibility for a relevant treatment under the Pharmaceutical Benefits Scheme; and (b) to detect the fusion status of at least ALK, ROS1, RET, NTRK1, NTRK2 and NTRK3 to determine eligibility for a relevant treatment under the PBS; and (c) not associated with a service to which item 73438, 73439, 73337, 73341, 73344, 73436 or 73351 applies

Fee From

01.11.2023

Category

Category 6 — Pathology

Description

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 eligibility for a relevant treatment under the Pharmaceutical Benefits Scheme; and (c) not associated with a service to which item 73437, 73337, 73436 or 73351 applies

Fee From

01.11.2023

Category

Category 6 — Pathology

Description

A nucleic acid-based multi-gene panel test of tumour tissue from a patient with a new diagnosis of non-small cell lung cancer and with documented absence of activating variants of the EGFR gene, KRAS, BRAF and MET exon14, requested by, or on behalf of, a specialist or consultant physician, if the test is: (a) for fusion status of at least ALK, ROS1, RET, NTRK1, NTRK2, and NTRK3 to determine eligibility for a relevant treatment under the Pharmaceutical Benefits Scheme; and (b) not associated with a service to which item 73437, 73341, 73344 or 73351 applies

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