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Health Insurance (Section 3C Diagnostic Imaging Services – Whole Body Magnetic Resonance Imaging Scan) Determination 2022
7. Limitation of items7. Limitation of items
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7. Limitation of items
(1) A service described under item 63564 applies only if the same patient has not received a service to which the same item applies within the preceding 12 months.
Schedule – relevant services
<table cellspacing="0" cellpadding="0" style="width:100%; border-collapse:collapse"><thead><tr><td colspan="3" style="border-top:1.5pt solid #000000; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; line-height:12pt"><span style="font-size:10pt; font-weight:bold">Group I5 – </span><a id="_Hlk116991954"><span style="font-size:10pt; font-weight:bold">Magnetic Resonance Imaging</span></a></p></td></tr><tr><td style="width:15%; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; line-height:12pt"><span style="font-size:10pt; font-weight:bold">Column 1</span></p><p style="margin-top:3pt; line-height:12pt"><span style="font-size:10pt; font-weight:bold">Item</span></p></td><td style="width:65%; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; line-height:12pt"><span style="font-size:10pt; font-weight:bold">Column 2</span></p><p style="margin-top:3pt; line-height:12pt"><span style="font-size:10pt; font-weight:bold">Description</span></p></td><td style="width:20%; border-bottom:1.5pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; margin-left:29.7pt; line-height:12pt"><span style="font-size:10pt; font-weight:bold">Column 3</span></p><p style="margin-top:3pt; margin-left:29.7pt; line-height:12pt"><span style="font-size:10pt; font-weight:bold">Fee ($)</span></p></td></tr><tr><td colspan="3" style="border-bottom:1pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; line-height:12pt"><span style="font-size:10pt; font-weight:bold">Subgroup 19 – Scan of Body – For Specified Conditions</span></p></td></tr></thead><tbody><tr style="height:52.35pt"><td style="width:15%; border-bottom:1pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="margin-top:3pt; line-height:normal; font-size:10pt"><span>63564</span></p></td><td style="width:65%; border-bottom:1pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="line-height:11.5pt"><span style="font-size:10pt">MRI – whole body scan for the early detection of cancer:</span></p><p style="margin-left:18pt; text-indent:-18pt; line-height:11.5pt"><span style="font-size:10pt">a)</span><span style="width:10.23pt; text-indent:0pt; font-size:10pt; display:inline-block"> </span><span style="font-size:10pt">requested by a specialist or consultant physician in consultation with a clinical geneticist in a familial cancer or genetic clinic; and</span></p><p style="margin-left:18pt; text-indent:-18pt; line-height:11.5pt"><span style="font-size:10pt">b)</span><span style="width:9.67pt; text-indent:0pt; font-size:10pt; display:inline-block"> </span><span style="font-size:10pt">the request identifies that the patient has a high risk of developing cancer malignancy</span></p><p style="line-height:11.5pt"><span style="font-size:10pt">due to heritable </span><span style="font-size:10pt; font-style:italic">TP53</span><span style="font-size:10pt"> </span><span style="font-size:10pt">‑</span><span style="font-size:10pt"> related cancer (</span><span style="font-size:10pt; font-style:italic">hTP53rc</span><span style="font-size:10pt">) syndrome</span></p><p style="margin-top:2pt; margin-bottom:6pt; line-height:11.5pt"><span style="font-size:10pt">(R) (Anaes.)</span></p></td><td style="width:20%; border-bottom:1pt solid #000000; padding-right:5.35pt; padding-left:5.35pt; vertical-align:top; background-color:#ffffff"><p style="text-align:right"><span style="font-size:10pt">1,655.20</span></p></td></tr></tbody></table>