Referrers

Referrers

Our commitment to patient focused care, state-of-the-art technology with world-class reporting ensures an outstanding, multifaceted experience for you and your patients.
PRP Diagnostic Imaging - proud to be your local medical imaging partner.

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Prostate MRI Scans
1 July 2018
  • A Medicare rebate will be available for these items numbers performed at - PRP Bathurst, Charlestown, Cumberland, Dee Why, Eastwood, Gordon, Gosford North, Maitland, Moore Park, Norwest, Tuggerah, Wollongong.
  • Specialists and consultant physicians are eligible to request these items.
  • GPs are not eligible to request these items.

ITEM NO

DESCRIPTION

63541

Diagnosis Item Number - 63541

For MBS item 63541 the patient must be suspected of having prostate cancer based on:

  1. A digital rectal examination (DRE) which is suspicious for prostate cancer; or
  2. in a person aged less than 70 years, at least two prostate specific antigen (PSA) tests performed within an interval of 1-3 months are greater than 3.0 ng/ml, and the free/total PSA ratio is less than 25% or the repeat PSA exceeds 5.5 ng/ml; or
  3. in a person aged less than 70 years, whose risk of developing prostate cancer based on family history is at least double the average risk , at least two PSA tests performed within an interval of 1-3 months are greater than 2.0 ng/ml, and the free/total PSA ratio is less than 25%; or
  4. in a person aged 70 years or older, at least two PSA tests performed within an interval of 1-3 months are greater than 5.5ng/ml and the free/total PSA ratio is less than 25%.

Relevant family history is a first degree relative with prostate cancer or suspected of carrying a BRCA 1, BRCA 2 mutation.

Note: Benefits are payable on one occasion in any 12 month period.

63543

Active Surveillance Item Number – 63543

For MBS item 63543 the below clinical criteria must be met:

  1. the patient is under active surveillance following a confirmed diagnosis of prostate cancer by biopsy histopathology; and
  2. the patient is not planning or undergoing treatment for prostate cancer.

Note: Benefits are payable for patients who have not had a diagnostic mpMRI, and are placed on active surveillance following confirmed diagnosis; or 12 months following diagnosis and then every 3rd year thereafter or at any time, if there is any concern clinically or with PSA progression. The item is not to be used for the purposes of treatment, planning or for monitoring after treatment.

PET Medicare Updates
1 May 2018

ITEM NO

DESCRIPTION

61647

Whole body 68Ga‑DOTA‑peptide PET study (including any associated computed tomography scans for anatomic localisation and attenuation correction), if:

  1. a gastro‑entero‑pancreatic neuroendocrine tumour is suspected on the basis of biochemical evidence with negative or equivocal conventional imaging; or
  2. both:
    (i) a surgically amenable gastro‑entero‑pancreatic neuroendocrine tumour has been identified on the basis of conventional techniques; and
    (ii) the study is for excluding additional disease sites (R)
Cardiac MRI updates
1 May 2018

ITEM NO

DESCRIPTION

63395

MRI scan of the cardiovascular system for assessment of myocardial structure and function involving:

  1. dedicated right ventricular views; and
  2. 3D volumetric assessment of the right ventricle; and
  3. reporting of end‑diastolic and end‑systolic volumes, ejection fraction and BSA‑indexed values;

    if the request for the scan indicates that:
  4. the patient presented with symptoms consistent with arrhythmogenic right ventricular cardiomyopathy (ARVC); or
  5. investigative findings in relation to the patient are consistent with ARVC

NOTE: benefits are payable once in 12 months (R) (K) (Contrast) (Anaes.)

63396

MRI scan of the cardiovascular system for assessment of myocardial structure and function involving:

  1. dedicated right ventricular views; and
  2. 3D volumetric assessment of the right ventricle; and
  3. reporting of end‑diastolic and end‑systolic volumes, ejection fraction and BSA‑indexed values;

    if the request for the scan indicates that:
  4. the patient presented with symptoms consistent with arrhythmogenic right ventricular cardiomyopathy (ARVC); or
  5. investigative findings in relation to the patient are consistent with ARVC

NOTE: benefits are payable once in 12 months (R) (K) (Contrast) (Anaes.)

63397

MRI scan of the cardiovascular system for assessment of myocardial structure and function involving:

  1. dedicated right ventricular views; and
  2. 3D volumetric assessment of the right ventricle; and
  3. reporting of end‑diastolic and end‑systolic volumes, ejection fraction and BSA‑indexed values;

    if the request for the scan indicates that the patient:
  4. is asymptomatic; and
  5. has one or more first degree relatives diagnosed with confirmed arrhythmogenic right ventricular cardiomyopathy (ARVC)

NOTE: benefits are payable once in 36 months (R) (K) (Contrast) (Anaes.)

63398

MRI scan of the cardiovascular system for assessment of myocardial structure and function involving:

  1. dedicated right ventricular views; and
  2. 3D volumetric assessment of the right ventricle; and
  3. reporting of end‑diastolic and end‑systolic volumes, ejection fraction and BSA‑indexed values;

    if the request for the scan indicates that the patient:
  4. is asymptomatic; and
  5. has one or more first degree relatives diagnosed with confirmed arrhythmogenic right ventricular cardiomyopathy (ARVC)

NOTE: benefits are payable once in 36 months (R) (K) (Contrast) (Anaes.)

Breast MRI updates
1 May 2018

ITEM NO

DESCRIPTION

63547

MRI scan of both breasts for the detection of cancer, if

  1. a dedicated breast coil is used; and
  2. the request for the scan identifies that:
    (i) the patient has a breast implant in situ; and
    (ii) anaplastic large cell lymphoma has been diagnosed

NOTE: benefits are payable once in a patient's lifetime (R) (K) (Contrast) (Anaes.)

63548

MRI scan of both breasts for the detection of cancer, if

  1. a dedicated breast coil is used; and
  2. the request for the scan identifies that:
    (i) the patient has a breast implant in situ; and
    (ii) anaplastic large cell lymphoma has been diagnosed

NOTE: benefits are payable once in a patient's lifetime (R) (K) (Contrast) (Anaes.)

Bone Mineral Density/DEXA
including medicare updates | 1 November 2017

ITEM NO

INDICATIONS

EXPLANATORY NOTES

12320
1 service per 60 consecutive months.

Patients 70 years and over who have not had a previous BMD.
Patients aged 70 years and over with a T score above -1.5.

MBS change 1.11.17

12322
1 service per 24 consecutive months

Patients aged 70 years and over with moderate to marked osteopenia. (T score between -1.5 and -2.5).

MBS change 1.11.17

PATIENTS DIAGNOSED WITH OSTEOPOROSIS WILL CONTINUE TO BE TESTED USING OTHER CLINICALLY APPROPRIATE MBS BONE DENSITOMETRY ITEMS.

12306
1 service per 24 months

  • The confirmation of a presumptive diagnosis of low bone mineral density made on the basis of 1 or more fractures occurring after minimal trauma, or
  • For the monitoring of low bone mineral density proven by bone densitometry at least 12 months previously.

Low bone mineral density is present when the bone mineral density falls more than 1.5 standard deviations below the age matched mean or more than 2.5 standard deviations below the young normal mean for the same site same gender.

12312
1 service per 12 consecutive months

For the diagnosis and monitoring of bone loss associated with 1 or more of the following conditions:

  • prolonged glucocorticoid therapy;
  • conditions associated with excess glucocorticoid secretion;
  • male hypogonadism; or
  • female hypogonadism lasting more than 6 months before the age of 45.

a. ‘Prolonged glucocorticoid therapy’ is defined as a dosage of inhaled glucocorticoid equivalent to or greater than 800 micrograms beclomethasone dipropionate or budesonide per day; or
b. a supraphysiological glucocorticoid dosage equivalent to or greater than 7.5 mg prednisolone in an adult taken orally per day; for a period anticipated to last for at least 4 months.

Glucocorticoid therapy must be going at the time of the scan. Patients no longer on steroids would not qualify for benefits.

12315
1 service per 24 consecutive months

For the diagnosis and monitoring of bone loss associated with 1 or more of the following conditions:

  • primary hyperparathyroidism;
  • chronic liver disease;
  • chronic renal disease;
  • proven malabsorptive disorders;
  • rheumatoid arthritis; or
  • conditions associated with thyroxine excess.

A malabsorptive disorder is defined as one or more of the following:

a. malabsorption of fat, defined as faecal fat estimated at greater than 18 gm per 72 hours on a normal fat diet; or
b. bowel disease with presumptive vitamin D malabsorption
as indicated by a sub-normal circulating 25-hydroxyvitamin D level; or
c. histologically proven Coeliac disease.

12321
1 service per 12 consecutive months

For the measurement of bone density 12 months following a significant change in therapy for:

  • established low bone mineral density; or
  • the confirmation of a presumptive diagnosis of low bone mineral density made on the basis of 1 or more fractures occurring after minimal trauma.

Item 12321 is intended to allow for bone mineral density measurement following a significant change in therapy - e.g. a change in the class of drugs - rather than for a change in the dosage regimen.

Chiropractic Spines
medicare updates | 1 November 2017

SERVICE

ITEM NO

DESCRIPTION OF CHANGE

SPINE
X-RAY
ONE REGION

58100
58103
58106
58109

These items amended to restrict allied health practitioners to requesting one of these items for the same patient on the same day.

SPINE
X-RAY
TWO REGION

58112

These items amended to restrict allied health practitioners to requesting one of these items for the same patient on the same day.

SPINE
X-RAY
THREE REGION

58121

Requesting rights for these items restricted to medical practitioners, physiotherapists and osteopaths.

Chiropractor referrals are not claimable from Medicare.

Alternatively, the patient may opt to have three (or four) region x-ray in one day. Two regions would be rebatable. The patient would need to pay a $25 flat fee for the non-rebatable regions.

SPINE
X-RAY
FOUR REGION

58120

Requesting rights for these items restricted to medical practitioners, physiotherapists and osteopaths.

Chiropractor referrals are not claimable from Medicare.

Alternatively, the patient may opt to have three (or four) region x-ray in one day. Two regions would be rebatable. The patient would need to pay a $25 flat fee for the non-rebatable regions.

MRI GP REBATES NOV 2014 | Head, Neck & Knee

One of the key initiatives of the Diagnostic Imaging Reform Package is to expand patient access to MRI services across Australia. This includes increased access to MRI services for primary care patients 16 years and over by extending requesting rights to GPs for a small set of clinically appropriate indications. GPs are able to request four new Magnetic Resonance Imaging (MRI) Medicare services for patients 16 years of age and over. The new items will be for the following:

Item No
63551
HEAD

referral by a medical practitioner (excluding a specialist or consultant physician) for a scan of head for a patient 16 years or older for any of the following:

  • unexplained seizure(s)
  • unexplained chronic headache with suspected intracranial pathology

Item No
63554
CERVICAL SPINE

referral by a medical practitioner (excluding a specialist or consultant physician) for a scan of spine for a patient 16 years or older for suspected: • cervical radiculopathy

Item No
63557
CERVICAL SPINE

referral by a medical practitioner (excluding a specialist or consultant physician) for a scan of spine for a patient 16 years or older for suspected:

  • cervical spine trauma

Item No
63560
KNEE

referral by a medical practitioner (excluding a specialist or consultant physician) for a scan of knee following acute knee trauma for a patient 16 years or older with:

  • inability to extend the knee suggesting the possibility of acute meniscal tear;
    or
  • clinical findings suggesting acute anterior cruciate ligament tear

Details of the item descriptors and explanatory notes can be found at mbsonline.gov.au or you can download the Australian Government Department of Health Fact Sheet here

PRP Diagnostic Imaging is an eligible provider.

To view the options for patients under 16 years old, please click here.

MRI ITEMS FOR CROHN’S DISEASE

New MRI Enterography items for the evaluation of:

  • small bowel Crohn’s disease
  • anal fistulas and pelvic sepsis in established or suspected Crohn’s disease

Please note that these scans are Medicare-eligible for Specialist referral only on fully or partially licensed magnets.

Item No
63740
MRI to evaluate small bowel Crohn’s disease

  • Evaluation of disease extent at time of initial diagnosis of Crohn’s disease.
  • Evaluation of exacerbation/suspected complications of known Crohn’s disease.
  • Evaluation of known or suspected Crohn’s disease in pregnancy.
  • Assessment of change to therapy in patients with small bowel Crohn’s disease. (This can only be claimed once in a 12 month period.)

Item No
63743
MRI for fistulising perianal Crohn’s disease

  • Evaluation of pelvic sepsis and fistulas associated with established or suspected Crohn’s disease.
  • Assessment of change to therapy of pelvic sepsis and fistulas from Crohn’s disease. (This can only be claimed once in a 12 month period.)

 

Every PRP clinic is committed to patient-focused care that harnesses state of the art technology with world-class reporting. You can be assured of an excellent standard of diagnostic imaging that helps you deliver the highest quality healthcare.

With patient comfort of the utmost importance, we offer easy convenient parking, spacious private changing rooms, modern stylish interiors, and a calm, supportive atmosphere to ensure the PRP experience is a highly positive one.

PACS Explained

PRP Diagnostic Imaging clinics are fitted with a state-of-the-art Picture Archiving and Communication System or PACS. Images and reports are stored electronically on a security protected archive data base that you have access to 24/7. There is also the option for you to review a patient's case with one of our imaging specialists.

As a valued referrer, you’re invited to apply for access to PACS. Simply complete this application and we’ll arrange for PRP PACS to be available to your practice at your convenience.

Billing Policy

Bulk-billing is offered to all health care card holders and patients who you deem to be financially disadvantaged (please note this on their referral). We will review the cost associated with each procedure with your patient when their appointment is made.

24 Hour Consult Contact

We believe that communication between the radiologist and referrer is essential for quality patient care. We hope you will see us as part of your medical support team, always on hand to consult with you about appropriate tests, procedure options and diagnostic reports. As a registered referrer you have direct access to our on-site clinic radiologists as well as an after hours emergency consult contact available 24 hours on 1800 233 390.  

High Quality Images With Minimum Radiation

PRP continues to invest in cutting-edge digital equipment which offers high quality images with minimal radiation. Many of our referrers are interested in the latest technology and machines we use. If you would like more information on this please contact us.