MRI – specialists
Item | Description |
---|---|
Head | |
63001 | tumour of the brain or meninges (unlimited) |
63004 | inflammation of the brain or meninges (unlimited) |
63007 | skull base or orbital tumour (unlimited) |
63010 | stereotactic scan of brain, with Fiducials in place, for planning for stereotactic neurosurgery (unlimited) |
63040 | acoustic neuroma (3 per year) |
63043 | pituitary tumour (3 per year) |
63046 | toxic or metabolic or ischaemic encephalopathy (3 per year) |
63049 | demyelinating disease of the brain (3 per year) |
63052 | congenital malformation of the brain or meninges (3 per year) |
63055 | venous sinus thrombosis (3 per year) |
63058 | head trauma (3 per year) |
63061 | epilepsy (3 per year) |
63064 | stroke (3 per year) |
63067 | carotid or vertebral artery dissection (3 per year) |
63070 | intracranial aneurysm (3 per year) |
63073 | intracranial arteriovenous malformation (3 per year) |
Head and neck vessels | |
63101 | stroke (3 per year) |
Head and cervical spine | |
63111 | tumour of the central nervous system or meninges (3 per year) |
63114 | inflammation of the central nervous system or meninges (3 per year) |
63125 | demyelinating disease of the central nervous system (3 per year) |
63128 | congenital malformation of the central nervous system or meninges (3 per year) |
63131 | syrinx (congenital or acquired) (3 per year) |
Spine - one region or two contiguous regions | |
63151 | infection (unlimited) |
63154 | tumour (unlimited) |
63161 | demyelinating disease (3 per year) |
63164 | congenital malformation of the spinal cord or the cauda equina or the meninges (3 per year) |
63167 | myelopathy (3 per year) |
63170 | syrinx (congenital or acquired) (3 per year) |
63173 | cervical radiculopathy (3 per year) |
63176 | sciatica (3 per year) |
63179 | spinal canal stenosis (3 per year) |
63182 | previous spinal surgery (3 per year) |
63185 | trauma (3 per year) |
Spine - three contiguous regions or two non-contiguous regions | |
63201 | infection (unlimited) |
63204 | tumour (unlimited) |
63219 | demyelinating disease (3 per year) |
63222 | congenital malformation of the spinal cord or the cauda equina or the meninges (3 per year) |
63225 | myelopathy (3 per year) |
63228 | syrinx (congenital or acquired) (3 per year) |
63231 | cervical radiculopathy (3 per year) |
63234 | sciatica (3 per year) |
63237 | spinal canal stenosis (3 per year) |
63240 | previous spinal surgery (3 per year) |
63243 | trauma (3 per year) |
Cervical spine and brachial plexus | |
63271 | tumour (3 per year) |
63274 | trauma (3 per year) |
63277 | cervical radiculopathy (3 per year) |
63280 | previous surgery (3 per year) |
Musculoskeletal (MSK) system | |
63301 | tumour arising in bone or MSK system excludes tumour arising in breast, prostate or rectum (unlimited) |
63304 | infection arising in bone or MSK system excludes infection arising in breast, prostate or rectum (unlimited) |
63307 | osteonecrosis (unlimited) |
63322 | derangement of hip or its supporting structures* (3 per year) |
63325 | derangement of shoulder or its supporting structures* (3 per year) |
63328 | derangement of knee or its supporting structures* (3 per year) |
63331 | derangement of ankle and/or foot or its supporting structures* (3 per year) |
63334 | derangement of one or both temporomandibular joints or their supporting structures (3 per year) |
63337 | derangement of wrist and/or hand or its supporting structures* (3 per year) |
63340 | derangement of elbow or its supporting structures* (3 per year) |
63361 | Gaucher disease (2 per year) |
*Limitation is 3 for each side in 12 months | |
Cardiovascular system | |
63385 | congenital disease of the heart or a great vessel (2 per year) |
63388 | tumour of the heart or a great vessel (2 per year) |
63391 | abnormality of thoracic aorta (2 per year) |
63395 | MRI scan of the cardiovascular system for assessment of myocardial structure and function involving:
if the request for the scan indicates that:
(1 per year) |
63397 | MRI scan of the cardiovascular system for assessment of myocardial structure and function involving:
if the request for the scan indicates that the patient:
(Once per 36 months) |
63399 | Cardiac MRI post covid vaccine |
Cardiovascular system MRA | |
63401 | vascular abnormality with a previous anaphylactic reaction to an iodinated contrast medium (3 per year) |
63404 | obstruction of the superior vena cava, inferior vena cava or a major pelvic vein (3 per year) |
Paediatric (<16yrs) MRA | |
63416 | the vasculature of limbs prior to limb or digit transfer surgery in congenital limb deficiency syndrome (1 per year) |
Paediatric (<16) | |
63425 | post-inflammatory or post-traumatic physeal fusion (2 per year) |
63428 | Gaucher disease (2 per year) |
63440 | pelvic or abdominal mass (unlimited) |
63443 | mediastinal mass (unlimited) |
63447 | pelvic or abdominal mass (unlimited) |
63449 | congenital uterine or anorectal abnormality (unlimited) |
Body scan | |
63461 | adrenal mass in a patient with malignancy which is otherwise resecetable (1 per year) |
Body scan - both breasts | |
63531 | MRI of both breasts where the patient has a breast lesion, the results of conventional imaging examinations are inconclusive for the presence of breast cancer, and biopsy has not been possible |
63533 | MRI of both breasts where the patient has been diagnosed with breast cancer, discrepancy exists between clinical assessment and conventional imaging assessment, and the results of breast MRI may alter treatment planning |
63464 | MRI scan of both breasts for the detection of cancer in a patient, if:
Applicable not more than once in a 12 month period (R) (Contrast) |
Body scan - both breasts | |
63467 | scan of both breast for the detection of cancer - where;
(1 per year) |
Body scan - one or both breast | |
63501 | MRI - scan of one or both breasts for the evaluation of implant integrity where:
(1 per year) |
63502 | MRI - scan of one or both breasts for the evaluation of implant integrity where:
(1 per year) |
63504 | MRI - scan of one or both breasts for the evaluation of implant integrity where:
|
63505 | MRI - scan of one or both breasts for the evaluation of implant integrity where:
|
63547 | MRI scan of both breasts for the detection of cancer, if (a) a dedicated breast coil is used; and (b) 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.) |
63487 | MRI—performed under the professional supervision of an eligible provider at an eligible location, if: (a) the patient is referred by a specialist or a consultant physician; and |
63489 | MRI-guided biopsy, performed under the professional supervision of an eligible provider at an eligible location, if: (a) the patient is referred by a specialist or a consultant physician; and |
Pelvis and upper abdomen | |
63470 | Pelvis for the staging of histologically diagnosed cervical cancer at FIGO stages 1B or greater when the request for scan identifies that
(1 in a lifetime) |
63473 | Pelvis and upper abdomen, in a single examination, for the staging of histologically diagnosed cervical cancer at FIGO stages 1B or greater (1 in a lifetime) |
63476 | Pelvis for the initial staging of rectal cancer where
(a) a high resolution T2 technique is used; and (b) the request for the scan identifies that the indication is for: (i) the initial staging of rectal cancer (including cancer of the rectosigmoid and anorectum); or (ii) the initial assessment of response to chemotherapy or chemoradiotherapy; or (III) the assessment of possible recurrent tumour after complete response to neoadjuvant therapy, within an active surveillance program; or (iv) the assessment of recurrent disease prior to treatment planning |
63563 | MRI scan of the pelvis or abdomen, if the request for the scan identifies that the investigation is for: (a) sub‑fertility that requires one or more of the following: (i) an investigation of suspected Mullerian duct anomaly seen in pelvic ultrasound or hysterosalpingogram; (ii) an assessment of uterine mass identified on pelvic ultrasound before consideration of surgery; (iii) an investigation of recurrent implantation failure in IVF (2 or more embryo transfer cycles without viable pregnancy); or (b) surgical planning of a patient with known or suspected deep endometriosis involving the bowel, bladder or ureter (or any combination of the bowel, bladder or ureter), where the results of pelvic ultrasound are inconclusive Applicable not more than once in a 2 year period (R) (Contrast) |
63549 | MRI scan of the pelvis or abdomen, for a patient with a multiple pregnancy, if: (a) the multiple pregnancy is at, or after, 18 weeks gestation; and (b) fetal abnormality is suspected; and (c) an ultrasound has been performed and is provided by, or on behalf of, or at the request of, a specialist who is practising in the specialty of obstetrics; and (d) the diagnosis of fetal abnormality as a result of the ultrasound is indeterminate or requires further examination; and (e) the MRI service is requested by a specialist practising in the specialty of obstetrics (R) (Contrast) |
Body - pancreas and biliary tree MRCP | |
63482 | suspected biliary or pancreatic pathology |
Pelvis and upper abdomen - for specified conditions (Crohn's Disease) | |
63740 | MRI to evaluate small bowel Crohn’s disease. Medicare benefits are only payable for this item if the service is provided to patients: (a) Evaluation of disease extent at time of initial diagnosis of Crohn’s disease |
63743 | MRI for fistulising perianal Crohn’s disease. Medicare benefits are only payable for this item if the service is provided to patients for:
|
Prostate | |
63541 | Diagnosis Multiparametric Magnetic Resonance Imaging (mpMRI) using a standardised image acquisition protocol involving T2 weighted imaging, Diffusion Weighted Imaging, and Dynamic Contrast Enhancement (unless contraindicated); and
Scan of the prostate for: Note: benefits are payable on one occasion only in any 12 month period. Relevant family history is first degree relative with prostate cancer or suspected of carrying a BRCA 1. BRCA 2 mutation |
63543 | Active Surveillance Multiparametric Magnetic Resonance Imaging (mpMRI) using a standardised image acquisition protocol involving T2 weighted imaging, Diffusion Weighted Imaging, and Dynamic Contrast Enhancement (unless contraindicated); and a) the patient is under active surveillance following a confirmed diagnosis of prostate cancer by the biopsy histopathology; and Scan of the prostate for: Note: benefits are payable at the time of diagnosis of prostate cancer, 12 months following diagnosis and then every 3rd year thereafter or at any time, if there is any concern clinically or with PSA progression. This item is not to be used for the purposes of treatment planning or for monitoring after treatment. |
Liver | |
63545 | MRI—multiphase scans of liver (including delayed imaging, if performed) with a contrast agent, for staging where surgical resection or interventional techniques are under consideration to treat any liver metastases detected, if: (a) The patient has a confirmed extra‑hepatic primary malignancy (other than hepatocellular carcinoma), with no persistent extra‑hepatic disease; and (b) computed tomography of the patient’s liver is negative or inconclusive for metastatic disease; and (c) the identification of liver metastases would change the patient’s treatment planning Applicable not more than once in a 12 month period (R) (Contrast) |
63546 | Patients with known or suspected hepatocellular carcinoma for the purposes of diagnosis or staging where the patient:
|
Whole-body | |
63564 | MRI – whole body scan for the early detection of cancer: a) requested by a specialist or consultant physician in consultation with a clinical geneticist in a familial cancer or genetic clinic; and b) the request identifies that the patient has a high risk of developing cancer malignancy due to heritable TP53 - related cancer (hTP53rc) syndrome (R) |