Magnetic Resonance Imaging – Specialists
Items | Descriptions | Limitations |
---|---|---|
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 tumour 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 | 3 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:
| 1 per year |
63397 | MRI scan of the cardiovascular system for assessment of myocardial structure and function involving:
| 1 every 3 years |
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 |
63444 | mediastinal mass | unlimited |
63447 | 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 | ||
63464 | scan of both breast for the detection of cancer where;
| 1 per year |
Body Scan - both breasts | ||
63467 | scan of both breast for the detection of cancer - where;
| 1 per year |
Body Scan - one or both breast | ||
63487 | MRI — performed under the professional supervision of an eligible provider at an eligible location, if:
| |
63489 | MRI - guided biopsy, performed under the professional supervision of an eligible provider at an eligible location, if:
| |
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:
| |
63531 | MRI - scan 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 - scan 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 the breast MRI may alter treatment planning. | |
63547 | MRI scan of both breasts for the detection of cancer, if
| 1 in a lifetime |
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
| 1 in a lifetime |
63740 | MRI to evaluate small bowel Crohn’s disease. Medicare benefits are only payable for this item if the service is provided to patients:
| 1 per year |
63741 | MRI enteroclysis for Crohn’s disease. Medicare benefits are only payable for this item if the service is related to item 63740 | |
63743 | MRI for fistulising perianal Crohn’s disease. Medicare benefits are only payable for this item if the service is provided to patients for:
| 1 per year |
Body - pancreas and biliary tree MRCP | ||
63482 | suspected biliary or pancreatic pathology | 3 per year |
Prostate | ||
63541 | MRI of the prostate, where the patient is referred by an urologist, radiation oncologist or medical oncologist; and the request specifies that the clinical criteria below are met; and the patient is suspected of having prostate cancer based on; 1. A digital rectal examination (DRE) which is suspicious for prostate cancer; or 2. Aged < 70 years, at least 2x PSA tests performed within an interval of 1-3 months > 3.0 ng/ml, and F/T PSA ratio is < 25% or the repeat PSA exceeds 5.5 ng/ml; or 3. Aged < 70 years, whose risk of developing prostate cancer based on family history is at least double the average risk (1st degree relative with prostate cancer or suspected of carrying BRCA 1, BRCA 2 mutation), at least 2 PSA tests performed within an interval of 1-3 months > 2.0 ng/ml, and the F/T PSA ratio is < 25%: or 4. Aged ≥ 70 years , at least 2 PSA tests performed within an interval of 1-3 months > 5.5 ng/ml and the F/T PSA ratio is < 25%. | 1 per year |
63543 | MRI of the prostate, where the patient is referred by an urologist, radiation oncologist or medical oncologist; and the request specifies that the clinical criteria below are met; (a) the patient is under active surveillance following a confirmed diagnosis of prostate cancer by biopsy histopathology; and (b) the patient is not planning or undergoing treatment for prostate cancer. 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 purpose of treatment planning or for the monitoring after treatment. |