Clinical guidance for MRI referral

MBS items

Clinical guidance for MRI referral
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A detailed list of MBS item descriptions and item numbers.

Summary of MBS item descriptions

Table 1

Summary of MBS item descriptions

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Magnetic resonance imaging – Group 15
 


Subgroup 34 – Magnetic resonance imaging – for specified conditions 
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) (R) (K)* (Contrast) (Anaes.)
  • unexplained chronic headache with suspected intracranial pathology (R) (K)* (Contrast) (Anaes.)

Fee: $403.20 | Benefit: 75% = $302.40, 85% = $342.75

​
Subgroup 34 – Magnetic resonance imaging – for specified conditions 
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) (R) (NK)* (Contrast) (Anaes.)
  • unexplained chronic headache with suspected intracranial pathology (R) (NK)* (Contrast) (Anaes.)

Fee: $201.60 | Benefit: 75% = $151.20, 85% = $171.40

​
Subgroup 34 – Magnetic resonance imaging – for specified conditions 
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 (R) (K)* (Contrast) (Anaes.)

Fee: $358.40 | Benefit: 75% = $268.80, 85% = $304.65

​
Subgroup 34 – Magnetic resonance imaging – for specified conditions 
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 (R) (NK)* (Contrast) (Anaes.)

Fee: $179.20 | Benefit: 75% = $134.40, 85% = $152.35

​
Subgroup 34 – Magnetic resonance imaging – for specified conditions 
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 (R) (K)*

Fee: $492.80 | Benefit: 75% = $369.60, 85% = $418.90

​
Subgroup 34 – Magnetic resonance imaging – for specified conditions 
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 (R) (NK)*

Fee: $246.40 | Benefit: 75% = $184.80, 85% = $209.45

​
Subgroup 34 – Magnetic resonance imaging – for specified conditions 
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 (R) (K)* (Contrast) (Anaes.); or
  • clinical findings suggesting acute anterior cruciate ligament tear. (R) (K)* (Contrast) (Anaes.)

Fee: $403.20 | Benefit: 75% = $302.40, 85% = $342.75

​
Subgroup 34 – Magnetic resonance imaging – for specified conditions 
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 (R) (NK)* (Contrast) (Anaes.); or
  • clinical findings suggesting acute anterior cruciate ligament tear. (R) (NK)* (Contrast) (Anaes.)

Fee: $201.60 | Benefit: 75% = $151.20, 85% = $171.40
 

*For information on K and NK Items refer to Capital Sensitivity for Diagnostic Imaging Equipment

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