Medicare Indications

Charged for confirmation of a presumptive diagnosis of low bone mineral density made on the basis of:

• 1 or more fractures occurring after minimal trauma;
• For the monitoring of osteoporosis proven by bone densitometry at least 12 months previously

Charged 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;
• Female hypogonadism lasting more than 6 months before age 45

Charged 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 (excluding kidney stones)
• Proven malabsorptive disorders
• Rheumatoid arthritis;
• Conditions associated with thyroxine excess.

MBS Item Number

Clinical Indicator

57960

Orthopantomography (OPG) for diagnosis and/or management of trauma, infection, tumours, congenital conditions or surgical conditions of the teeth or maxillofacial region ®

57963

OPG, for diagnosis and/or management of impacted teeth, caries, periodontal or peripical pathology where signs or symptoms of those conditions are evident ®

57966

OPG, for diagnosis and/or management of missing or crowded teeth, or developmental anomalies of the teeth or jaws ®

57969

OPG, for diagnosis and/or management of temporomandibular joint arthroses or dysfunction ®

57902

Cephalometry, not in association with item 57901 ®

57927

TMJs (Temporomandibular joints)

58300

Bone Age Study

MBS Item Number

Descriptor

56022

Computer Tomography Scan of facial bones, para nasal sinuses

63007

MRI skull base or orbital tumour

63334

MRI derangement of one or both temporomandibular joints

• the past occurrence of breast malignancy in the patient or in a member of the patient’s family (blood relative) OR
• symptoms or indications of malignancy found on an examination of the patient by a medical practitioner.

Item Number

MBS Item Number

• the patient has stable symptoms consistent with coronary ischaemia, is at low to intermediate risk of coronary artery disease and would have been considered for coronary angiography; or
• the patient requires exclusion of coronary artery anomaly or fistula; or
• the patient will be undergoing non-coronary cardiac surgery.

• The patient has had an incomplete colonoscopy in the 3 months before the scan (date stated on request)
• There is a known high grade obstruction that will not allow passage of the scope
• The patient is referred by a specialist or consultant physician who performs colonoscopies AND
• Items 56552 56554 and 56553 have not been billed in the 36 months before this procedure

MBS Item Number

Knee ultrasound to be eligible for a Medicare rebate, the request MUST state that the service is for the assessment of a specific or suspected condition.

Benefits are not payable when referred for:-

• non-specific knee pain
• Meniscal and cruciate ligament tears OR
• Assessment of chondral surfaces