Document ID: chunk:federal_register_of_legislation:F2025C00214:clause:1_63464
Version: federal_register_of_legislation:F2025C00214
Segment Type: clause
Provision Reference: sch 1 cl 63464
Character Range: 370874–373799

63464                                                                                                          MRI—scan of both breasts for the detection of cancer in a patient, if:                                                                                                                                                                                          690.00
                                                                                                               (a) a dedicated breast coil is used; and
                                                                                                               (b) the request for the scan identifies that the patient is asymptomatic and is younger than 60 years of age; and
                                                                                                               (c) the request for the scan identifies that the patient is at high risk of developing breast cancer due to one or more of the following:
                                                                                                               (i) genetic testing has identified the presence of a high risk breast cancer gene mutation in the patient or in a first degree relative of the patient;
                                                                                                               (ii) both:
                                                                                                               (A) one of the patient's first or second degree relatives was diagnosed with breast cancer at age 45 years or younger; and
                                                                                                               (B) another first or second degree relative on the same side of the patient's family was diagnosed with bone or soft tissue sarcoma at age 45 years or younger;
                                                                                                               (iii) the patient has a personal history of breast cancer before the age of 50 years;
                                                                                                               (iv) the patient has a personal history of mantle radiation therapy;
                                                                                                               (v) the patient has a lifetime risk estimation greater than 30% or a 10 year absolute risk estimation greater than 5% using a clinically relevant risk evaluation algorithm; and
                                                                                                               (d) the service is not performed in conjunction with item 55076 or 55079
                                                                                                               Applicable not more than once in a 12 month period (R) (Anaes.) (Contrast)