Document ID: chunk:federal_register_of_legislation:F2024C01086:clause:1_12201
Version: federal_register_of_legislation:F2024C01086
Segment Type: clause
Provision Reference: sch 1 cl 12201
Character Range: 730357–732483

12201                                                            Administration, by a specialist or consultant physician in the practice of the specialist's or consultant physician's specialty, of thyrotropin alfa‑rch (recombinant human thyroid‑stimulating hormone), and arranging services to which items 61426 and 66650 apply, for the detection of recurrent well‑differentiated thyroid cancer in a patient if:                                                                                                                                                                                                                   2,489.85
                                                                 (a) the patient has had a total thyroidectomy and one ablative dose of radioactive iodine; and
                                                                 (b) the patient is maintained on thyroid hormone therapy; and
                                                                 (c) the patient is at risk of recurrence; and
                                                                 (d) on at least one previous whole body scan or serum thyroglobulin test when withdrawn from thyroid hormone therapy, the patient did not have evidence of well‑differentiated thyroid cancer; and
                                                                 (e) either:
                                                                 (i) withdrawal from thyroid hormone therapy resulted in severe psychiatric disturbances when hypothyroid; or
                                                                 (ii) withdrawal is medically contra‑indicated because the patient has:
                                                                 (A) unstable coronary artery disease; or
                                                                 (B) hypopituitarism; or
                                                                 (C) a high risk of relapse or exacerbation of a previous severe psychiatric illness
                                                                 Applicable once only in a 12 month period