Description of Medical ServiceIt is proposed that a new test is listed to investigate the presence of neuromyelitis optica by the detection of aquaporin 4 antibodies in serum and/or CSF (cerebrospinal fluid). The disease can be diagnosed by other methods, however this test provides a rapid diagnosis in young people. This test helps with diagnosis of neuromyelitis optica and it leads to specific treatment early in the course of the disease.
Neuromyelitis optica (NMO) testing has been in clinical use for 10 years. Currently, NMO is tested under generic MBS (Medicare Benefits Schedule) item 71119 – ‘antibodies to tissue antigens not elsewhere specified’. This item is funded at a lower level than providers currently bill for NMO.
Description of Medical ConditionThis disease is similar to multiple sclerosis and presents with optic neuritis and spinal cord inflammation that can lead to paraplegia and blindness. NMO primarily affects young women (relapsing NMO), but both genders can develop monophasic NMO. NMO attacks optic nerves and the spinal cord, resulting in blindness and paralysis. NMO is similar to multiple sclerosis; however, there is a much lower frequency of brain lesions in NMO. NMO can be detected via the presence of aquaporin 4 antibodies in serum and/or cerebrospinal fluid. NMO treatment can include glucocorticoids, azathioprine, plasmapheresis, intravenous immunoglobulin, and anti-CD20 monoclonal antibody. Early treatment in the course of the disease can have a significant impact on patient outcomes.
Reason for ApplicationReferral from the MBS Taskforce
Medical Service TypeInvestigative
Previous Application Number/sNot Applicable
Consultation SurveyConsultation Survey (PDF 486 KB)
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PICO ConfirmationPICO Confirmation (PDF 1925 KB)
PICO Confirmation (Word 1467 KB)