A new MBS item will be introduced on 1 November for the diagnosis of neuromyelitis optica spectrum disorder (NMOSD) or myelin oligodendrocyte glycoprotein antibody-related demyelination (MARD).

The new item 71175 will cover concurrent testing for the detection of anti-aquaporin-4 and anti-myelin oligodendrocyte glycoprotein antibodies (MOG-Abs) for the differential diagnosis of NMOSD and MARD. It will exclude the use of these antibody tests for disease monitoring in either condition.

The item, with a proposed fee of $50 will be for patients suspected of having NMOSD, or MARD, with:

• Recurrent, bilateral or severe optic neuritis; or
• Recurrent longitudinal extensive transverse myelitis (LETM)a; or
• Area postrema syndrome (otherwise unexplained hiccups or nausea/vomiting) or
• Acute brainstem syndrome or
• Symptomatic narcolepsy or acute diencephalic clinical syndrome with typical NMOSD MRI lesions or
• Symptomatic cerebral syndrome with typical NMOSD MRI lesions or
• Monophasic neuromyelitis optica (no recurrence; simultaneous or closely related optic neuritis and LETM within 30 days); or
• Acute disseminated encephalomyelitis; or
• Aseptic meningitis and encephalomyelitis; or
• Patient has poor recovery from multiple sclerosis relapses

According to the Medicare Services Advisory Committee (MSAC), the listing of tests that could provide a correct diagnosis was important because some MS treatments were harmful to people who have NMOSD or MARD, and vice versa.

“These antibody tests allow a doctor to make a more accurate diagnosis and start treating the patient with the correct medicines earlier,” it said.

This test looks for two types of antibodies: aquaporin-4 antibodies, which indicate that the person has NMOSD; and MOG antibodies, which indicate that the person has MARD. MSAC noted that this test looks for the two types of antibodies at the same time, which gives an answer faster and is more cost-effective than doing one test after another. MSAC noted that the tests are already being done under a generic antibody-testing MBS item number. This application was for a specific MBS item number that has a more appropriate fee.