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New MBS Item for BNP Testing

Clinical Utility of BNP Testing

B-type natriuretic peptides (BNP) are primarily synthesised and released by the heart's ventricles in response to ventricular stretch and pressure overload, reflecting myocardial wall tension. This makes BNP an important biomarker for the diagnosis, evaluation, and management of heart failure. It is particularly useful for distinguishing heart failure from other causes of dyspnoea.

  • Laboratory Diagnostics

    Two forms of the test are available: BNP and N-terminal proBNP (NT-proBNP). The precursor protein, ProBNP, is cleaved into BNP and the inactive NT-proBNP.

    Elevated levels of BNP or NT-proBNP correlate with the severity of heart failure and may indicate the need for further diagnostic evaluation. NT-proBNP is stable for 3 days in serum and is typically analysed in central laboratories. In contrast, BNP is often used as a point-of-care test.

    In our laboratories, an NT-proBNP level of less than 125 ng/L makes a diagnosis of congestive heart failure unlikely.

  • Additional MBS Items

    Several other MBS items are available for BNP or NTproBNP testing in the diagnosis of heart failure, each with specific restrictions:

    • 66830: Quantitation of BNP or NT-proBNP for the diagnosis of heart failure in patients presenting with dyspnoea to a hospital Emergency Department. This test is available up to six times within a 12-month period.
    • 66585: Quantification of laboratory-based BNP or NT-proBNP testing in a patient with systemic sclerosis (scleroderma) to assess risk of pulmonary arterial hypertension. Maximum of 2 tests in a 12-month period.
    • 66586: Quantification of BNP or NT-proBNP testing in a patient with diagnosed pulmonary arterial hypertension to monitor for disease progression. Applicable 4 times in any 12-month period.

  • How to Order BNP Testing

    Request Form Instructions:

    • Use the Clinical Labs general pathology request form to order NT-proBNP.

    Important Clinical Notes Requirement:

    • In the Clinical Notes section, please specify the reasons the patient requires the test to meet Medicare eligibility criteria. If the patient does not meet the eligibility criteria, they will receive an invoice for payment.

    Test Cost:

    • The test is bulk-billed, subject to Medicare eligibility criteria. If the patient does not meet the MBS criteria or exceeds the testing allowance for each item, the test can still be ordered, but the patient will receive a bill for the test.

About the Author

Dr David Deam

Dr David Deam

MBBS MAACB FRCPA

Dr David Deam

MBBS MAACB FRCPA
Location: Clayton (VIC)
Speciality: Chemical Pathology
Areas of Interest:
  • endocrine function testing
  • laboratory automation
  • protein abnormalities
About

Dr Deam graduated with Honours in Medicine from Monash University in 1978 and obtained his FRCPA in 1985 following postgraduate training in Biochemistry at the Royal Melbourne Hospital. After several posts in Chemical Pathology at the Royal Melbourne Hospital and the Royal Women’s Hospital, he was appointed Head of Chemical Pathology at the Royal Melbourne in 1996. He joined Gribbles Pathology (now Australian Clinical Labs) in 1998.

Dr Deam has played an active role in teaching scientific, nursing and medical staff at both undergraduate and postgraduate levels and has been an examiner for the Australasian Association of Clinical Biochemists as well as the Royal College of Pathologists of Australasia.

Dr Deam’s research interests and publications include work on thyroid function testing, various aspects of diagnostic protein measurement and the rational use of biochemical tests. His special interests include testing of endocrine function; protein abnormalities; as well as laboratory automation and application of computing to pathology services.