BNP Listed on the Medicare Schedule

The Medical Services Advisory Committee (MSAC) has considered the safety, effectiveness and cost effectiveness of the use of assays of brain natriuretic peptides (BNP) in the diagnosis of heart failure in patients presenting with dyspnoea in the hospital emergency setting. From November 1st 2007 BNP will be included in the Medicare Benefits Schedule book with the following item number and schedule fee

BNP is a cardiac neurohormone synthesized in ventricular myocardium and released upon stimulation by a change in left ventricular wall stretch and volume overload. As such, BNP may be a more sensitive and specific marker of ventricular disorders than other members of the natriuretic peptide family. BNP functions in natiuresis, vasodilation, reninangiotensin- aldosterone system (RAAS) inhibition, and sympathetic nerve activity inhibition. The measurement and interpretation of levels of circulating BNP are accepted as a tool in differentiating dyspnea due to HF from that due to other causes in an emergent setting.

Algorithms are now employed that include BNP tests and their results, along with other clinical test results, as part of the diagnosis of HF. An adaption of an algorithm developed by Maisel is clinically useful for patients presenting with dyspnea to the Emergency Department.

BNP Algorithm Poster [pdf]

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