This Determination is the Health Insurance (Gippsland
and South Eastern New South Wales Mobile MRI Service) Determination 2009.
This
Determination commences on 1 November 2009.
This Determination ceases to have effect at 23:59, 30 June
2011.
(1)
In this Determination, unless the contrary intention appears:
Act means the Health
Insurance Act 1973.
after hours means from 5pm on Mondays,
Tuesdays, Wednesdays and Thursdays to 9am on the following day, and from 5pm on
Fridays to 9am on Mondays.
Bega means Bega, New South Wales, 2250.
eligible provider means a specialist in
diagnostic radiology who has satisfied the Medicare Australia CEO that he or
she is a participant in the Royal Australian and New Zealand College of
Radiologists’ Quality and Accreditation Program.
funding agreement means the agreement
between the Department of Health and Ageing and Regional Imaging Pty Limited
[ABN 81 095 630 792] as in force on the day this Determination commences.
item means an item in the Schedule.
MRA means magnetic resonance angiography.
MRI means magnetic resonance imaging.
relevant service means a health service, as
defined in subsection 3C(8) of the Act, that is specified in the Schedule.
Schedule means the Schedule to this
Determination.
teleradiology means the electronic
transmission of radiological images in digital form from one location to
another using a data communication link provided by a third party carrier.
transition period means the period beginning on 1 November 2009 and
ending at 23.59, 30 June 2011.
Traralgon means Traralgon, Victoria, 3844.
Note Unless the
contrary intention appears, expressions used in this Determination have the
same meanings as in the Act—see section 13 of the Legislative
Instruments Act 2003.
(2)
For the avoidance of doubt, in this Determination:
(a)
a reference to the Act includes a reference to regulations made under
the Act; and
(b)
a reference to the National Health Act 1953 includes a reference
to regulations made under that Act; and
(c)
a reference to any legislation shall be construed as a reference to that
legislation as in force from time to time; and
(d)
a reference to the Health Insurance (Diagnostic Imaging Services
Table) Regulations 2009 is a reference to such regulations made pursuant to
section 4AA of the Act as are in force from time to time.
(1)
This Determination applies to a relevant service where the following
circumstances apply:
(a)
in respect of items 63002 to 63483, where the service is performed pursuant
to a request that is in accordance with subsection (2); and
(b)
where the service is performed pursuant to the funding agreement during
the transition period; and
(c)
where the service is performed in a permissible circumstance in accordance
with subsection (3), (4), (5), (6), (7) or (8); and
(d)
where the service is a service of a kind referred to in paragraph
10(2)(a) of the Act – the patient in respect of whom the service is provided is
charged a fee that is no more than 75% of the amount specified in the Schedule
as the fee applicable to the item that relates to the service; and
(e)
where the service is not a service to which paragraph (d) applies – the
patient in respect of whom the service is provided is charged a fee that is no
more than 85% of the amount specified in the Schedule as the fee applicable to
the item that relates to the service.
(2)
The request referred to in paragraph (1)(a) must:
(a)
be made by a practitioner who is a specialist, consultant physician or
dental practitioner; and
(b)
be made in writing; and
(c)
identify the clinical indications for the service.
Note: Subsection 16B(2) of the Act limits the
R-type diagnostic imaging services in respect of which a medicare benefit is
payable where the service is requested by a dental practitioner. See section 12
below.
(3)
For paragraph (1)(c), subject to subsection (4), a relevant service is
performed in a permissible circumstance if the service is performed in Bega and
it is:
(a)
performed under the professional supervision of an eligible provider who
is available to monitor and influence the conduct and diagnostic quality of the
examination via telephone and real-time teleradiology; and
(b)
reported by an eligible provider; and
(c)
monitored by a medical practitioner by personal attendance on the
patient if the circumstances are such as to require on-site monitoring by a
medical practitioner.
(4)
If subsection (3) is not complied with, a relevant service is performed
in a permissible circumstance if the service is performed in Bega and it is
performed in an emergency.
(5)
For paragraph (1)(c), subject to subsection (6), a relevant service is
performed in a permissible circumstance if the service is performed in Traralgon
during after hours and it is:
(a)
performed under the professional supervision of an eligible provider who
is available to monitor and influence the conduct and diagnostic quality of the
examination via telephone and real-time teleradiology; and
(b)
reported by an eligible provider; and
(c)
monitored by a medical practitioner by personal attendance on the
patient if the circumstances are such as to require on-site monitoring by a
medical practitioner; and
(d)
not a service to which items 63492 to 63495 are attributable.
(6)
If subsection (5) is not complied with, a relevant service is performed
in a permissible circumstance if the service is performed in Traralgon during
after hours and it is performed in an emergency.
(7)
For paragraph (1)(c), subject to subsection (8), a relevant service is
performed in a permissible circumstance if it is:
(a)
performed under the professional supervision of an eligible provider who
is available to monitor and influence the conduct and diagnostic quality of the
examination, including, if necessary, by personal attendance on the patient;
and
(b)
reported by an eligible provider.
(8)
If subsection (7) is not complied with, a relevant service is performed
in a permissible circumstance if it is performed:
(a)
in an emergency; or
(b)
because of medical necessity, in a remote location.
5A. Bulk billing incentive
(1) This rule
applies if:
(a) a service that is mentioned in an item in the Schedule is provided;
and
(b) the service is not provided in a hospital; and
(c) the service is bulk billed.
(2) The fee for the service is 95% of the fee mentioned in the Schedule for
the service.
(3) For subsection 10(2) of the Act, the benefit payable is the amount
calculated under subrule (2).
Note Under
regulation 6EF of the Health Insurance Regulations 1975, the medicare
benefit payable is 100% of the amount calculated under subrule (2).
A relevant service shall be treated as if:
(a)
it were both a professional service and a medical service for the
purposes of the provisions of the Act and the National Health Act 1953
that relate to professional and medical services; and
(b)
there was an item in the diagnostic imaging services table that related
to the relevant service and specified in respect of the service a fee in
relation to a State, being the fee specified in the Schedule in relation to the
State specified; and
(c)
the item specified in paragraph (b) was part of Group I5 of the
diagnostic imaging services table and of the relevant subgroup of Group I5 as
is specified in the Schedule.
Rule 37
of Part 2 of Schedule 1 of the Health Insurance (Diagnostic Imaging Services
Table) Regulations 2009 shall have effect as if the reference to “items
63001 to 63482” in that rule was a reference to “items 63002 to 63483” of the
Schedule.
Rule 39 of
Part 2 of Schedule 1 of the Health Insurance (Diagnostic Imaging Services
Table) Regulations 2009 shall have effect as if the references to the items
mentioned in column 1 of the table below (Existing references) include
references to the items mentioned in column 2 of the following table (Additional
references).
|
Existing references
|
Additional references
|
|
63040 to 63073
|
63041 to 63065
|
|
63101
|
63102
|
|
63125 to 63131
|
63126 to 63132
|
|
63161 to 63185
|
63163 to 63177
|
|
63219 to 63243
|
63220 to 63244
|
|
63271 to 63280
|
63272 to 63281
|
|
63322 to 63340
|
63323 to 63332
|
|
63361
|
63363
|
|
63385 to 63391
|
63386 to 63389
|
|
63401 and 63404
|
63402 and 63405
|
|
63416
|
63417
|
|
63425 and 63428
|
63426 and 63429
|
|
63461, 63464 and 63467
|
63463, 63466 and 63469
|
|
63482
|
63483
|
Rule 40 of
Part 2 of Schedule 1 of the Health Insurance (Diagnostic Imaging Services
Table) Regulations 2009 shall have effect as if:
(a)
the reference to item 63473 in subrule 40(1) was a reference to “item
63472, 63473 or 63475”;
(b)
the reference to item 63470 in subrule 40(2) was a reference to “item
63470, 63472 or 63475”;
(c)
there is an additional subrule 40(3) as follows “Item 63472 does not
apply to the service described in that item if the person to whom the service
is provided has previously been provided with that service or a service
described in items 63470, 63473 or 63475”; and
(d)
there is an additional subrule 40(4) as follows “Item 63475 does not
apply to the service described in that item if the person to whom the service
is provided has previously been provided with that service or a service
described in item 63470, 63472 or 63473”.
Item 63478
does not apply to the service described in that item if the person to whom the
service is provided has previously been provided with that service or a service
described in item 63476 of Part 3 of Schedule 1 of the Health Insurance
(Diagnostic Imaging Services Table) Regulations 2009.
Rule 41 of
Part 2 of Schedule 1 of the Health Insurance (Diagnostic Imaging Services
Table) Regulations 2009 shall have effect as if:
(a)
the reference to item 63491 in that rule was a reference to item 63492;
and
(b)
the references to item 63494 in that rule were references to item 63493;
and
(c)
the references to item 63497 in that rule were references to item 63495.
Regulation
10 of the Health Insurance Regulations 1975 shall have effect as if the paragraphs
of that regulation mentioned in column 1 of the table below (Existing references)
include references to the items mentioned in column 2 of the table below
(Additional references).
|
Existing references
|
Additional references
|
|
paragraph 10(1)(a)
|
63008, 63329
|
|
paragraph 10(1)(b)
|
63329
|
|
paragraph 10(1)(c)
|
63329
|
|
paragraph 10(1)(d)
|
63008, 63329
|
Schedule -
Specified health services
|
Item
|
Health Service
|
Fee for all
States
|
Relevant subgroup
of Group I5
|
|
63002
|
MRI — scan of head
(including MRA, if performed) for
tumour
of the brain or meninges (R) (Anaes.) (Contrast)
|
403.20
|
Subgroup
1 – Scan of head – for specified conditions
|
|
63005
|
MRI — scan of head
(including MRA, if performed) for
inflammation
of brain or meninges (R) (Anaes.) (Contrast)
|
403.20
|
Subgroup
1 – Scan of head – for specified conditions
|
|
63008
|
MRI — scan of head (including
MRA, if performed) for
skull
base or orbital tumour (R) (Anaes.) (Contrast)
|
403.20
|
Subgroup
1 – Scan of head – for specified conditions
|
|
63011
|
MRI — scan of head
(including MRA, if performed) for
stereotactic scan of brain,
with fiducials in place, for the
sole purpose of allowing
planning for stereotactic
neurosurgery
(R) (Anaes.) (Contrast)
|
336.00
|
Subgroup
1 – Scan of head – for specified conditions
|
|
63041
|
MRI — scan of head
(including MRA, if performed) for
acoustic neuroma (R) (Anaes.) (Contrast)
|
336.00
|
Subgroup
2 – Scan of head – for specified conditions
|
|
63042
|
MRI — scan of head
(including MRA, if performed) for
pituitary
tumour (R) (Anaes.) (Contrast)
|
358.40
|
Subgroup
2 – Scan of head – for specified conditions
|
|
63044
|
MRI — scan of head
(including MRA, if performed) for
toxic or metabolic or
ischaemic encephalopathy (R)
(Anaes.)
(Contrast)
|
403.20
|
Subgroup
2 – Scan of head – for specified conditions
|
|
63045
|
MRI — scan of head
(including MRA, if performed) for
demyelinating
disease of the brain (R) (Anaes.) (Contrast)
|
403.20
|
Subgroup
2 – Scan of head – for specified conditions
|
|
63047
|
MRI — scan of head
(including MRA, if performed) for
congenital malformation of
the brain or meninges (R)
(Anaes.)
(Contrast)
|
403.20
|
Subgroup
2 – Scan of head – for specified conditions
|
|
63048
|
MRI — scan of head
(including MRA, if performed) for
venous
sinus thrombosis (R) (Anaes.) (Contrast)
|
403.20
|
Subgroup
2 – Scan of head – for specified conditions
|
|
63051
|
MRI — scan of head
(including MRA, if performed) for
head
trauma (R) (Anaes.) (Contrast)
|
403.20
|
Subgroup
2 – Scan of head – for specified conditions
|
|
63054
|
MRI — scan of head
(including MRA, if performed) for
epilepsy
(R) (Anaes.) (Contrast)
|
403.20
|
Subgroup
2 – Scan of head – for specified conditions
|
|
63057
|
MRI — scan of head
(including MRA, if performed) for
stroke
(R) (Anaes.) (Contrast)
|
403.20
|
Subgroup
2 – Scan of head – for specified conditions
|
|
63060
|
MRI — scan of head
(including MRA, if performed) for
carotid or vertebral artery
dissection (R) (Anaes.)
(Contrast)
|
403.20
|
Subgroup
2 – Scan of head – for specified conditions
|
|
63063
|
MRI — scan of head
(including MRA, if performed) for
intracranial
aneurysm (R) (Anaes.) (Contrast)
|
403.20
|
Subgroup
2 – Scan of head – for specified conditions
|
63065
|
MRI — scan of head (including
MRA, if performed) for
intracranial
arteriovenous malformation (R) (Anaes.)
(Contrast)
|
403.20
|
Subgroup
2 – Scan of head – for specified conditions
|
|
63102
|
MRI and MRA of extracranial
or intracranial circulation
(or
both) — scan of head and neck vessels for stroke (R) (Anaes.) (Contrast)
|
492.80
|
Subgroup
3 – Scan of head and neck vessels – for specified conditions
|
|
63113
|
MRI
— scan of head and cervical spine (including MRA, if performed) for tumour of
the central nervous system or meninges (R) (Anaes.) (Contrast)
|
492.80
|
Subgroup
4 – Scan of head and cervical spine – for specified conditions
|
|
63116
|
MRI
— scan of head and cervical spine (including MRA, if performed) for
inflammation of the central nervous system or meninges (R) (Anaes.)
(Contrast)
|
492.80
|
Subgroup
4 – Scan of head and cervical spine – for specified conditions
|
|
63126
|
MRI
— scan of head and cervical spine (including MRA, if performed) for
demyelinating disease of the central nervous system (R) (Anaes.) (Contrast)
|
492.80
|
Subgroup
5 – Scan of head and cervical spine – for specified conditions
|
|
63129
|
MRI
— scan of head and cervical spine (including MRA, if performed) for
congenital malformation of the central nervous system or meninges (R)
(Anaes.) (Contrast)
|
492.80
|
Subgroup
5 – Scan of head and cervical spine – for specified conditions
|
|
63132
|
MRI
— scan of head and cervical spine (including MRA, if performed) for syrinx
(congenital or acquired) (R) (Anaes.) (Contrast)
|
492.80
|
Subgroup
5 – Scan of head and cervical spine – for specified conditions
|
|
63152
|
MRI — scan of 1 region or 2
contiguous regions of the
spine
for infection (R) (Anaes.) (Contrast)
|
358.40
|
Subgroup
6 – Scan of spine – 1 region or 2 contiguous regions – for specified
conditions
|
|
63155
|
MRI — scan of 1 region or 2
contiguous regions of the
spine
for tumour (R) (Anaes.) (Contrast)
|
358.40
|
Subgroup
6 – Scan of spine – 1 region or 2 contiguous regions – for specified
conditions
|
|
63163
|
MRI — scan of 1 region or 2
contiguous regions of the
spine
for demyelinating disease (R) (Anaes.) (Contrast)
|
358.40
|
Subgroup
7 – Scan of spine – 1 region or 2 contiguous regions – for specified
conditions
|
|
63165
|
MRI — scan of 1 region or 2
contiguous regions of the
spine
for congenital malformation of the spinal cord or the cauda equina or the
meninges (R) (Anaes.) (Contrast)
|
358.40
|
Subgroup
7 – Scan of spine – 1 region or 2 contiguous regions – for specified
conditions
|
|
63168
|
MRI — scan of 1 region or 2
contiguous regions of the
spine
for myelopathy (R) (Anaes.) (Contrast)
|
358.40
|
Subgroup
7 – Scan of spine – 1 region or 2 contiguous regions – for specified
conditions
|
|
63169
|
MRI — scan of 1 region or 2
contiguous regions of the
spine for syrinx
(congenital or acquired) (R) (Anaes.)
(Contrast)
|
358.40
|
Subgroup
7 – Scan of spine – 1 region or 2 contiguous regions – for specified
conditions
|
|
63171
|
MRI — scan of 1 region or 2
contiguous regions of the
spine
for cervical radiculopathy (R) (Anaes.) (Contrast)
|
358.40
|
Subgroup
7 – Scan of spine – 1 region or 2 contiguous regions – for specified
conditions
|
|
63172
|
MRI — scan of 1 region or 2
contiguous regions of the
spine
for sciatica (R) (Anaes.) (Contrast)
|
358.40
|
Subgroup
7 – Scan of spine – 1 region or 2 contiguous regions – for specified
conditions
|
|
63174
|
MRI — scan of 1 region or 2
contiguous regions of the
spine
for spinal canal stenosis (R) (Anaes.) (Contrast)
|
358.40
|
Subgroup
7 – Scan of spine – 1 region or 2 contiguous regions – for specified
conditions
|
|
63175
|
MRI — scan of 1 region or 2
contiguous regions of the
spine
for previous spinal surgery (R) (Anaes.) (Contrast)
|
358.40
|
Subgroup
7 – Scan of spine – 1 region or 2 contiguous regions – for specified
conditions
|
|
63177
|
MRI — scan of 1 region or 2
contiguous regions of the
spine
for trauma (R) (Anaes.)
|
358.40
|
Subgroup
7 – Scan of spine – 1 region or 2 contiguous regions – for specified
conditions
|
|
63202
|
MRI
— scan of 3 contiguous or 2 non-contiguous regions of the spine for infection
(R) (Anaes.) (Contrast)
|
448.00
|
Subgroup
8 – Scan of spine – 3 contiguous or 2 non-contiguous regions – for specified
conditions
|
|
63205
|
MRI
— scan of 3 contiguous or 2 non-contiguous regions of the spine for tumour
(R) (Anaes.) (Contrast)
|
448.00
|
Subgroup
8 – Scan of spine – 3 contiguous or 2 non-contiguous regions – for specified
conditions
|
|
63220
|
MRI
— scan of 3 contiguous or 2 non-contiguous regions of the spine for
demyelinating disease (R) (Anaes.) (Contrast)
|
448.00
|
Subgroup
9 – Scan of spine – 3 contiguous or 2 non-contiguous regions – for specified
conditions
|
|
63223
|
MRI
— scan of 3 contiguous or 2 non-contiguous regions of the spine for congenital
malformation of the spinal cord or the cauda equina or the meninges (R)
(Anaes.) (Contrast)
|
448.00
|
Subgroup
9 – Scan of spine – 3 contiguous or 2 non-contiguous regions – for specified
conditions
|
|
63224
|
MRI
— scan of 3 contiguous or 2 non-contiguous regions of the spine for
myelopathy (R) (Anaes.) (Contrast)
|
448.00
|
Subgroup
9 – Scan of spine – 3 contiguous or 2 non-contiguous regions – for specified
conditions
|
63226
|
MRI
— scan of 3 contiguous or 2 non-contiguous regions of the spine for syrinx (congenital
or acquired) (R) (Anaes.) (Contrast)
|
448.00
|
Subgroup
9 – Scan of spine – 3 contiguous or 2 non-contiguous regions – for specified
conditions
|
|
63227
|
MRI
— scan of 3 contiguous or 2 non-contiguous regions of the spine for cervical
radiculopathy (R) (Anaes.) (Contrast)
|
448.00
|
Subgroup
9 – Scan of spine – 3 contiguous or 2 non-contiguous regions – for specified
conditions
|
|
63229
|
MRI
— scan of 3 contiguous or 2 non-contiguous regions of the spine for sciatica
(R) (Anaes.) (Contrast)
|
448.00
|
Subgroup
9 – Scan of spine – 3 contiguous or 2 non-contiguous regions – for specified
conditions
|
|
63230
|
MRI
— scan of 3 contiguous or 2 non-contiguous regions of the spine for spinal
canal stenosis (R) (Anaes.) (Contrast)
|
448.00
|
Subgroup
9 – Scan of spine – 3 contiguous or 2 non-contiguous regions – for specified
conditions
|
|
63232
|
MRI
— scan of 3 contiguous or 2 non-contiguous regions of the spine for previous
spinal surgery (R) (Anaes.) (Contrast)
|
448.00
|
Subgroup
9 – Scan of spine – 3 contiguous or 2 non-contiguous regions – for specified
conditions
|
|
63244
|
MRI
— scan of 3 contiguous or 2 non-contiguous regions of the spine for trauma
(R) (Anaes.)
|
448.00
|
Subgroup
9 – Scan of spine – 3 contiguous or 2 non-contiguous regions – for specified
conditions
|
|
63272
|
MRI — Scan of cervical
spine and brachial plexus for
tumour
(R) (Anaes.) (Contrast)
|
492.80
|
Subgroup
10 – Scan of cervical spine and brachial plexus – for specified conditions
|
|
63275
|
MRI — Scan of cervical
spine and brachial plexus for
trauma
(R) (Anaes.) (Contrast)
|
492.80
|
Subgroup
10 – Scan of cervical spine and brachial plexus – for specified conditions
|
|
63278
|
MRI — Scan of cervical
spine and brachial plexus for
cervical
radiculopathy (R) (Anaes.) (Contrast)
|
492.80
|
Subgroup
10 – Scan of cervical spine and brachial plexus – for specified conditions
|
|
63281
|
MRI — Scan of cervical
spine and brachial plexus for
previous
surgery (R) (Anaes.) (Contrast)
|
492.80
|
Subgroup
10 – Scan of cervical spine and brachial plexus – for specified conditions
|
|
63302
|
MRI
— scan of musculoskeletal system for tumour arising in bone or
musculoskeletal system, excluding tumours arising in breast, prostate or
rectum (R) (Anaes.) (Contrast)
|
380.80
|
Subgroup
11 – Scan of musculoskeletal system – for specified conditions
|
63305
|
MRI — scan of musculoskeletal
system for infection
arising in bone or
musculoskeletal system, excluding
infection
arising in breast, prostate or rectum (R) (Anaes.) (Contrast)
|
380.80
|
Subgroup
11 – Scan of musculoskeletal system – for specified conditions
|
|
63308
|
MRI
— scan of musculoskeletal system for osteonecrosis (R) (Anaes.) (Contrast)
|
380.80
|
Subgroup
11 – Scan of musculoskeletal system – for specified conditions
|
|
63323
|
MRI
— scan of musculoskeletal system for derangement of hip or its supporting
structures (R) (Anaes.) (Contrast)
|
403.20
|
Subgroup
12 – Scan of musculoskeletal system – for specified conditions
|
|
63324
|
MRI
— scan of musculoskeletal system for derangement of shoulder or its
supporting structures (R) (Anaes.) (Contrast)
|
403.20
|
Subgroup
12 – Scan of musculoskeletal system – for specified conditions
|
|
63326
|
MRI
— scan of musculoskeletal system for derangement of knee or its supporting
structures (R) (Anaes.) (Contrast)
|
403.20
|
Subgroup
12 – Scan of musculoskeletal system – for specified conditions
|
|
63327
|
MRI
— scan of musculoskeletal system for derangement of ankle or foot (or both)
or its supporting structures (R) (Anaes.) (Contrast)
|
403.20
|
Subgroup
12 – Scan of musculoskeletal system – for specified conditions
|
|
63329
|
MRI
— scan of musculoskeletal system for derangement of 1 or both
temporomandibular joints or their supporting structures (R) (Anaes.)
(Contrast)
|
336.00
|
Subgroup
12 – Scan of musculoskeletal system – for specified conditions
|
|
63330
|
MRI
— scan of musculoskeletal system for derangement of wrist or hand (or both)
or its supporting structures (R) (Anaes.) (Contrast)
|
448.00
|
Subgroup
12 – Scan of musculoskeletal system – for specified conditions
|
|
63332
|
MRI
— scan of musculoskeletal system for derangement of elbow or its supporting
structures (R) (Anaes.) (Contrast)
|
403.20
|
Subgroup
12 – Scan of musculoskeletal system – for specified conditions
|
|
63363
|
MRI — scan of
musculoskeletal system for Gaucher
disease
(R) (Anaes.)
|
403.20
|
Subgroup
13 – Scan of musculoskeletal system – for specified conditions
|
|
63386
|
MRI — scan of cardiovascular
system for congenital
disease of the heart or a
great vessel (R) (Anaes.)
(Contrast)
|
448.00
|
Subgroup
14 – Scan of cardiovascular system – for specified conditions
|
|
63387
|
MRI — scan of
cardiovascular system for tumour of the
heart
or a great vessel (R) (Anaes.) (Contrast)
|
448.00
|
Subgroup
14 – Scan of cardiovascular system – for specified conditions
|
|
63389
|
MRI
— scan of cardiovascular system for abnormality of thoracic aorta (R)
(Anaes.) (Contrast)
|
403.20
|
Subgroup
14 – Scan of cardiovascular system – for specified conditions
|
|
63402
|
MRA — if the request for
the scan specifically identifies the clinical indication for the scan — scan
of
cardiovascular
system for vascular abnormality in a patient with a previous anaphylactic
reaction to an iodinated contrast medium (R) (Anaes.) (Contrast)
|
403.20
|
Subgroup
15 – Magnetic resonance angiography – scan of cardiovascular system – for
specified conditions
|
|
63405
|
MRA — if the request for
the scan specifically identifies the clinical indication for the scan — scan
of
cardiovascular system for
obstruction of the superior vena cava, inferior vena cava or a major pelvic
vein (R)
(Anaes.)
(Contrast)
|
403.20
|
Subgroup
15 – Magnetic resonance angiography – scan of cardiovascular system – for
specified conditions
|
|
63417
|
MRA — scan of person under
the age of 16 for the
vasculature
of limbs prior to limb or digit transfer surgery in congenital limb
deficiency syndrome (R) (Anaes.) (Contrast)
|
403.20
|
Subgroup
16 – Magnetic resonance angiography – for specified conditions – person under
the age of 16 years
|
|
63426
|
MRI — scan of person under
the age of 16 for
post-inflammatory or
post-traumatic physeal fusion (R)
(Anaes.)
|
403.20
|
Subgroup
17 – Magnetic resonance imaging – for specified conditions – person under the
age of 16 years
|
|
63429
|
MRI — scan of person under
the age of 16 for Gaucher
disease
(R) (Anaes.)
|
403.20
|
Subgroup
17 – Magnetic resonance imaging – for specified conditions – person under the
age of 16 years
|
|
63441
|
MRI — scan of person under
the age of 16 for pelvic or
abdominal
mass (R) (Anaes.) (Contrast)
|
403.20
|
Subgroup
18 – Magnetic resonance imaging – for specified conditions – person under the
age of 16 years
|
|
63442
|
MRI
— scan of person under the age of 16 for mediastinal mass (R) (Anaes.)
(Contrast)
|
403.20
|
Subgroup
18 – Magnetic resonance imaging – for specified conditions – person under the
age of 16 years
|
|
63444
|
MRI
— scan of person under the age of 16 for congenital uterine or anorectal
abnormality (R) (Anaes.) (Contrast)
|
403.20
|
Subgroup
18 – Magnetic resonance imaging – for specified conditions – person under the
age of 16 years
|
|
63463
|
MRI
— scan of the body for adrenal mass in a patient with a malignancy that is
otherwise resectable (R) (Anaes.)
|
358.40
|
Subgroup
19 – Scan of body – for specified conditions
|
|
63466
|
MRI – scan of both breasts
for the detection of cancer, if a dedicated breast coil is used, the request
for the scan identifies that the woman is asymptomatic and is less than 50
years of age, and the request for the scan identifies:
(a)
that the patient is at high risk of developing breast cancer due to 1 of
the following:
(i) 3 or more first or second degree
relatives on the same side of the family diagnosed with breast or ovarian
cancer;
(ii) 2 or more first or second degree
relatives on the same side of the family diagnosed with breast or ovarian
cancer, if any of the following applies to at least 1 of the relatives:
(A) has been diagnosed with bilateral
breast cancer:
(B) had onset of breast cancer before the age
of 40 years;
(C) had onset of ovarian cancer before
the age of 50 years;
(D)
has been diagnosed with breast and ovarian cancer, at the same time or at
different times;
(E)
has Ashkenazi Jewish ancestry;
(F)
is a male relative who has had breast cancer;
(iii) 1 first or second degree relative
diagnosed with breast cancer at age 45 years or younger plus another first
or second degree relative on the same side of the family with bone or soft
tissue sarcoma at age 45 years or younger; or
(b)
that genetic testing has identified the presence of a high risk breast
cancer gene mutation.
(R)
(Anaes)
|
690.00
|
Subgroup
19 – Scan of body – for specified conditions
|
|
63469
|
MRI – scan of both
breasts for the detection of cancer, if:
(a) a dedicated
breast coil is used: and
(b) the woman has
had an abnormality detected as a result of a service described in item 63464 or
63466 performed in the previous 12 months
(R) (Anaes)
|
690.00
|
Subgroup
19 – Scan of body – for specified conditions
|
|
63472
|
MRI
— scan of the pelvis for the staging of histologically diagnosed cervical
cancer at FIGO stages 1B or greater, if the request for scan identifies that:
(a) a histological
diagnosis of carcinoma of the cervix has been made; and
(b) the patient has been diagnosed with
cervical
cancer
at FIGO stage 1B or greater.
(R)
(Anaes.) (Contrast)
|
403.20
|
Subgroup
20 – Scan of pelvis and upper abdomen – for specified conditions
|
|
63475
|
MRI
— scan of the pelvis and upper abdomen, in a single examination, for the
staging of histologically diagnosed cervical cancer at FIGO stage 1B or
greater, if the request for scan identifies that:
(a) a histological
diagnosis of carcinoma of the cervix has been made; and
(b) the patient has been diagnosed with cervical cancer at FIGO stage 1B
or greater.
(R) (Anaes.) (Contrast)
|
627.20
|
Subgroup
20 – Scan of pelvis and upper abdomen – for specified conditions
|
|
63478
|
MRI
— scan of the pelvis for the initial staging of rectal cancer, if:
(a)
a phased array body coil is used; and
(b)
the request for scan identifies that the indication is for the initial
staging of rectal cancer (including cancer of the rectosigmoid and
anorectum).
(R)
(Anaes.) (Contrast)
|
403.20
|
Subgroup
20 – Scan of pelvis and upper abdomen – for specified conditions
|
|
63483
|
MRI — scan of pancreas and
biliary tree for suspected
biliary
or pancreatic pathology (R) (Anaes.)
|
403.20
|
Subgroup
21 – Scan of body – for specified conditions
|
|
63492
|
MRI or MRA service to which
an item in this Group
(other than an item in this
Subgroup) applies if:
(a) the item for the
service includes in its description
‘(Contrast)’; and
(b)
the service is performed using a contrast agent
|
44.80
|
Subgroup
22 – Modifying items
|
|
63493
|
MRI or MRA service to which
an item in this Group
(other than an item in this
Subgroup) applies if
the service is performed on
a person using
intravenous
or intra muscular sedation
|
44.80
|
Subgroup
22 – Modifying items
|
|
63495
|
MRI or MRA service to which
an item in this Group
(other than an item in this
Subgroup) applies if
the service is performed on
a person under
anaesthetic in the presence
of a medical practitioner
who
is qualified to perform an anaesthetic
|
156.80
|
Subgroup
22 – Modifying items
|
Note Section
3C (7) of the Act deems an internal Territory to form part of the State of New
South Wales.