(ii) the fee applicable for each item.
(a) a medicare benefit is payable to a person in
relation to the service; and
(b) under an agreement entered into under
section 20A of the Act:
(i) the person assigns to the eligible
provider by whom, or on whose behalf, the service is provided, his or her right
to the payment of the medicare benefit; and
(ii) the eligible provider accepts the
assignment in full payment of his or her fee for the service provided.
(h) x-ray.
(a) using a detector coupled to an x‑ray
tube that emits a finely collimated x‑ray beam as it rotates within a
gantry around a patient either in incremental or helical manner; and
(b) registering a resulting variable amount of x‑rays
and transforming that information into a cross‑sectional image after the
application of complex algorithms.
(e) a generator.
(iii) Part 3 of the general
medical services table; and
(b) in a reference immediately followed by a
number — the item so numbered.
A reference by number to any of items 11240, 11603 to 11612,
30361 and 30488 is a reference to the item so numbered in the general
medical services table.
(a) a hospital that provides a radiology or
computed tomography service under the direction of a specialist in the
specialty of diagnostic radiology; or
(b) a free‑standing radiology or computed
tomography facility under the direction of a specialist in the specialty of
diagnostic radiology.
(2) A reference to a Group in the table
includes every item in the Group and a reference to a Subgroup in the table
includes every item in the Subgroup.
(3) A reference to a diagnostic imaging
service in an item in Part 3 includes a reference to the undertaking
of the diagnostic imaging procedure used for rendering the service.
(ii) provides the service under the
supervision of a medical practitioner in accordance with accepted medical
practice.
(1) An item in Part 3 (except an item to which
subrule (2) applies) applies only if the providing practitioner gives a
report of the service performed to the practitioner who requested the service.
(a) items 55054, 55130, 55135, 55848, 55850,
57341, 57345, 59312, 59314, 60506, 60509 and 61109, being items of services
performed in conjunction with a surgical procedure;
(b) items 60918 and 60927, being items of service
performed in preparation for a radiological procedure.
Items 55028 to 55854 (except items 55600
and 55603) apply to an ultrasound service only if the service is performed:
(b) by a registered sonographer on behalf of a
medical practitioner.
(1) Items 55028 to 55854 (except items 55600
and 55603), if marked with the symbol (R), apply to an
ultrasound service (the eligible service) only if the service is
performed:
(a) under the professional supervision of a
specialist or a consultant physician in the practice of his or her specialty
who is available:
(i) to monitor and influence the
conduct and diagnostic quality of the examination; and
(ii) if necessary, to attend on the
patient personally; or
(i) is not a specialist or consultant
physician; and
(iii) is available to monitor and
influence the conduct and diagnostic quality of the examination and, if
necessary, to attend on the patient personally; or
(c) in the circumstance mentioned in subrule (3),
and under the professional supervision of a practitioner who is available:
(i) to monitor and influence the
conduct and diagnostic quality of the examination; and
(ii) if necessary, to attend on the
patient personally; or
(ii) in a location that is not less
than 30 kilometres by the most direct road route from another practice
where services that comply with paragraph (a) or (b) are available.
(2) For subparagraph (1) (b) (ii),
the requirement is that, between 1 September 1997 and 31 August 1999, at
least 50 services were rendered by or on behalf of the practitioner at the
location where the eligible service was rendered, and the rendering of those
services entitled payment of medicare benefits.
(3) For paragraph (1) (c), the circumstance is
that, between 1 September 1997 and 31 August 1999, at least 50 services
were rendered in nursing homes or patients’ residences by or on behalf of the
practitioner, and the rendering of those services entitled payment of medicare
benefits.
(3) The date from which the age of equipment
is worked out for this rule is:
(a) the date that the equipment was first
installed in Australia; or
(b) if the equipment was imported as used
equipment — the date of manufacture of the oldest component of the
equipment.
(1) For NR‑type diagnostic imaging
services described in any of items 55700 to 55774, the specified fee for no
more than 3 services provided to the same patient in any 1 pregnancy
applies.
(2) For any patient, items 55706, 55707,
55708, 55709, 55718, 55723, 55759, 55762, 55768 and 55770 are applicable not
more than once in a pregnancy.
Items 55712, 55721, 55764 and 55772 apply
to a service for which a referral is given by a medical practitioner who has
obstetric privileges at a non‑metropolitan hospital only if the words
‘non‑metropolitan obstetric privileges’ are specified on the referral
form.
For items 55800 to 55854, the fee
applicable for the item includes any views of another part of the patient taken
for comparison purposes.
Items 55800 to 55854 apply only to an
ultrasound service performed using an ultrasound system that has available on‑site
a transducer capable of operation at a frequency of at least 7.5 MHz.
(a) for CT equipment that was first installed
and used as new equipment at a site in Australia:
(i) the service was rendered earlier
than 10 years after the earliest date on which any component of the equipment
was first installed and ready for use; or
(ii) the service was performed in a
remote location; or
(i) the service was rendered earlier
than 10 years after the earliest date of manufacture of any component of
the equipment; or
(ii) the service was rendered in a
remote location.
(a) for CT equipment that was first installed
and used as new equipment in Australia — the earliest date on which any
component of the equipment was first installed and ready for use; or
(b) for CT equipment imported as pre‑used
equipment — the earliest date of manufacture of any component of the
equipment.
(1) Subject to subrule (2), items 56001
to 57356 apply only to a CT service that is:
(a) performed
under the professional supervision of a specialist in the specialty of
diagnostic radiology who is available:
(i) to monitor and influence the
conduct and diagnostic quality of the examination; and
(ii) if necessary, to attend on the
patient personally; and
(b) reported by a specialist in the specialty of
diagnostic radiology.
(2) Items 56001 to 57360
apply to a CT service that fails to comply with subrule (1) if the service
is performed:
20 CT services — exclusion of
attenuation correction and anatomical correlation
Items 56001 to 57356 do not apply to a CT
service that is performed for the purpose of attenuation correction or
anatomical correlation of another diagnostic imaging procedure.
If an axial scan is performed for the
exclusion of acoustic neuroma, item 56001 or 56007 applies instead of any other
item in this table that might be taken to apply to the service.
(1) If the service described in item 56007 or
56047 is used for the assessment of a headache of a patient to whom this rule
applies, the fee mentioned in the item applies only if:
(a) a scan without intravenous contrast medium
has been performed on the patient; and
(b) the service is required because the result of
the scan is abnormal.
(d) has no history of malignancy or
immunosuppression.
Items 56220 to 56240 and 56619 to 56665
apply once only for a service described in any of those items, regardless of
the number of patient attendances required to complete the service.
Items
59300 to 59318 apply only to a mammography service performed:
(a) under the professional supervision of a
specialist in the specialty of diagnostic radiology who is available:
(i) to monitor and influence the
conduct and diagnostic quality of the examination; and
(ii) if necessary, to attend on the
patient personally; or
(ii) because of medical necessity, in a
remote location.
Items 60918 and 60927 apply only to the
preparation of a patient for a radiological procedure for a service to which
any of items 59903 to 59974 apply by:
(b) removing fluid and replacing it with air,
oxygen or other contrast media; or
(c) a similar
method.
(a) the performance of the service does not
involve the use of positron‑emission radio‑isotopes or a PET
scanner; and
(i) by
a specialist or consultant physician whose name is included in a register,
given to the Medicare Australia CEO by the JNMCAC, of participants in the Joint
Nuclear Medicine Specialist Credentialling Program of the JNMCAC; or
(ii) by a
person acting on behalf of a specialist or consultant physician mentioned in
subparagraph (i); and
(c) the final report of the service is compiled
by the specialist or consultant physician who performed the preliminary
examination of the patient and the estimation and administration of the dosage
of radiopharmaceuticals.
(1) Items 61523
to 61613 apply only if the service is performed on a person:
(a) at the written request of a specialist or
consultant physician (the requesting practitioner) if:
(i) the person is the requesting practitioner’s
patient; and
(ii) the requesting practitioner
decides that the service is necessary; and
(c) in accordance with rules 27B and 27C.
(2) Also, the items apply only if the owner or
operator of the equipment used to perform the service is not in breach of rule 27D.
27B PET nuclear scanning services —
performance under personal supervision
(1) For rule 27A, the service must be
performed on a person by or under the personal supervision of:
(a) a credentialled specialist other than the
requesting practitioner; or
(b) a medical practitioner other than the
requesting practitioner if the medical practitioner:
(ii) has reported 400 or more studies
forming part of PET services for which a medicare benefit was payable; and
(iii) is authorised under State or
Territory law to prescribe and administer to humans the PET
radiopharmaceuticals that are to be administered to the person.
For rule
27A, the service must be performed on a person using equipment that meets the
following requirements:
(1) The owner or operator mentioned in subrule 27A (2)
must have given a statutory declaration to the Medicare Australia CEO that includes
the following information:
(a) whether the owner or operator is a
credentialled specialist or a medical practitioner who satisfies the
requirements mentioned in subparagraphs 27B (1) (b) (i) to (iii);
(b) whether the place where the owner or operator
provides the service is an accredited site in a comprehensive facility;
(c) whether the equipment meets the requirements
mentioned in rule 27C;
(e) the provider number for the facility given
by the Medicare Australia CEO;
(f) the location specific practice number for
the facility given by the Minister;
(g) the models, serial numbers and manufacturers
of the equipment.
(2) If the matters declared in the statutory declaration
change, the owner or operator must give the Medicare Australia CEO written
notice of the change as soon as the owner or operator knows about the change.
(a) a service that is mentioned in an item in
Groups I1 to I5 of this table is provided; and
(c) the service is bulk‑billed.
(2) The fee for the service is 95% of the fee
mentioned in this table for the service.
(3) For
subsection 10 (2) of the Act, the benefit payable is the amount calculated
under subrule (2).
(4) This rule does not apply to the service
specified in item 61369.
(1) If a medical practitioner provides 2 or
more vascular ultrasound services for the same patient on the same day, the
fees specified for the items that apply to the services are affected as
follows:
(b) any other fee, except the highest, is reduced
by 50%.
(a) if 2 or more applicable fees are equally the
highest, one only of those fees is taken to be the highest fee; and
(b) if paragraph (a) applies — the other, or
another, highest fee is taken to be the second highest fee; and
(c) if 2 or more fees are equally second
highest, any 1 of those fees may be taken to be the second highest for the
purpose of paragraph (1) (b); and
(d) if a reduced fee calculated under subrule (1)
is not a multiple of 5 cents, the reduced fee is taken to be the nearest amount
that is a multiple of 5 cents.
(3) This rule does not apply to the fee
specified in item 64990 or 64991.
(1) If a medical practitioner renders 2 or
more diagnostic imaging services for the same patient on the same day, the fees
set out in the items that apply to the services, other than the item with the
highest fee, are reduced by $5.
(2) If a
medical practitioner renders at least 1 R‑type diagnostic imaging service
and at least 1 consultation service for the same patient on the same day, the
highest fee, set out in the items that apply to diagnostic imaging services
rendered by the practitioner for that patient on that day, is reduced:
(a) if the fee for the relevant consultation is
at least $40 — by $35; or
(b) if that fee is less than $40 but more than
$15 — by $15; or
(c) if that fee is less than $15 — by the
amount of that fee.
(3) For subrule (2), if more than 1
consultation has occurred, the relevant consultation is the consultation having
the highest fee set out in the items that apply to the consultation.
(4) If a
medical practitioner renders at least 1 R‑type diagnostic imaging service
and at least 1 non‑consultation service for the same patient on the same
day, the highest fee that applies to any diagnostic imaging services performed
by the medical practitioner for the same patient on the same day, is reduced
by $5.
(5) If a medical practitioner renders an R‑type
diagnostic imaging service, a consultation and a non‑consultation service
for the same patient on the same day, the sum of the reductions under subrules
(2) and (4) must not exceed the highest fee that applies to any diagnostic
imaging services rendered by the medical practitioner for the same patient on
the same day.
(6) Rules 29 and 38 apply, subject to subrules
(7) and (8), in addition to this rule.
(a) 2 or more vascular ultrasound services for
the same patient on the same day; and
(b) 1 or more other diagnostic imaging services
for that patient on that day;
the amount of the fees payable for the vascular ultrasound services
is taken, for this rule, to be an amount payable for 1 diagnostic imaging
service.
(a) 2 or more MRI services described in Subgroup
12 or 13 of Group I5 in this table for the same patient on the same day;
and
(b) 1 or more other diagnostic imaging services
for that patient on that day;
the amount of the fees payable for the MRI services is taken, for
this rule, to be an amount payable for 1 diagnostic imaging service.
(9) This rule does not apply to diagnostic
imaging services that are rendered in a remote area by a medical practitioner
for whom a remote area exemption under section 23DX of the Act is in force for
that area.
(10) This rule does not apply to the fee
specified in item 59103, 64990 or 64991.
(1) Subject to subrules (2), (2A) and
(2B), items 63001 to 63482 apply only to an MRI or MRA service performed:
(a) at the request of a specialist or consultant
physician, made in accordance with rule 32; and
(b) in a permissible circumstance, in accordance
with rule 31; and
(c) with eligible equipment, in accordance with
rule 33 or 35.
(2) If a
service described in an item mentioned in subrule (1) is performed with
eligible equipment described in paragraph 36 (1) (c) or (d), the
item for the service applies only if the service is bulk‑billed for the
fee for the service.
(2A) If a service described in an item mentioned
in subrule (1) is performed with eligible equipment described in paragraph 36 (1) (e),
the item for the service applies only if:
(a) for a service performed on a concessional
beneficiary — the service is bulk‑billed; or
(b) for a service performed on a person who is
not a concessional beneficiary — the medical expenses incurred by the
person for the service are not more than the fee specified for the item.
(2B) If a service described
in an item mentioned in subrule (1) is performed with eligible equipment
described in paragraph 36 (1) (f), the item for the service
applies only if:
(a) for a service performed on a concessional
beneficiary or a child under 16 — the maximum charge is the sum of the medicare
benefit and any private health insurance benefit payable for the service; and
(b) all the
conditions of the agreement, mentioned in the following table, that applies to
the eligible equipment are met.
(a) a person who is the holder of a seniors
health card, a health care card or a pensioner concession card under the Social
Security Act 1991; or
(b) a person (other than the holder of the card)
whose name is included in a card mentioned in paragraph (a).
Items 63001 to 63482 apply only to a
service for which the request:
(b) identified the clinical indications for the
service.
(i) 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
(ii) because of medical necessity, in a
remote location.
(i) that is registered under the
scheme, administered
by the Department, titled ‘MRI Additional Units Eligibility Scheme’, as in
force on 27 June 2001; and
(ii) for which the registration has not
been cancelled or otherwise ceased to have effect; or
(i) that
is registered under the scheme, administered by the Department, titled ‘2004
MRI Additional Units Eligibility Scheme’, as in force on 29 November 2004;
and
(ii) for which the registration has not
been cancelled or otherwise ceased to have effect; or
(i) is situated in the radiology
department at a location specified in column 2 of an item in Table 1; and
(ii) is described in columns 3 and 4 of
that item by reference to the manufacturer, scanner model and magnet strength;
or
(i) is situated in a location
specified in column 2 of an item in Table 2; and
(ii) is described in columns 3 and 4 of
that item by reference to the manufacturer, scanner model and magnet strength;
and
(iii) forms part of a comprehensive
radiology department that provides x‑ray, computed tomography and
ultrasound services; and
(A) from 9 am to 5 pm,
Monday to Friday, excluding public holidays, for the provision of routine
services; and
(e) the Siemens Symphony equipment situated at
Orana Radiology, 168‑172 Brisbane Street, Dubbo, NSW 2830 that:
(ii) forms part of a comprehensive
radiology department that provides x‑ray, computed tomography and
ultrasound services; and
(iii) except
for periods reasonably required for maintenance, repairs and upgrades, is
available for use:
(A) from 9 am to 5 pm,
Monday to Friday, excluding public holidays, for the provision of routine
services; and
(B) at all times for the
provision of emergency services; or
(i) is situated in a location
specified in column 2 of an item in Table 3; and
(ii) is described in columns 3 and 4 of
that item by reference to the manufacturer, scanner model and magnet strength;
and
(iii) forms part of a comprehensive
radiology department, or a medical practice, that provides x‑ray,
computed tomography and ultrasound services; and
(iv) except
for periods reasonably required for maintenance, repairs and upgrades, is
available for use at least from 9 am to 5 pm, Monday to Friday,
excluding public holidays.
(a) a medical practice conducted by a group of
practitioners within the meaning of subsection 16A (9) or (10) of the Act
or by a sole practitioner; or
(1) If an MRI service described in an item in
Subgroup 1, 2, 4, 5 or 14 of Group I5 in this table, and an MRA
service described in an item in Subgroup 3 or 15 of that Group, are provided to
the same person on the same day, only the fee specified in the item in Subgroup
1, 2, 4, 5 or 14 applies to the services.
(2) If a medical practitioner provides 2 or
more MRI services described in Subgroup 12 or 13 of Group I5 in this table for
the same patient on the same day, the fees specified for the items that apply
to the services, other than the item with the highest fee, are reduced by 50%.
(a) if 2 or more applicable fees are equally the
highest, 1 only of those fees is taken to be the highest fee; and
(b) if a reduced fee calculated under subrule (2)
is not a multiple of 5 cents, the reduced fee is taken to be the nearest amount
that is a multiple of 5 cents.
39 MRI or MRA services — related
services that can be claimed in a 12 month period
(1) An MRI or MRA item mentioned in column 2
of the table in subrule (2) does not apply to the service described in
that item if the service is provided to a person who, in the 12 months before
the service, has been provided with the maximum number of those services
mentioned in column 3 of the table for that item.
(1) Item 63470 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 63473.
(2) Item 63473 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.
(1) Subject to subrules (2), (3) and (4), if
item 63491, 63494 or 63497 applies to an MRI or MRA service, the
fee specified in that item applies in addition to the fee specified in the
other item in Group I5 of this table that applies to the service.
(2) If 2 or more MRI or MRA services described
in item 63494 are performed for a person on the same day, the fee
specified in that item applies to 1 of those services only.
(3) If 2 or more MRI or MRA services described
in item 63497 are performed for a person on the same day, the fee specified in
that item applies to 1 of those services only.
(a) 1 or more MRI or MRA services described in
item 63494; and
are performed for a person on the same day, the fee specified in
item 63494 or item 63497, but not both those items, applies to 1 of those
services only.
(1) If the diagnostic imaging service
described in item 64991 is provided to a person, either that item or item 64990,
but not both those items, applies to the service.
(2) If item 64990 or 64991 applies to a
diagnostic imaging service, the fee specified in that item applies in addition
to the fee specified in any other item in this table that applies to the
service.
(a) is provided to a person by, or on behalf of,
a medical practitioner, being a medical practitioner who is not a consultant
physician, or specialist, in any speciality (other than a medical practitioner
who is, for the Act, both a general practitioner and a consultant physician, or
specialist, in a particular speciality); and
(b) has not been referred to the medical
practitioner by another medical practitioner or person with referring rights.
|
Item
|
Diagnostic imaging service
|
Fee ($)
|
|
Group I1 — Ultrasound
|
|
Subgroup 1 — General
|
|
55028
|
Head, ultrasound scan of, if:
(a) the patient is referred by a medical practitioner
for ultrasonic examination not being a service associated with a service to
which an item in Subgroup 2 or 3 applies; and
(b) the referring medical practitioner is not a member
of a group of practitioners of which the providing practitioner is a member
(R)
|
109.10
|
|
55029
|
Head, ultrasound scan of, if the patient is not referred
by a medical practitioner, not being a service associated with a service to
which an item in Subgroup 2 or 3 applies (NR)
|
37.85
|
|
55030
|
Orbital contents, ultrasound scan of, if:
(a) the patient is referred by a medical practitioner
for ultrasonic examination not being a service associated with a service to
which an item in Subgroup 2 or 3 applies; and
(b) the referring medical practitioner is not a member
of a group of practitioners of which the providing practitioner is a member
(R)
|
109.10
|
|
55031
|
Orbital contents, ultrasound scan of, if the patient is
not referred by a medical practitioner, not being a service associated with a
service to which an item in Subgroup 2 or 3 applies (NR)
|
37.85
|
|
55032
|
Neck, 1 or more structures of, ultrasound scan of, if:
(a) the patient is referred by a medical practitioner
for ultrasonic examination not being a service associated with a service to
which an item in Subgroup 2 or 3 applies; and
(b) the referring medical practitioner is not a member
of a group of practitioners of which the providing practitioner is a member
(R)
|
109.10
|
|
55033
|
Neck, 1 or more structures of, ultrasound scan of, if the
patient is not referred by a medical practitioner, not being a service
associated with a service to which an item in Subgroup 2 or 3 applies
(NR)
|
37.85
|
|
55036
|
Abdomen, ultrasound scan of (including scan of urinary
tract when performed), if:
(a) the patient is referred by a medical practitioner
for ultrasonic examination; and
(b) the referring medical practitioner is not a member
of a group of practitioners of which the practitioner is a member; and
(c) the service is not a service associated with a
service to which an item in Subgroup 2 or 3 applies; and
|
111.30
|
|
|
(d) the service is not solely a transrectal ultrasonic
examination of the prostate gland, bladder base and urethra, or any of those
organs; and
|
|
|
|
(e) within 24 hours of the service, a service
described in item 55038, 55044 or 55731 is not performed on the same
patient by the providing practitioner (R)
|
|
|
55037
|
Abdomen, ultrasound scan of (including scan of urinary
tract when performed), if:
(a) the patient is not referred by a medical
practitioner; and
|
37.85
|
|
|
(b) the service is not a service associated with a
service to which an item in Subgroup 2 or 3 applies; and
(c) the service is not solely a transrectal ultrasonic
examination of the prostate gland, bladder base and urethra, or any of those
organs (NR)
|
|
|
55038
|
Urinary tract, ultrasound scan of, if:
(a) the patient is referred by a medical practitioner
for ultrasonic examination; and
(b) the referring medical practitioner is not a member
of a group of practitioners of which the providing practitioner is a member;
and
(c) the service is not a service associated with a
service to which an item in Subgroup 2 or 3 applies; and
|
109.10
|
|
|
(d) the service is not solely a transrectal ultrasonic
examination of the prostate gland, bladder base and urethra, or any of those
organs; and
(e) within 24 hours of the service, a service
described in item 55036, 55044 or 55731 is not performed on the same
patient by the providing practitioner (R)
|
|
|
55039
|
Urinary tract, ultrasound scan of, if:
(a) the patient is not referred by a medical
practitioner; and
(b) the service is not a service associated with a
service to which an item in Subgroup 2 or 3 applies; and
(c) the service is not solely a transrectal ultrasonic
examination of the prostate gland, bladder base and urethra, or any of those
organs (NR)
|
37.85
|
|
55044
|
Pelvis, male, ultrasound scan of, by any or all
approaches, if:
(a) the patient is referred by a medical practitioner
for ultrasonic examination; and
(b) the referring medical practitioner is not a member
of a group of practitioners of which the providing practitioner is a member;
and
(c) the service is not a service associated with a
service to which an item in Subgroup 2 or 3 applies; and
|
111.30
|
|
|
(d) the service is not solely a transrectal ultrasonic
examination of the prostate gland, bladder base and urethra, or any of those
organs; and
(e) within 24 hours of the service, a service
described in item 55036 or 55038 is not performed on the same patient by
the providing practitioner (R)
|
|
|
55045
|
Pelvis, male, ultrasound scan of, by any or all
approaches, if:
(a) the patient is not referred by a medical
practitioner; and
(b) the service is not a service associated with a
service to which an item in Subgroup 2 or 3 applies; and
(c) the service is not solely a transrectal ultrasonic
examination of the prostate gland, bladder base and urethra, or any of those
organs (NR)
|
37.85
|
|
55048
|
Scrotum, ultrasound scan of, if:
(a) the patient is referred by a medical practitioner
for ultrasonic examination not being a service associated with a service to
which an item in Subgroup 2 or 3 applies; and
(b) the referring medical practitioner is not a member
of a group of practitioners of which the providing practitioner is a member
(R)
|
109.50
|
|
55049
|
Scrotum, ultrasound scan of, if the patient is not
referred by a medical practitioner, not being a service associated with a
service to which an item in Subgroup 2 or 3 applies (NR)
|
37.85
|
|
55054
|
Ultrasonic cross‑sectional echography, in
conjunction with a surgical procedure using interventional techniques, not
being a service associated with a service to which any other item in this
group applies (R)
|
109.10
|
|
55070
|
Breast, one, ultrasound scan of, if:
(a) the patient is referred by a medical practitioner;
and
(b) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies; and
(c) the referring medical practitioner is not a member
of a group of practitioners of which the providing practitioner is a member (R)
|
98.25
|
|
55073
|
Breast, one, ultrasound scan of, if:
(a) the patient is not referred by a medical
practitioner; and
(b) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies (NR)
|
34.05
|
|
55076
|
Breasts, both, ultrasound scan of, if:
(a) the patient is referred by a medical practitioner;
and
(b) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies; and
(c) the referring medical practitioner is not a member
of a group of practitioners of which the providing practitioner is a member
(R)
|
109.10
|
|
55079
|
Breasts, both, ultrasound scan of, if:
(a) the patient is not referred by a medical
practitioner; and
(b) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies (NR)
|
37.85
|
|
55084
|
Urinary bladder, ultrasound scan of, by any or all
approaches, if:
(a) the patient is referred by a medical practitioner
for ultrasonic examination; and
(b) the referring medical practitioner is not a member
of a group of practitioners of which the providing practitioner is a member;
and
|
98.25
|
|
|
(c) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies; and
(d) within 24 hours of the service, a service described
in item 11917, 55036, 55038, 55044, 55600, 55603 or 55731 is not performed on
the same patient by the providing practitioner (R)
|
|
|
55085
|
Urinary bladder, ultrasound scan of, by any or all
approaches, if:
(a) the patient is not referred by a medical
practitioner; and
(b) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies; and
|
34.05
|
|
|
(c) within 24 hours of the service, a service described
in item 11917, 55037, 55039, 55045, 55600, 55603 or 55733 is not performed on
the same patient by the providing practitioner (NR)
|
|
|
Subgroup 2 — Cardiac
|
|
55113
|
M‑mode and two‑dimensional real time
echocardiographic examination of the heart from at least 2 acoustic windows
for the investigation of symptoms or signs of cardiac failure, or suspected
or known ventricular hypertrophy or dysfunction, or chest pain:
|
230.65
|
|
|
(a) with:
(i) measurement
of blood flow velocities across the cardiac valves using pulsed wave and
continuous wave Doppler techniques; and
(ii) real time
colour flow mapping from at least 2 acoustic windows; and
(iii) recordings on
video tape or digital media; and
(b) not being a service
associated with a service to which an item in Subgroup 1 (except item 55054)
or 3, or another item in this Subgroup (except items 55118 and
55130), applies (R)
|
|
|
55114
|
M‑mode and two‑dimensional real time
echocardiographic examination of the heart from at least 2 acoustic windows
for the investigation of suspected or known acquired valvular, aortic,
pericardial, thrombotic or embolic disease or heart tumour:
(a) with:
(i) measurement of blood flow velocities across
the cardiac valves using pulsed wave and continuous wave Doppler techniques;
and
|
230.65
|
|
|
(ii) real time colour flow mapping from at least
2 acoustic windows; and
(iii) recordings on video tape or digital media;
and
(b) not being a service associated with a service to
which an item in Subgroup 1 (except item 55054) or 3, or another
item in this Subgroup (except items 55118 and 55130), applies (R)
|
|
|
55115
|
M‑mode and two‑dimensional real time
echocardiographic examination of the heart from at least 2 acoustic windows
for the investigation of symptoms or signs of congenital heart disease:
(a) with:
(i) measurement of blood flow velocities across
the cardiac valves using pulsed wave and continuous wave Doppler techniques;
and
|
230.65
|
|
|
(ii) real time colour flow mapping from at least
2 acoustic windows; and
(iii) recordings on video tape or digital media;
and
(b) not being a service associated with a service to
which an item in Subgroup 1 (except item 55054) or 3, or another
item in this Subgroup (except items 55118 and 55130), applies (R)
|
|
|
55116
|
Exercise stress echocardiography performed in conjunction
with item 11712:
(a) with:
(i) two‑dimensional recordings before
exercise (baseline) from at least 3 acoustic windows; and
|
261.65
|
|
|
(ii) matching recordings from the same windows
at, or immediately after, peak exercise; and
(iii) recordings on digital media with equipment
permitting display of baseline and matching peak images on the same screen;
and
(b) not being a service associated with a service to
which an item in Subgroup 1 (except item 55054) or 3, or another
item in this Subgroup (except items 55118 and 55130), applies (R)
|
|
|
55117
|
Pharmacological stress
echocardiography performed in conjunction with item 11712:
(a) with:
(i) two‑dimensional
recordings before drug infusion (baseline) from at least 3 acoustic
windows; and
(ii) matching
recordings from the same windows at least twice during drug infusion,
including a recording at the peak drug dose; and
|
261.65
|
|
|
(iii) recordings
on digital media with equipment permitting display of baseline and matching
peak images on the same screen; and
(b) not being a
service associated with a service to which an item in Subgroup 1 (except item 55054)
or 3, or another item in this Subgroup (except items 55118
and 55130), applies (R)
|
|
|
55118
|
Heart, two‑dimensional
real time transoesophageal examination of, from at least 2 levels, and in
more than 1 plane at each level:
(a) with:
(i) real
time colour flow mapping and, if indicated, pulsed wave Doppler examination;
and
(ii) recordings
on video tape or digital medium; and
|
275.50
|
|
|
(b) not being an intra‑operative service or a
service associated with a service to which an item in Subgroup 1 (except item 55054)
or 3 applies (R) (Anaes.)
|
|
|
55130
|
Intra‑operative 2 dimensional real time
transoesophageal echocardiography incorporating Doppler techniques with
colour flow mapping and recording onto video tape or digital medium,
performed during cardiac surgery incorporating sequential assessment of
cardiac function before and after the surgical procedure, not being a service
associated with a service to which item 55135 applies (R) (Anaes.)
|
170.00
|
|
55135
|
Intra‑operative 2 dimensional real time
transoesophageal echocardiography incorporating Doppler techniques with
colour flow mapping and recording onto video tape or digital medium,
performed during cardiac valve surgery (replacement or repair) incorporating
sequential assessment of cardiac function and valve competence before and
after the surgical procedure, not being a service associated with a service
to which item 55130 applies (R) (Anaes.)
|
353.60
|
|
Subgroup 3 — Vascular
|
|
55238
|
Duplex scanning, unilateral, involving B mode
ultrasound imaging and integrated Doppler flow measurements by spectral
analysis of arteries or bypass grafts in the lower limb or of arteries and
bypass grafts in the lower limb, below the inguinal ligament, not being a
service associated with a service to which an item in Subgroup 1 (with the
exception of item 55054) or 4 applies (R)
|
169.50
|
|
55244
|
Duplex scanning, unilateral, involving B mode
ultrasound imaging and integrated Doppler flow measurements by spectral
analysis of veins in the lower limb, below the inguinal ligament, for acute
venous thrombosis, not being a service associated with a service to which an
item in Subgroup 1 (with the exception of item 55054) or 4 applies (R)
|
169.50
|
|
55246
|
Duplex scanning, unilateral, involving B mode
ultrasound imaging and integrated Doppler flow measurements by spectral
analysis of veins in the lower limb, below the inguinal ligament, for chronic
venous disease, not being a service associated with a service to which an
item in Subgroup 1 (with the exception of item 55054) or 4 applies (R)
|
169.50
|
|
55248
|
Duplex scanning, unilateral, involving B mode
ultrasound imaging and integrated Doppler flow measurements by spectral
analysis of arteries or bypass grafts in the upper limb or of arteries and
bypass grafts in the upper limb, not being a service associated with a
service to which an item in Subgroup 1 (with the exception of item 55054)
or 4 applies (R)
|
169.50
|
|
55252
|
Duplex scanning, unilateral, involving B mode
ultrasound imaging and integrated Doppler flow measurements by spectral
analysis of veins in the upper limb, not being a service associated with a
service to which an item in Subgroup 1 (with the exception of item 55054)
or 4 applies (R)
|
169.50
|
|
55274
|
Duplex scanning, bilateral, involving B mode
ultrasound imaging and integrated Doppler flow measurements by spectral
analysis of extra‑cranial bilateral carotid and vertebral vessels, with
or without subclavian and innominate vessels, with or without
oculoplethysmography or peri‑orbital Doppler examination, not being a
service associated with a service to which an item in Subgroup 1 (with
the exception of item 55054) or 4 applies (R)
|
169.50
|
|
55276
|
Duplex scanning involving B mode ultrasound imaging
and integrated Doppler flow measurements by spectral analysis of intra‑abdominal,
aorta and iliac arteries or inferior vena cava and iliac veins or of intra‑abdominal,
aorta and iliac arteries and inferior vena cava and iliac veins, excluding
pregnancy related studies, not being a service associated with a service to
which an item in Subgroup 1 (with the exception of item 55054) or 4 applies (R)
|
169.50
|
|
55278
|
Duplex scanning involving B mode ultrasound imaging
and integrated Doppler flow measurements by spectral analysis of renal or
visceral vessels or of renal and visceral vessels, including aorta, inferior
vena cava and iliac vessels as required excluding pregnancy related studies,
not being a service associated with a service to which an item in Subgroup 1
(with the exception of item 55054) or 4 applies (R)
|
169.50
|
|
55280
|
Duplex scanning involving B mode ultrasound imaging
and integrated Doppler flow measurements by spectral analysis of intra‑cranial
vessels, not being a service associated with a service to which an item in Subgroup 1 (with
the exception of item 55054) or 4 applies (R)
|
169.50
|
|
55282
|
Duplex scanning involving B mode ultrasound imaging
and integrated Doppler flow measurements:
(a) by spectral analysis of cavernosal artery of the
penis following intracavernosal administration of a vasoactive agent; and
(b) performed during the period of pharmacological
activity of the injected agent, to confirm a diagnosis of vascular aetiology
for impotence; and
|
169.50
|
|
|
(c) if a specialist in diagnostic radiology, nuclear
medicine, urology, general surgery (sub‑specialising in vascular
surgery) or a consultant physician in nuclear medicine attends the patient in
person at the practice location where the service is performed, immediately
before or for a period during the performance of the service; and
|
|
|
|
(d) if the specialist or consultant physician
interprets the results and prepares a report, not being a service associated
with a service to which an item in Subgroup 1 (with the exception of
item 55054) or 4 applies (R)
|
|
|
55284
|
Duplex scanning involving B mode ultrasound imaging
and integrated Doppler flow measurements:
(a) by spectral analysis of cavernosal tissue of the
penis to confirm a diagnosis; and
|
169.50
|
|
|
(b) if indicated, assess the progress and management
of:
(i) priapism; or
(ii) fibrosis of any type; or
(iii) fracture of the tunica; or
(iv) arteriovenous malformations; and
|
|
|
|
(c) if a specialist in diagnostic radiology, nuclear
medicine, urology, general surgery (sub‑specialising in vascular
surgery) or a consultant physician in nuclear medicine attends the patient in
person at the practice location where the service is performed, immediately
before or for a period during the performance of the service; and
|
|
|
|
(d) if the specialist or consultant physician
interprets the results and prepares a report, not being a service associated
with a service to which an item in Subgroup 1 (with the exception of
item 55054) or 4 applies (R)
|
|
|
55292
|
Duplex scanning, unilateral, involving B mode ultrasound
imaging and integrated Doppler flow measurements by spectral analysis of
surgically created arteriovenous fistula or surgically created arteriovenous
access grafts in the upper or lower limbs, not being a service associated
with a service to which an item in Subgroup 1 (with the exception of item
55054) or 4 applies (R)
|
169.50
|
|
55294
|
Duplex scanning involving B mode ultrasound imaging and
integrated Doppler flow measurements by spectral analysis of arteries or
veins, or both, including any associated skin marking, for mapping of bypass
conduit before vascular surgery, not being a service associated with a
service to which an item in Subgroup 1 (with the exception of item 55054), 3
or 4 applies (R)
|
169.50
|
|
55296
|
Duplex scanning, unilateral, involving B mode ultrasound
imaging and integrated Doppler flow spectral analysis and marking of veins in
the lower limbs below the inguinal ligament before varicose vein surgery,
including any associated skin marking, not being a service associated with a
service to which an item in Subgroup 1 (with the exception of item 55054), 3
or 4 applies (R)
|
111.05
|
|
Subgroup 4 —
Urological
|
|
55600
|
Prostate, bladder base and urethra, transrectal ultrasound
scan of, if performed:
(a) personally by a medical practitioner (not being the
medical practitioner who assessed the patient as specified in paragraph (c))
using a transducer probe that:
(i) has a nominal frequency of 7 to 7.5 MHz
or a nominal frequency range that includes frequencies of 7 to 7.5 MHz;
and
(ii) can obtain both axial and sagittal scans in
2 planes at right angles; and
(b) following a digital rectal examination of the
prostate by that medical practitioner; and
|
109.10
|
|
|
(c) on a patient who has been assessed by a specialist
in urology, radiation oncology or medical oncology or a consultant physician
in medical oncology who has:
(i) examined the patient in the 60 days
before the scan; and
(ii) recommended the scan for the management of
the patient’s current prostatic disease (R)
|
|
|
55603
|
Prostate, bladder base and urethra, transrectal ultrasound
scan of, if performed:
(a) personally by a medical practitioner who made the
assessment mentioned in paragraph (c) using a transducer probe that:
(i) has a nominal frequency of 7 to 7.5 MHz
or a nominal frequency range that includes frequencies of 7 to 7.5 MHz;
and
(ii) can obtain both axial and sagittal scans in
2 planes at right angles; and
(b) following a digital rectal examination of the prostate
by that medical practitioner; and
|
109.10
|
|
|
(c) on a patient who has been assessed by a specialist
in urology, radiation oncology or medical oncology or a consultant physician
in medical oncology who has:
(i) examined the patient in the 60 days
before the scan; and
(ii) recommended the scan for the management of
the patient’s current prostatic disease (R)
|
|
|
Subgroup
5 — Obstetric and gynaecological
|
|
55700
|
Pelvis or abdomen, pregnancy‑related or pregnancy
complication, ultrasound scan of, by any or all approaches, if:
(a) the patient is referred by a medical practitioner;
and
(b) the dating of the pregnancy (as confirmed by
ultrasound) is less than 12 weeks of gestation; and
(c) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies; and
(d) the referring practitioner is not a member of a
group of practitioners of which the providing practitioner is a member; and
|
60.00
|
|
|
(e) 1 or more of the following conditions are present:
(i) hyperemesis gravidarum;
(ii) diabetes mellitus;
(iii) hypertension;
|
|
|
|
(iv) toxaemia of
pregnancy;
(v) liver or renal
disease;
(vi) autoimmune
disease;
(vii) cardiac
disease;
(viii) alloimmunisation;
(ix) maternal
infection;
(x) inflammatory
bowel disease;
(xi) bowel stoma;
(xii) abdominal wall
scarring;
|
|
|
|
(xiii) previous spinal or pelvic trauma or disease;
(xiv) drug dependency;
|
|
|
|
(xv) thrombophilia;
(xvi) significant maternal obesity;
(xvii) advanced maternal age;
(xviii) abdominal pain or mass;
(xix) uncertain dates;
(xx) high risk pregnancy;
(xxi) previous post dates delivery;
(xxii) previous caesarean section;
(xxiii) poor obstetric history;
(xxiv) suspicion of ectopic pregnancy;
(xxv) risk of miscarriage;
(xxvi) diminished symptoms of pregnancy;
(xxvii) suspected or known cervical incompetence;
(xxviii) suspected or known uterine abnormality;
(xxix) pregnancy after assisted reproduction;
(xxx) risk of fetal abnormality (R)
|
|
|
55703
|
Pelvis or abdomen, pregnancy‑related or pregnancy
complication, ultrasound scan of, by any or all approaches, if:
(a) the patient is not referred by a medical
practitioner; and
(b) the dating of the pregnancy (as confirmed by
ultrasound) is less than 12 weeks of gestation; and
|
35.00
|
|
|
(c) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies; and
(d) 1 or more of the following conditions are present:
(i) hyperemesis gravidarum;
(ii) diabetes mellitus;
(iii) hypertension;
(iv) toxaemia of pregnancy;
(v) liver or renal disease;
(vi) autoimmune disease;
(vii) cardiac disease;
(viii) alloimmunisation;
(ix) maternal infection;
|
|
|
|
(x) inflammatory bowel disease;
(xi) bowel stoma;
|
|
|
|
(xii) abdominal wall scarring;
(xiii) previous spinal or pelvic trauma or disease;
(xiv) drug dependency;
|
|
|
|
(xv) thrombophilia;
(xvi) significant maternal obesity;
(xvii) advanced maternal age;
(xviii) abdominal pain or mass;
|
|
|
|
(xix) uncertain dates;
(xx) high risk pregnancy;
(xxi) previous post dates delivery;
(xxii) previous caesarean section;
(xxiii) poor obstetric history;
|
|
|
|
(xxiv) suspicion of ectopic pregnancy;
(xxv) risk of miscarriage;
(xxvi) diminished symptoms of pregnancy;
(xxvii) suspected or known cervical incompetence;
(xxviii) suspected or known uterine abnormality;
(xxix) pregnancy after assisted reproduction;
(xxx) risk of fetal abnormality (NR)
|
|
|
55704
|
Pelvis or abdomen, pregnancy‑related or pregnancy
complication, fetal development and anatomy, ultrasound scan of, by any or
all approaches, if:
(a) the patient is referred by a medical practitioner;
and
(b) the dating of the pregnancy (as confirmed by
ultrasound) is 12 to 16 weeks of gestation; and
(c) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies; and
(d) the referring practitioner is not a member of a
group of practitioners of which the providing practitioner is a member; and
|
70.00
|
|
|
(e) 1 or more of the following conditions are present:
(i) hyperemesis gravidarum;
(ii) diabetes mellitus;
(iii) hypertension;
(iv) toxaemia of pregnancy;
(v) liver or renal disease;
(vi) autoimmune disease;
(vii) cardiac disease;
(viii) alloimmunisation;
(ix) maternal infection;
(x) inflammatory bowel disease;
(xi) bowel stoma;
(xii) abdominal wall scarring;
(xiii) previous spinal or pelvic trauma or disease;
(xiv) drug dependency;
(xv) thrombophilia;
(xvi) significant maternal obesity;
|
|
|
|
(xvii) advanced maternal age;
(xviii) abdominal pain or mass;
(xix) uncertain dates;
(xx) high risk pregnancy;
(xxi) previous post dates delivery;
(xxii) previous caesarean section;
(xxiii) poor obstetric history;
|
|
|
|
(xxiv) suspicion of ectopic pregnancy;
(xxv) risk of miscarriage;
(xxvi) diminished symptoms of pregnancy;
(xxvii) suspected or known cervical incompetence;
(xxviii) suspected or known uterine abnormality;
(xxix) pregnancy after assisted reproduction;
(xxx) risk of fetal abnormality (R)
|
|
|
55705
|
Pelvis or abdomen, pregnancy‑related or pregnancy
complication, fetal development and anatomy, ultrasound scan of, by any or
all approaches, if:
(a) the patient is not referred by a medical
practitioner; and
(b) the dating of the pregnancy (as confirmed by
ultrasound) is 12 to 16 weeks of gestation; and
(c) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies; and
|
35.00
|
|
|
(d) 1 or more of the following conditions are present:
(i) hyperemesis gravidarum;
(ii) diabetes mellitus;
(iii) hypertension;
(iv) toxaemia of pregnancy;
(v) liver or renal disease;
(vi) autoimmune disease;
|
|
|
|
(vii) cardiac disease;
(viii) alloimmunisation;
(ix) maternal infection;
(x) inflammatory bowel disease;
(xi) bowel stoma;
(xii) abdominal wall scarring;
(xiii) previous spinal or pelvic trauma or disease;
(xiv) drug dependency;
(xv) thrombophilia;
|
|
|
|
(xvi) significant
maternal obesity;
(xvii) advanced
maternal age;
(xviii) abdominal pain
or mass;
|
|
|
|
(xix) uncertain dates;
(xx) high risk pregnancy;
(xxi) previous post dates delivery;
(xxii) previous caesarean section;
(xxiii) poor obstetric history;
(xxiv) suspicion of ectopic pregnancy;
(xxv) risk of miscarriage;
|
|
|
|
(xxvi) diminished symptoms of pregnancy;
(xxvii) suspected or known cervical incompetence;
(xxviii) suspected or known uterine abnormality;
(xxix) pregnancy after assisted reproduction;
(xxx) risk of fetal abnormality (NR)
|
|
|
55706
|
Pelvis or abdomen, pregnancy‑related or pregnancy
complication, fetal development and anatomy, ultrasound scan of, by any or
all approaches, with measurement of all parameters for dating purposes, if:
(a) the patient is referred by a medical practitioner;
and
(b) the dating for the pregnancy (as confirmed by
ultrasound) is 17 to 22 weeks of gestation; and
(c) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies; and
|
100.00
|
|
|
(d) the referring practitioner is not a member of a
group of practitioners of which the providing practitioner is a member; and
(e) the service is not performed in the same pregnancy
as item 55709 (R)
(Item is subject to subrule 11 (2))
|
|
|
55707
|
Pelvis or abdomen, pregnancy‑related or pregnancy
complication, fetal development and anatomy, ultrasound scan of, by any or
all approaches, if:
(a) the patient is referred by a medical practitioner;
and
(b) the pregnancy (as confirmed by ultrasound) is dated
by a fetal crown rump length of 45 to 84 mm; and
|
70.00
|
|
|
(c) the service is not
associated with a service to which an item in Subgroup 2 or 3 applies; and
(d) the referring
practitioner is not a member of a group of practitioners of which the
providing practitioner is a member; and
(e) at least 1 condition
mentioned in paragraph (e) of item 55704 is present; and
|
|
|
|
(f) nuchal translucency measurement is performed to
assess the risk of fetal abnormality; and
|
|
|
|
(g) the service is not performed with item 55700,
55703, 55704 or 55705 on the same patient within 24 hours (R)
(Item is subject to subrule 11 (2))
|
|
|
55708
|
Pelvis or abdomen, pregnancy‑related or pregnancy
complication, fetal development and anatomy, ultrasound scan of, by any or
all approaches, if:
(a) the patient is not referred by a medical
practitioner; and
(b) the pregnancy (as confirmed by ultrasound) is dated
by a crown rump length of 45 to 84 mm; and
(c) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies; and
(d) at least 1 condition mentioned in paragraph (e)
of item 55704 is present; and
(e) nuchal translucency measurement is performed to
assess the risk of fetal abnormality; and
(f) the service is not performed with item 55700,
55703, 55704 or 55705 on the same patient within 24 hours (NR)
(Item is subject to subrule 11 (2))
|
35.00
|
|
55709
|
Pelvis or abdomen, pregnancy‑related or pregnancy
complication, fetal development and anatomy, ultrasound scan of, by any or
all approaches, with measurement of all parameters for dating purposes, if:
(a) the patient is not referred by a medical
practitioner; and
|
38.00
|
|
|
(b) the dating of the
pregnancy (as confirmed by ultrasound) is 17 to 22 weeks of gestation; and
(c) the service is not
associated with a service to which an item in Subgroup 2 or 3 applies;
and
(d) the service is not
performed in the same pregnancy as item 55706 (NR)
(Item is subject to subrule
11 (2))
|
|
|
55712
|
Pelvis or abdomen, pregnancy‑related or pregnancy
complication, fetal development and anatomy, ultrasound scan of, by any or
all approaches, with measurement of all parameters for dating purposes, if:
(a) the patient is referred by a medical practitioner
who:
(i) is a Member or a Fellow of the Royal
Australian and New Zealand College of Obstetricians and Gynaecologists; or
(ii) has a Diploma of Obstetrics; or
|
115.00
|
|
|
(iii) has a qualification recognised by the Royal
Australian and New Zealand College of Obstetricians and Gynaecologists as
being equivalent to a Diploma of Obstetrics; or
(iv) has obstetric privileges at a non‑metropolitan
hospital; and
(b) the dating of the pregnancy (as confirmed by
ultrasound) is 17 to 22 weeks of gestation; and
|
|
|
|
(c) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies; and
|
|
|
|
(d) the referring practitioner is not a member of a
group of practitioners of which the providing practitioner is a member; and
|
|
|
|
(e) further examination is clinically indicated after
performance, in the same pregnancy, of a scan mentioned in item 55706 or
55709 (R)
|
|
|
55715
|
Pelvis or abdomen, pregnancy‑related or pregnancy
complication, fetal development and anatomy, ultrasound scan of, by any or
all approaches, with measurement of all parameters for dating purposes,
performed by or on behalf of a medical practitioner who is a Member or a
Fellow of the Royal Australian and New Zealand College of Obstetricians and
Gynaecologists, if:
|
40.00
|
|
|
(a) the patient is not referred by a medical
practitioner; and
|
|
|
|
(b) the dating of the pregnancy (as confirmed by
ultrasound) is 17 to 22 weeks of gestation; and
(c) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies; and
|
|
|
|
(d) further examination is clinically indicated after
performance, in the same pregnancy, of a scan mentioned in item 55706 or
55709 (NR)
|
|
|
55718
|
Pelvis or abdomen, pregnancy‑related or pregnancy
complication, fetal development and anatomy, ultrasound scan of, by any or
all approaches, if:
(a) the patient is referred by a medical practitioner;
and
(b) the dating of the pregnancy (as confirmed by
ultrasound) is after 22 weeks of gestation; and
(c) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies; and
|
100.00
|
|
|
(d) the referring practitioner is not a member of a
group of practitioners of which the providing practitioner is a member; and
(e) the service is not performed in the same pregnancy
as item 55723; and
(f) 1 or more of the following conditions are present:
(i) known or suspected fetal abnormality or
fetal cardiac arrhythmia;
|
|
|
|
(ii) fetal anatomy (late booking or incomplete
mid‑trimester scan);
(iii) malpresentation;
(iv) cervical assessment;
(v) clinical suspicion of amniotic fluid
abnormality;
|
|
|
|
(vi) clinical suspicion of placental or umbilical
cord abnormality;
(vii) previous complicated delivery;
(viii) uterine scar assessment;
(ix) uterine fibroid;
|
|
|
|
(x) previous fetal
death in utero or neonatal death;
(xi) antepartum
haemorrhage;
(xii) clinical
suspicion of intrauterine growth retardation;
(xiii) clinical
suspicion of macrosomia;
|
|
|
|
(xiv) reduced fetal movements;
(xv) suspected fetal death;
(xvi) abnormal cardiotocography;
(xvii) prolonged pregnancy;
(xviii) premature labour;
(xix) fetal infection;
(xx) pregnancy after assisted reproduction;
(xxi) trauma;
(xxii) diabetes mellitus;
(xxiii) hypertension;
(xxiv) toxaemia of pregnancy;
(xxv) liver or renal disease;
|
|
|
|
(xxvi) autoimmune disease;
(xxvii) cardiac disease;
(xxviii) alloimmunisation;
(xxix) maternal infection;
(xxx) inflammatory bowel disease;
|
|
|
(xxxi) bowel stoma;
(xxxii) abdominal wall scarring;
(xxxiii) previous spinal or pelvic trauma or disease;
(xxxiv) drug dependency;
|
|
|
|
(xxxv) thrombophilia;
(xxxvi) gross maternal obesity;
(xxxvii) advanced maternal age;
|
|
|
|
(xxxviii) abdominal pain or mass (R)
(Item is subject to subrule 11 (2))
|
|
|
55721
|
Pelvis or abdomen,
pregnancy‑related or pregnancy complication, fetal development and
anatomy, ultrasound scan of, by any or all approaches, if:
(a) the patient is
referred by a medical practitioner who:
(i) is a Member
or a Fellow of the Royal Australian and New Zealand College of Obstetricians
and Gynaecologists; or
(ii) has a Diploma
of Obstetrics; or
(iii) has a
qualification recognised by the Royal Australian and New Zealand College of
Obstetricians and Gynaecologists as being equivalent to a Diploma of
Obstetrics; or
|
115.00
|
|
|
(iv) has obstetric privileges at a non‑metropolitan
hospital; and
|
|
|
|
(b) the dating of the pregnancy (as confirmed by ultrasound)
is after 22 weeks of gestation; and
(c) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies; and
|
|
|
|
(d) the referring practitioner is not a member of a
group of practitioners of which the providing practitioner is a member; and
(e) further examination is clinically indicated in the
same pregnancy to which item 55718 or 55723 applies (R)
|
|
|
55723
|
Pelvis or abdomen, pregnancy‑related or pregnancy
complication, fetal development and anatomy, ultrasound scan of, by any or
all approaches, if:
(a) the patient is not referred by a medical
practitioner; and
|
38.00
|
|
|
(b) the dating of the pregnancy (as confirmed by
ultrasound) is after 22 weeks of gestation; and
|
|
|
|
(c) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies; and
(d) the service is not performed in the same pregnancy
as item 55718; and
|
|
|
|
(e) 1 or more of the following conditions are present:
(i) known or suspected fetal abnormality or
fetal cardiac arrhythmia;
(ii) fetal anatomy (late booking or incomplete
mid‑trimester scan);
(iii) malpresentation;
(iv) cervical assessment;
|
|
|
|
(v) clinical suspicion of amniotic fluid
abnormality;
(vi) clinical suspicion of placental or umbilical
cord abnormality;
(vii) previous complicated delivery;
(viii) uterine scar assessment;
(ix) uterine fibroid;
|
|
|
|
(x) previous fetal death in utero or neonatal
death;
(xi) antepartum haemorrhage;
(xii) clinical suspicion of intrauterine growth
retardation;
|
|
|
|
(xiii) clinical suspicion of macrosomia;
(xiv) reduced fetal movements;
(xv) suspected fetal death;
(xvi) abnormal cardiotocography;
(xvii) prolonged pregnancy;
(xviii) premature labour;
|
|
|
|
(xix) fetal infection;
(xx) pregnancy after assisted reproduction;
(xxi) trauma;
(xxii) diabetes mellitus;
(xxiii) hypertension;
(xxiv) toxaemia of pregnancy;
(xxv) liver or renal disease;
|
|
|
|
(xxvi) autoimmune disease;
(xxvii) cardiac disease;
(xxviii) alloimmunisation;
|
|
|
|
(xxix) maternal infection;
(xxx) inflammatory bowel disease;
(xxxi) bowel stoma;
(xxxii) abdominal wall scarring;
|
|
|
|
(xxxiii) previous spinal or pelvic trauma or disease;
(xxxiv) drug dependency;
(xxxv) thrombophilia;
(xxxvi) gross maternal obesity;
(xxxvii) advanced maternal age;
(xxxviii) abdominal pain or mass (NR)
(Item is subject to subrule 11 (2))
|
|
|
55725
|
Pelvis or abdomen, pregnancy‑related or pregnancy
complication, fetal development and anatomy, ultrasound scan of, by any or
all approaches, performed by or on behalf of a medical practitioner who is a
Member or a Fellow of the Royal Australian and New Zealand College of
Obstetricians and Gynaecologists, if:
(a) the patient is not referred by a medical
practitioner; and
(b) the dating of the pregnancy (as confirmed by
ultrasound) is after 22 weeks of gestation; and
|
40.00
|
|
|
(c) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies; and
(d) further examination is clinically indicated in the
same pregnancy to which item 55718 or 55723 applies (NR)
|
|
|
55729
|
Duplex scanning involving B mode ultrasound imaging and
integrated Doppler flow measurements by spectral analysis of the umbilical
artery, and measured assessment of amniotic fluid volume after the 24th week
of gestation, if the patient is referred by a medical practitioner for this
procedure and if there is reason to suspect intrauterine growth retardation
or a significant risk of fetal death, not being a service associated with a
service to which an item in this group applies — examination and report
(R)
|
27.25
|
|
55731
|
Pelvis, female, ultrasound scan of, by any or all
approaches, if:
(a) the patient is referred by a medical practitioner;
and
(b) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies; and
|
98.00
|
|
|
(c) the referring practitioner is not a member of a
group of practitioners of which the providing practitioner is a member; and
(d) the service is not performed with item 55036 or
55038 on the same patient within 24 hours (R)
|
|
|
55733
|
Pelvis, female, ultrasound scan of, by any or all
approaches, if:
(a) the patient is not referred by a medical
practitioner; and
(b) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies (NR)
|
35.00
|
|
55736
|
Pelvis, female, ultrasound scan of, in association with
saline infusion of the endometrial cavity, by any or all approaches, if:
(a) the patient is referred by a medical practitioner;
and
(b) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies; and
|
127.00
|
|
|
(c) the referring medical practitioner is not a member
of a group of medical practitioners of which the providing practitioner is a
member; and
|
|
|
|
(d) a previous transvaginal ultrasound has revealed an
abnormality of the uterus or fallopian tube (R)
|
|
|
55739
|
Pelvis, female, ultrasound scan of, in association with
saline infusion of the endometrial cavity, by any or all approaches, if:
(a) the patient is not referred by a medical
practitioner; and
(b) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies; and
(c) a previous transvaginal ultrasound has revealed an
abnormality of the uterus or fallopian tube (NR)
|
57.00
|
|
55759
|
Pelvis or abdomen, pregnancy‑related or pregnancy
complication, fetal development and anatomy, ultrasound scan of, by any or
all approaches, with measurement of all parameters for dating purposes, if:
(a) the patient is referred by a medical practitioner;
and
(b) ultrasound of the same pregnancy confirms a
multiple pregnancy; and
|
150.00
|
|
|
(c) the dating of the pregnancy (as confirmed by
ultrasound) is 17 to 22 weeks gestation; and
(d) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies; and
|
|
|
|
(e) the referring practitioner is not a member of a
group of practitioners of which the providing practitioner is a member; and
(f) the service described in item 55706, 55709, 55712,
55715 or 55762 is not performed in conjunction with the scan during the same
pregnancy (R)
(Item is subject to subrule 11 (2))
|
|
|
55762
|
Pelvis or abdomen, pregnancy‑related or pregnancy
complication, fetal development and anatomy, ultrasound scan of, by any or
all approaches, with measurement of all parameters for dating purposes, if:
(a) the patient is not referred by a medical
practitioner; and
(b) ultrasound of the same pregnancy confirms a
multiple pregnancy; and
|
60.00
|
|
|
(c) the dating of the pregnancy (as confirmed by
ultrasound) is 17 to 22 weeks gestation; and
(d) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies; and
|
|
|
|
(e) the service described in item 55706, 55709, 55712,
55715 or 55759 is not performed in conjunction with the scan during the same
pregnancy (NR)
(Item is subject to subrule 11 (2))
|
|
|
55764
|
Pelvis or abdomen, pregnancy‑related or pregnancy
complication, fetal development and anatomy, ultrasound scan of, by any or
all approaches, with measurement of all parameters for dating purposes, if:
|
160.00
|
|
|
(a) the patient is referred by a medical practitioner
who:
(i) is a Member or Fellow of the Royal
Australian and New Zealand College of Obstetricians and Gynaecologists; or
(ii) has a Diploma of Obstetrics; or
(iii) has a qualification recognised by the Royal
Australian and New Zealand College of Obstetricians and Gynaecologists as
equivalent to a Diploma of Obstetrics; or
|
|
|
|
(iv) has obstetric privileges at a non‑metropolitan
hospital; and
(b) ultrasound of the same pregnancy confirms a
multiple pregnancy; and
|
|
|
|
(c) the dating of the pregnancy (as confirmed by
ultrasound) is 17 to 22 weeks gestation; and
|
|
|
|
(d) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies; and
(e) the referring practitioner is not a member of a
group of practitioners of which the providing practitioner is a member; and
(f) further examination is clinically indicated in the
same pregnancy in which item 55759 or 55762 has been performed; and
|
|
|
|
(g) the service described in item 55706, 55709,
55712 or 55715 is not performed in conjunction with the scan during the
same pregnancy (R)
|
|
|
55766
|
Pelvis or abdomen, pregnancy‑related or pregnancy
complication, fetal development and anatomy, ultrasound scan of, by any or
all approaches, with measurement of all parameters for dating purposes,
performed by or on behalf of a medical practitioner, who is a Member or
Fellow of the Royal Australian and New Zealand College of Obstetricians and
Gynaecologists, if:
(a) the patient is not referred by a medical
practitioner; and
(b) ultrasound of the same pregnancy confirms a
multiple pregnancy; and
(c) the dating of the pregnancy (as confirmed by
ultrasound) is 17 to 22 weeks of gestation; and
|
65.00
|
|
|
(d) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies; and
(e) further examination is clinically indicated in the
same pregnancy in which item 55759 or 55762 has been performed; and
|
|
|
|
(f) the service described in item 55706, 55709,
55712 or 55715 is not performed in conjunction with the scan during the
same pregnancy (NR)
|
|
|
55768
|
Pelvis or abdomen, pregnancy‑related or pregnancy
complication, fetal development and anatomy, ultrasound scan of, by any or
all approaches, if:
(a) dating of the pregnancy (as confirmed by
ultrasound) is after 22 weeks of gestation; and
(b) the ultrasound confirms a multiple pregnancy; and
(c) the patient is referred by a medical practitioner;
and
|
150.00
|
|
|
(d) the service is not performed in the same pregnancy
as item 55770; and
(e) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies; and
|
|
|
|
(f) the referring practitioner is not a member of a
group of practitioners of which the providing practitioner is a member; and
|
|
|
|
(g) the service described in item 55718, 55721,
55723 or 55725 is not performed in conjunction with the scan during the
same pregnancy (R)
(Item is subject to subrule 11 (2))
|
|
|
55770
|
Pelvis or abdomen,
pregnancy‑related or pregnancy complication, fetal development and
anatomy, ultrasound scan of, by any or all approaches, if:
(a) dating of the
pregnancy as confirmed by ultrasound is after 22 weeks of gestation; and
(b) the patient is
not referred by a medical practitioner; and
|
60.00
|
|
|
(c) the service is not
performed in the same pregnancy as item 55768; and
|
|
|
|
(d) the pregnancy
as confirmed by ultrasound is a multiple pregnancy; and
|
|
|
|
(e) the service is
not associated with a service to which an item in Subgroup 2 or 3 applies;
and
(f) the service described in item 55718, 55721, 55723,
or 55725 is not performed in conjunction with the scan during the same
pregnancy (NR)
(Item is subject to subrule 11 (2))
|
|
|
55772
|
Pelvis or abdomen,
pregnancy‑related or pregnancy complication, fetal development and
anatomy, ultrasound scan of, by any or all approaches, if:
(a) dating of the
pregnancy as confirmed by ultrasound is after 22 weeks of gestation; and
(b) the
patient is referred by a medical practitioner who:
(i) is a Member or Fellow of the Royal
Australian and New Zealand College of Obstetricians and Gynaecologists; or
(ii) has a Diploma of Obstetrics; or
|
160.00
|
|
|
(iii) has a qualification recognised by the Royal
Australian and New Zealand College of Obstetricians and Gynaecologists as
equivalent to a Diploma of Obstetrics; or
|
|
|
|
(iv) has obstetric privileges at a non‑metropolitan
hospital; and
|
|
|
|
(c) further examination is clinically indicated in the
same pregnancy to which item 55768 or 55770 has been performed; and
|
|
|
(d) the pregnancy
as confirmed by ultrasound is a multiple pregnancy; and
(e) the service is
not associated with a service to which an item in Subgroup 2 or 3 applies;
and
|
|
|
|
(f) the referring
practitioner is not a member of a group of practitioners of which the
providing practitioner is a member; and
(g) the service described in item 55718, 55721,
55723 or 55725 is not performed in conjunction with the scan during the
same pregnancy (R)
|
|
|
55774
|
Pelvis or abdomen,
pregnancy‑related or pregnancy complication, fetal development and
anatomy, ultrasound scan of, by any or all approaches, performed by or on
behalf of a medical practitioner who is a Member or a Fellow of the Royal
Australian and New Zealand College of Obstetricians and Gynaecologists, if:
(a) dating of the
pregnancy as confirmed by ultrasound is after 22 weeks of gestation; and
|
65.00
|
|
|
(b) the patient is
not referred by a medical practitioner; and
(c) further examination is clinically indicated in the
same pregnancy to which item 55768 or 55770 has been performed; and
|
|
|
|
(d) the pregnancy
as confirmed by ultrasound is a multiple pregnancy; and
(e) the service is
not associated with a service to which an item in Subgroup 2 or 3 applies;
and
(f) the service described in item 55718, 55721,
55723 or 55725 is not performed in conjunction with the scan during the
same pregnancy (NR)
|
|
|
Subgroup 6 —
Musculoskeletal Ultrasound
|
|
55800
|
Hand or wrist, 1 or
both sides, ultrasound scan of, if:
(a) the service is
not associated with a service to which an item in Subgroup 2 or 3 applies;
and
(b) the patient is
referred by a medical practitioner; and
(c) the referring
practitioner is not a member of a group of practitioners of which the
providing practitioner is a member (R)
|
109.10
|
|
55802
|
Hand or wrist, 1 or
both sides, ultrasound scan of, if:
(a) the service is
not associated with a service to which an item in Subgroup 2 or 3 applies; and
(b) the patient is
not referred by a medical practitioner (NR)
|
37.85
|
|
55804
|
Forearm or elbow, 1 or
both sides, ultrasound scan of, if:
(a) the service is
not associated with a service to which an item in Subgroup 2 or 3 applies;
and
(b) the patient is
referred by a medical practitioner; and
(c) the referring
practitioner is not a member of a group of practitioners of which the
providing practitioner is a member (R)
|
109.10
|
|
55806
|
Forearm or elbow, 1 or
both sides, ultrasound scan of, if:
(a) the service is
not associated with a service to which an item in Subgroup 2 or 3 applies; and
(b) the patient is
not referred by a medical practitioner (NR)
|
37.85
|
|
55808
|
Shoulder or upper arm,
1 or both sides, ultrasound scan of, if:
(a) the service is
not associated with a service to which an item in Subgroup 2 or 3 applies;
and
(b) the patient is
referred by a medical practitioner; and
(c) the referring
practitioner is not a member of a group of practitioners of which the
providing practitioner is a member; and
(d) the service is
used for the assessment of 1 or more of the following suspected or known
conditions:
(i) an injury to a muscle, tendon or
muscle/tendon junction;
(ii) rotator cuff tear, calcification or
tendinosis (biceps, subscapular, supraspinatus, infraspinatus);
|
109.10
|
|
|
(iii) biceps subluxation;
(iv) capsulitis and bursitis;
(v) a mass, including a ganglion;
|
|
|
|
(vi) an occult fracture;
(vii) acromioclavicular joint pathology (R)
|
|
|
55810
|
Shoulder or upper arm,
1 or both sides, ultrasound scan of, if:
(a) the service is
not associated with a service to which an item in Subgroup 2 or 3 applies;
and
(b) the patient is
not referred by a medical practitioner; and
(c) the service is
used for the assessment of 1 or more of the following suspected or known
conditions:
(i) an injury to a muscle, tendon or
muscle/tendon junction;
|
37.85
|
|
|
(ii) rotator cuff tear, calcification or
tendinosis (biceps, subscapular, supraspinatus, infraspinatus);
(iii) biceps subluxation;
(iv) capsulitis and bursitis;
(v) a mass, including a ganglion;
(vi) an occult fracture;
(vii) acromioclavicular joint pathology (NR)
|
|
|
55812
|
Chest or abdominal
wall, 1 or more areas, ultrasound scan of, if:
(a) the service is
not associated with a service to which an item in Subgroup 2 or 3 applies; and
(b) the patient is
referred by a medical practitioner; and
(c) the referring
practitioner is not a member of a group of practitioners of which the
providing practitioner is a member (R)
|
109.10
|
|
55814
|
Chest or abdominal
wall, 1 or more areas, ultrasound scan of, if:
(a) the service is
not associated with a service to which an item in Subgroup 2 or 3 applies; and
(b) the patient is
not referred by a medical practitioner (NR)
|
37.85
|
|
55816
|
Hip or groin, 1 or
both sides, ultrasound scan of, if:
(a) the service is
not associated with a service to which an item in Subgroup 2 or 3 applies; and
(b) the patient is
referred by a medical practitioner; and
(c) the referring
practitioner is not a member of a group of practitioners of which the
providing practitioner is a member (R)
|
109.10
|
|
55818
|
Hip or groin, 1 or
both sides, ultrasound scan of, if:
(a) the service is
not associated with a service to which an item in Subgroup 2 or 3 applies; and
(b) the patient is
not referred by a medical practitioner (NR)
|
37.85
|
|
55820
|
Paediatric hip
examination for dysplasia, 1 or both sides, ultrasound scan of, if:
(a) the service is
not associated with a service to which an item in Subgroup 2 or 3 applies; and
(b) the patient is
referred by a medical practitioner; and
(c) the referring
practitioner is not a member of a group of practitioners of which the
providing practitioner is a member (R)
|
109.10
|
|
55822
|
Paediatric hip
examination for dysplasia 1 or both sides, ultrasound scan of, if:
(a) the service is
not associated with a service to which an item in Subgroup 2 or 3 applies; and
(b) the patient is
not referred by a medical practitioner (NR)
|
37.85
|
|
55824
|
Buttock or thigh, 1 or
both sides, ultrasound scan of, if:
(a) the service is
not associated with a service to which an item in Subgroup 2 or 3 applies; and
(b) the patient is
referred by a medical practitioner; and
(c) the referring
practitioner is not a member of a group of practitioners of which the
providing practitioner is a member (R)
|
109.10
|
|
55826
|
Buttock or thigh, 1 or
both sides, ultrasound scan of, if:
(a) the service is
not associated with a service to which an item in Subgroup 2 or 3 applies; and
(b) the patient is
not referred by a medical practitioner (NR)
|
37.85
|
|
55828
|
Knee, 1 or both sides,
ultrasound scan of, if:
(a) the service is
not associated with a service to which an item in Subgroup 2 or 3 applies;
and
(b) the patient is
referred by a medical practitioner; and
(c) the referring
practitioner is not a member of a group of practitioners of which the
providing practitioner is a member; and
|
109.10
|
|
|
(d) the service is
used for the assessment of 1 or more of the following suspected or known
conditions:
(i) abnormality of tendons or bursae about the
knee;
(ii) a meniscal cyst, popliteal fossa cyst, mass
or pseudomass;
(iii) a nerve entrapment or a nerve or nerve
sheath tumour;
(iv) an injury of collateral ligaments (R)
|
|
|
55830
|
Knee, 1 or both sides,
ultrasound scan of, if:
(a) the service is
not associated with a service to which an item in Subgroup 2 or 3 applies;
and
(b) the patient is
not referred by a medical practitioner; and
(c) the service is
used for the assessment of 1 or more of the following suspected or known
conditions:
(i) abnormality of tendons or bursae about the
knee;
(ii) a meniscal cyst, popliteal fossa cyst, mass
or pseudomass;
(iii) a nerve entrapment or a nerve or nerve
sheath tumour;
(iv) an injury of collateral ligaments (NR)
|
37.85
|
|
55832
|
Lower leg, 1 or both
sides, ultrasound scan of, if:
(a) the service is
not associated with a service to which an item in Subgroup 2 or 3 applies; and
(b) the patient is
referred by a medical practitioner; and
|
109.10
|
|
|
(c) the referring
practitioner is not a member of a group of practitioners of which the
providing practitioner is a member (R)
|
|
|
55834
|
Lower leg, 1 or both
sides, ultrasound scan of, performed by or on behalf of a medical
practitioner, if:
(a) the service is
not associated with a service to which an item in Subgroup 2 or 3 applies; and
(b) the patient is
not referred by a medical practitioner (NR)
|
37.85
|
|
55836
|
Ankle or hind foot, 1
or both sides, ultrasound scan of, if:
(a) the service is
not associated with a service to which an item in Subgroup 2 or 3 applies; and
(b) the patient is
referred by a medical practitioner; and
(c) the referring
practitioner is not a member of a group of practitioners of which the
providing practitioner is a member (R)
|
109.10
|
|
55838
|
Ankle or hind foot, 1
or both sides, ultrasound scan of, if:
(a) the service is
not associated with a service to which an item in Subgroup 2 or 3 applies; and
(b) the patient is
not referred by a medical practitioner (NR)
|
37.85
|
|
55840
|
Mid foot or fore foot,
1 or both sides, ultrasound scan of, if:
(a) the service is
not associated with a service to which an item in Subgroup 2 or 3 applies; and
(b) the patient is
referred by a medical practitioner; and
(c) the referring
practitioner is not a member of a group of practitioners of which the
providing practitioner is a member (R)
|
109.10
|
|
55842
|
Mid foot or fore foot,
1 or both sides, ultrasound scan of, if:
(a) the service is
not associated with a service to which an item in Subgroup 2 or 3 applies; and
(b) the patient is
not referred by a medical practitioner (NR)
|
37.85
|
|
55844
|
Assessment of a mass
associated with the skin or subcutaneous structures, not being a part of the
musculoskeletal system, 1 or more areas, ultrasound scan of, if:
(a) the service is
not associated with a service to which an item in Subgroup 2 or 3 applies;
and
(b) the patient is
referred by a medical practitioner; and
|
87.35
|
|
|
(c) the referring
practitioner is not a member of a group of practitioners of which the
providing practitioner is a member (R)
|
|
|
55846
|
Assessment of a mass
associated with the skin or subcutaneous structures, not being a part of the
musculoskeletal system, 1 or more areas, ultrasound scan of, if:
(a) the service is
not associated with a service to which an item in Subgroup 2 or 3 applies; and
(b) the patient is
not referred by a medical practitioner (NR)
|
37.85
|
|
55848
|
Musculoskeletal cross‑sectional
echography, in conjunction with a surgical procedure using interventional
techniques, not being a service associated with a service to which any other
item in this group applies, and not performed in conjunction with item 55054
(R)
|
109.10
|
|
55850
|
Musculoskeletal cross‑sectional
echography, in conjunction with a surgical procedure using interventional
techniques, inclusive of a diagnostic musculoskeletal ultrasound service, if:
(a) the referring
practitioner has indicated on a referral for a musculoskeletal ultrasound
that an ultrasound guided intervention be performed if clinically indicated;
and
|
152.85
|
|
|
(b) the service is
not performed in conjunction with items 55054, or 55800 to 55848; and
(c) the patient is
referred by a medical practitioner; and
(d) the referring
practitioner is not a member of a group of practitioners of which the
providing practitioner is a member (R)
|
|
|
55852
|
Paediatric spine, spinal cord and overlying subcutaneous
tissues, ultrasound scan of, if:
(a) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies; and
(b) the patient is referred by a medical practitioner;
and
(c) the referring practitioner is not a member of a
group of practitioners of which the providing practitioner is a member (R)
|
109.10
|
|
55854
|
Paediatric spine, spinal cord and overlying subcutaneous
tissues, ultrasound scan of, if:
(a) the service is not associated with a service to
which an item in Subgroup 2 or 3 applies; and
(b) the patient is not referred by a medical
practitioner (NR)
|
37.85
|
|
Group I2 — Computed tomography — Examination
|
|
56001
|
Computed tomography — scan of brain without
intravenous contrast medium, not being a service to which item 57001
applies (R) (K) (Anaes.)
|
195.05
|
|
56007
|
Computed tomography — scan of brain with intravenous
contrast medium and with any scans of the brain before intravenous contrast
injection, when performed, not being a service to which item 57007
applies (R) (K) (Anaes.)
|
250.00
|
|
56010
|
Computed tomography — scan of pituitary fossa with or
without intravenous contrast medium and with or without brain scan when
performed (R) (K) (Anaes.)
|
252.10
|
|
56013
|
Computed tomography — scan of orbits with or without
intravenous contrast medium and with or without brain scan when performed (R)
(K) (Anaes.)
|
250.00
|
|
56016
|
Computed tomography — scan of petrous bones in axial
and coronal planes in 1 mm or 2 mm sections, with or without intravenous
contrast medium, with or without scan of brain (R) (K) (Anaes.)
|
290.00
|
|
56022
|
Computed tomography — scan of facial bones, para
nasal sinuses or both without intravenous contrast medium (R) (K)
(Anaes.)
|
225.00
|
|
56028
|
Computed tomography — scan of facial bones, para
nasal sinuses or both with intravenous contrast medium and with any scans of
the facial bones, para nasal sinuses or both before intravenous contrast
injection, when performed (R) (K) (Anaes.)
|
336.80
|
|
56030
|
Computed tomography — scan of facial bones, para
nasal sinuses or both, with scan of brain, without intravenous contrast
medium (R) (K) (Anaes.)
|
225.00
|
|
56036
|
Computed tomography — scan of facial bones, para
nasal sinuses or both, with scan of brain, with intravenous contrast medium, if:
(a) a scan without intravenous contrast medium has been
performed; and
(b) the service is required because the result of the
scan mentioned in paragraph (a) is abnormal (R) (K) (Anaes.)
|
336.80
|
|
56041
|
Computed tomography — scan of brain without
intravenous contrast medium, not being a service to which item 57041
applies (R) (NK) (Anaes.)
|
98.75
|
|
56047
|
Computed tomography — scan of brain with intravenous
contrast medium and with any scans of the brain before intravenous contrast
injection, when performed, not being a service to which item 57047
applies (R) (NK) (Anaes.)
|
126.10
|
|
56050
|
Computed tomography — scan of pituitary fossa with or
without intravenous contrast medium and with or without brain scan when
performed (R) (NK) (Anaes.)
|
128.20
|
|
56053
|
Computed tomography — scan of orbits with or without
intravenous contrast medium and with or without brain scan when performed (R)
(NK) (Anaes.)
|
128.20
|
|
56056
|
Computed tomography — scan of petrous bones in axial
and coronal planes in 1 mm or 2 mm sections, with or without intravenous
contrast medium, with or without scan of brain (R) (NK) (Anaes.)
|
155.45
|
|
56062
|
Computed tomography — scan of facial bones, para
nasal sinuses or both without intravenous contrast medium (R) (NK)
(Anaes.)
|
113.15
|
|
56068
|
Computed tomography — scan of facial bones, para
nasal sinuses or both with intravenous contrast medium and with any scans of
the facial bones, para nasal sinuses or both before intravenous contrast
injection, when performed (R) (NK) (Anaes.)
|
168.40
|
|
56070
|
Computed tomography — scan of facial bones, para
nasal sinuses or both, with scan of brain, without intravenous contrast
medium (R) (NK) (Anaes.)
|
113.15
|
|
56076
|
Computed tomography — scan of facial bones, para
nasal sinuses or both, with scan of brain, with intravenous contrast medium, if:
(a) a scan without intravenous contrast medium has been
performed; and
(b) the service is required because the result of the
scan mentioned in paragraph (a) is abnormal (R) (NK) (Anaes.)
|
168.40
|
|
56101
|
Computed tomography — scan of soft tissues of neck,
including larynx, pharynx, upper oesophagus and salivary glands (not associated
with cervical spine) without intravenous contrast medium, not being a service
to which item 56801 applies (R) (K) (Anaes.)
|
230.00
|
|
56107
|
Computed tomography — scan of soft tissues of neck,
including larynx, pharynx, upper oesophagus and salivary glands (not
associated with cervical spine) — with intravenous contrast medium and
with any scans of soft tissues of neck, including larynx, pharynx, upper
oesophagus and salivary glands (not associated with cervical spine) before
intravenous contrast injection, when undertaken, not being a service
associated with a service to which item 56807 applies (R) (K) (Anaes.)
|
340.00
|
|
56141
|
Computed tomography — scan of soft tissues of neck,
including larynx, pharynx, upper oesophagus and salivary glands (not associated
with cervical spine) without intravenous contrast medium, not being a service
to which item 56841 applies (R) (NK) (Anaes.)
|
116.45
|
|
56147
|
Computed tomography — scan of soft tissues of neck,
including larynx, pharynx, upper oesophagus and salivary glands (not
associated with cervical spine) — with intravenous contrast medium and
with any scans of soft tissues of neck, including larynx, pharynx, upper
oesophagus and salivary glands (not associated with cervical spine) before
intravenous contrast injection, when performed, not being a service
associated with a service to which item 56847 applies (R) (NK) (Anaes.)
|
171.60
|
|
56219
|
Computed tomography — scan of spine, 1 or more
regions with intrathecal contrast medium, including the preparation for
intrathecal injection of contrast medium and any associated plain x‑rays,
not being a service to which item 59724 applies (R) (K) (Anaes.)
|
326.20
|
|
56220
|
Computed tomography — scan of spine, cervical region,
without intravenous contrast medium (R) (K) (Anaes.)
|
240.00
|
|
56221
|
Computed tomography — scan of spine, thoracic region,
without intravenous contrast medium (R) (K) (Anaes.)
|
240.00
|
|
56223
|
Computed tomography — scan of spine, lumbosacral
region, without intravenous contrast medium (R) (K) (Anaes.)
|
240.00
|
|
56224
|
Computed tomography — scan of spine, cervical region,
with intravenous contrast medium and with any scans of the cervical region of
the spine before intravenous contrast injection when undertaken (R) (K)
(Anaes.)
|
351.40
|
|
56225
|
Computed tomography — scan of spine, thoracic region,
with intravenous contrast medium and with any scans of the thoracic region of
the spine before intravenous contrast injection when undertaken (R) (K)
(Anaes.)
|
351.40
|
|
56226
|
Computed tomography — scan of spine, lumbosacral
region, with intravenous contrast medium and with any scans of the
lumbosacral region of the spine prior to intravenous contrast injection when
undertaken (R) (K) (Anaes.)
|
351.40
|
|
56227
|
Computed tomography — scan of spine, cervical region,
without intravenous contrast medium (R) (NK) (Anaes.)
|
122.50
|
|
56228
|
Computed tomography — scan of spine, thoracic region,
without intravenous contrast medium (R) (NK) (Anaes.)
|
122.50
|
|
56229
|
Computed tomography — scan of spine, lumbosacral
region, without intravenous contrast medium (R) (NK) (Anaes.)
|
122.50
|
|
56230
|
Computed tomography — scan of spine, cervical region,
with intravenous contrast medium and with any scans to the cervical region of
the spine before intravenous contrast injection when undertaken (R) (NK)
(Anaes.)
|
177.45
|
|
56231
|
Computed tomography — scan of spine, thoracic region,
with intravenous contrast medium and with any scans to the cervical region of
the spine before intravenous contrast injection when undertaken (R) (NK)
(Anaes.)
|
177.45
|
|
56232
|
Computed tomography — scan of spine, lumbosacral
region, with intravenous contrast medium and with any scans to the
lumbosacral region of the spine before intravenous contrast injection when
undertaken (R) (NK) (Anaes.)
|
177.45
|
|
56233
|
Computed tomography — scan of spine, 2 examinations
of the kind referred to in items 56220, 56221 and 56223, without intravenous
contrast medium (R) (K) (Anaes.)
|
240.00
|
|
56234
|
Computed tomography — scan of spine, 2 examinations
of the kind referred to in items 56224, 56225 and 56226, with intravenous contrast
medium and with any scans of these regions of the spine before intravenous
contrast injection when undertaken (R) (K) (Anaes.)
|
351.40
|
|
56235
|
Computed tomography — scan of spine, 2 examinations
of the kind referred to in items 56227, 56228 and 56229, without intravenous
contrast medium (R) (NK) (Anaes.)
|
122.45
|
|
56236
|
Computed tomography — scan of spine, 2 examinations
of the kind referred to in items 56230, 56231 and 56232, with intravenous
contrast medium and with any scans of these regions of the spine before
intravenous contrast injection when undertaken (R) (NK) (Anaes.)
|
177.45
|
|
56237
|
Computed tomography — scan of spine, 3 regions
cervical, thoracic and lumbosacral, without intravenous contrast medium (R)
(K) (Anaes.)
|
240.00
|
|
56238
|
Computed tomography —
scan of spine, 3 regions, cervical, thoracic and lumbosacral, with
intravenous contrast medium and with any scans of these regions of the spine
before intravenous contrast injection when undertaken (R) (K) (Anaes.)
|
351.40
|
|
56239
|
Computed tomography — scan of spine, 3 regions,
cervical, thoracic and lumbosacral, without intravenous contrast medium (R)
(NK) (Anaes.)
|
122.45
|
|
56240
|
Computed tomography — scan of spine, 3 regions,
cervical, thoracic and lumbosacral, with intravenous contrast medium and with
any scans of these regions of the spine before intravenous contrast injection
when undertaken (R) (NK) (Anaes.)
|
177.45
|
|
56259
|
Computed tomography — scan of spine, 1 or more
regions with intrathecal contrast medium, including the preparation for
intrathecal injection of contrast medium and any associated plain x‑rays,
not being a service to which item 59724 applies (R) (NK) (Anaes.)
|
164.80
|
|
56301
|
Computed tomography — scan of chest, including lungs,
mediastinum, chest wall and pleura, with or without scans of the upper
abdomen, without intravenous contrast medium, not being a service to which
item 56801 or 57001 applies and not including a study performed to
exclude coronary artery calcification or image the coronary arteries (R) (K)
(Anaes.)
|
295.00
|
|
56307
|
Computed tomography — scan of chest, including lungs,
mediastinum, chest wall and pleura, with or without scans of the upper
abdomen, with intravenous contrast medium and with any scans of the chest,
including lungs, mediastinum, chest wall or pleura and upper abdomen before
intravenous contrast injection, when undertaken, not being a service to which
item 56807 or 57007 applies and not including a study performed to
exclude coronary artery calcification or image the coronary arteries (R) (K)
(Anaes.)
|
400.00
|
|
56341
|
Computed tomography — scan of chest, including lungs,
mediastinum, chest wall and pleura, with or without scans of the upper
abdomen, without intravenous contrast medium, not being a service to which
item 56841 or 57041 applies and not including a study performed to
exclude coronary artery calcification or image the coronary arteries (R) (NK)
(Anaes.)
|
149.45
|
|
56347
|
Computed tomography — scan of chest, including lungs,
mediastinum, chest wall and pleura, with or without scans of the upper
abdomen, with intravenous contrast medium and with any scans of the chest,
including lungs, mediastinum, chest wall or pleura and upper abdomen before
intravenous contrast injection, when undertaken, not being a service to which
item 56847 or 57047 applies and not including a study performed to
exclude coronary artery calcification or image the coronary arteries (R) (NK)
(Anaes.)
|
202.00
|
|
56401
|
Computed tomography — scan of upper abdomen only
(diaphragm to iliac crest) without intravenous contrast medium, not being a service
to which item 56301, 56501, 56801 or 57001 applies (R) (K) (Anaes.)
|
250.00
|
|
56407
|
Computed tomography — scan of upper abdomen only
(diaphragm to iliac crest), with intravenous contrast medium, and with any
scans of upper abdomen (diaphragm to iliac crest) before intravenous contrast
injection, when undertaken, not being a service to which item 56307,
56507, 56807 or 57007 applies (R) (K) (Anaes.)
|
360.00
|
|
56409
|
Computed tomography — scan of pelvis only (iliac
crest to pubic symphysis) without intravenous contrast medium not being a
service associated with a service to which item 56401 applies (R) (K)
(Anaes.)
|
250.00
|
|
56412
|
Computed tomography — scan of pelvis only (iliac
crest to pubic symphysis), with intravenous contrast medium and with any
scans of pelvis (iliac crest to pubic symphysis) before intravenous contrast
injection, when undertaken, not being a service to which item 56407 applies
(R) (K) (Anaes.)
|
360.00
|
|
56441
|
Computed tomography — scan of upper abdomen only
(diaphragm to iliac crest) without intravenous contrast medium, not being a
service to which item 56341, 56541, 56841 or 57041 applies (R) (NK)
(Anaes.)
|
126.80
|
|
56447
|
Computed tomography — scan of upper abdomen only
(diaphragm to iliac crest), with intravenous contrast medium, and with any
scans of upper abdomen (diaphragm to iliac crest) before intravenous contrast
injection, when performed, not being a service to which item 56347,
56547, 56847 or 57047 applies (R) (NK) (Anaes.)
|
181.50
|
|
56449
|
Computed tomography — scan of pelvis only (iliac
crest to pubic symphysis) without intravenous contrast medium not being a
service associated with a service to which item 56441 applies (R) (NK)
(Anaes.)
|
126.80
|
|
56452
|
Computed tomography — scan of pelvis only (iliac
crest to pubic symphysis), with intravenous contrast medium and with any
scans of pelvis (iliac crest to pubic symphysis) before intravenous contrast
injection, when undertaken, not being a service to which item 56447 applies
(R) (NK) (Anaes.)
|
181.50
|
|
56501
|
Computed tomography — scan of upper abdomen and
pelvis without intravenous contrast medium, not for the purposes of virtual
colonoscopy and not being a service to which item 56801 or 57001 applies
(R) (K) (Anaes.)
|
385.00
|
|
56507
|
Computed tomography — scan of upper abdomen and
pelvis with intravenous contrast medium and with any scans of upper abdomen
and pelvis before intravenous contrast injection, when performed, not for the
purposes of virtual colonoscopy and not being a service to which item 56807
or 57007 applies (R) (K) (Anaes.)
|
480.05
|
|
56541
|
Computed tomography — scan of upper abdomen and
pelvis without intravenous contrast medium, not for the purposes of virtual
colonoscopy and not being a service to which item 56841 or 57041 applies
(R) (NK) (Anaes.)
|
193.15
|
|
56547
|
Computed tomography — scan of upper abdomen and
pelvis with intravenous contrast medium and with any scans of upper abdomen
and pelvis before intravenous contrast injection, when performed, not for the
purposes of virtual colonoscopy and not being a service to which item 56847
or 57047 applies (R) (NK) (Anaes.)
|
243.75
|
|
56552
|
Computed tomography — scan of colon for exclusion of
colorectal neoplasia in symptomatic or high risk patients if:
(a) the patient has had an incomplete colonoscopy in
the 3 months before the scan; and
(b) the date of incomplete colonoscopy is set out on
the request for scan; and
(c) the service is not a service to which item 56301,
56307, 56401, 56407, 56409, 56412, 56501, 56507, 56801, 56807 or 57001
applies (R) (K) (Anaes.)
|
600.00
|
|
56554
|
Computed tomography — scan of colon for exclusion of
colorectal neoplasia in symptomatic or high risk patients if:
(a) the request for scan states that 1 of the following
contraindications to colonoscopy is present:
(i) suspected perforation of the colon;
(ii) complete or high‑grade obstruction
that will not allow passage of the scope; and
(b) the service must not be a service to which item
56301, 56307, 56401, 56407, 56409, 56412, 56501, 56507, 56801, 56807 or 57001
applies (R) (K) (Anaes.)
|
600.00
|
|
56619
|
Computed tomography — scan of extremities, 1 or more
regions without intravenous contrast medium (R) (K) (Anaes.)
|
220.00
|
|
56625
|
Computed tomography — scan of extremities, 1 or more
regions with intravenous contrast medium and with any scans of extremities
before intravenous contrast injection, when performed (R) (K) (Anaes.)
|
334.65
|
|
56659
|
Computed tomography — scan of extremities, 1 or more
regions without intravenous contrast medium (R) (NK) (Anaes.)
|
112.10
|
|
56665
|
Computed tomography — scan of extremities, 1 or more
regions with intravenous contrast medium and with any scans of extremities
before intravenous contrast injection, when performed (R) (NK) (Anaes.)
|
167.40
|
|
56801
|
Computed tomography — scan of chest, abdomen and
pelvis with or without scans of soft tissues of neck without intravenous
contrast medium, not including a study performed to exclude coronary artery
calcification or image the coronary arteries (R) (K) (Anaes.)
|
466.55
|
|
56807
|
Computed tomography — scan of chest, abdomen and
pelvis with or without scans of soft tissues of neck with intravenous
contrast medium and with any scans of chest, abdomen and pelvis with or
without scans of soft tissue of neck before intravenous contrast injection,
when performed, not including a study performed to exclude coronary artery
calcification or image the coronary arteries (R) (K) (Anaes.)
|
560.00
|
|
56841
|
Computed tomography — scan of chest, abdomen and
pelvis with or without scans of soft tissues of neck without intravenous
contrast medium, not including a study performed to exclude coronary artery
calcification or image the coronary arteries (R) (NK) (Anaes.)
|
233.35
|
|
56847
|
Computed tomography — scan of chest, abdomen and
pelvis with or without scans of soft tissues of neck with intravenous
contrast medium and with any scans of chest, abdomen and pelvis with or
without scans of soft tissue of neck before intravenous contrast injection,
when performed, not including a study performed to exclude coronary artery
calcification or image the coronary arteries (R) (NK) (Anaes.)
|
283.85
|
|
57001
|
Computed tomography — scan of brain and chest with or
without scans of upper abdomen without intravenous contrast medium, not
including a study performed to exclude coronary artery calcification or image
the coronary arteries (R) (K) (Anaes.)
|
466.65
|
|
57007
|
Computed tomography — scan of brain and chest with or
without scans of upper abdomen with intravenous contrast medium and with any
scans of brain and chest and upper abdomen before intravenous contrast
injection, when performed, not including a study performed to exclude
coronary artery calcification or image the coronary arteries (R) (K)
(Anaes.)
|
567.75
|
|
57041
|
Computed tomography — scan of brain and chest with or
without scans of upper abdomen without intravenous contrast medium, not
including a study performed to exclude coronary artery calcification or image
the coronary arteries (R) (NK) (Anaes.)
|
233.40
|
|
57047
|
Computed tomography — scan of brain and chest with or
without scans of upper abdomen with intravenous contrast medium and with any scans
of brain and chest and upper abdomen before intravenous contrast injection,
when performed, not including a study performed to exclude coronary artery
calcification or image the coronary arteries (R) (NK) (Anaes.)
|
283.90
|
|
57201
|
Computed tomography — pelvimetry (R) (K) (Anaes.)
|
155.20
|
|
57247
|
Computed tomography — pelvimetry (R) (NK) (Anaes.)
|
77.55
|
|
57341
|
Computed tomography, in conjunction with a surgical
procedure using interventional techniques, not being a service associated
with a service to which another item in this table applies (R) (K) (Anaes.)
|
470.00
|
|
57345
|
Computed tomography, in conjunction with a surgical
procedure using interventional techniques, not being a service associated
with a service to which another item in this table applies (R) (NK) (Anaes.)
|
241.60
|
|
57350
|
Computed tomography — spiral angiography with
intravenous contrast medium including any scans performed before intravenous
contrast injection — 1 or more spiral data acquisitions, including image
editing, and maximum intensity projections or 3 dimensional surface
shaded display, with hardcopy recording of multiple projections, if:
(a) the service is not a service to which another item
in this group applies; and
|
510.00
|
|
|
(b) the service is performed for the exclusion of
arterial stenosis, occlusion, aneurysm or embolism; and
|
|
|
|
(c) the service has not been performed on the same
patient within the previous 12 months; and
(d) the service is not a study performed to image the
coronary arteries (R) (K) (Anaes.)
|
|
|
57351
|
Computed tomography — spiral angiography with
intravenous contrast medium, including any scans performed before intravenous
contrast injection — 1 or more spiral data acquisitions, including image
editing, and maximum intensity projections or 3 dimensional surface shaded
display, with hardcopy recording of multiple projections, if:
(a) the service is not a service to which another item
in this group applies; and
|
510.00
|
|
|
(b) the service is
performed for the exclusion of acute or recurrent pulmonary embolism, acute
symptomatic arterial occlusion, post operative complication of arterial
surgery, acute ruptured aneurysm, or acute dissection of the aorta, carotid
or vertebral artery; and
|
|
|
|
(c) a service to which item 57350 or 57355 applies has
been performed on the same patient within the previous 12 months; and
(d) the service is not a study performed to image the
coronary arteries (R) (K) (Anaes.)
|
|
|
57355
|
Computed tomography — spiral angiography with
intravenous contrast medium including any scans performed before intravenous
contrast injection — 1 or more spiral data acquisitions, including image
editing, and maximum intensity projections or 3 dimensional surface
shaded display, with hardcopy recording of multiple projections, if:
(a) the service is not a service to which another item
in this group applies; and
(b) the service is performed for the exclusion of
arterial stenosis, occlusion, aneurysm or embolism; and
|
264.15
|
|
|
(c) the service has not been performed on the same
patient within the previous 12 months; and
(d) the service is not a study performed to image the
coronary arteries (R) (NK) (Anaes.)
|
|
|
57356
|
Computed tomography — spiral angiography with
intravenous contrast medium, including any scans performed before intravenous
contrast injection — 1 or more spiral data acquisitions, including image
editing, and maximum intensity projections or 3 dimensional surface shaded
display, with hardcopy recording of multiple projections, if:
(a) the service is not a service to which another item
in this group applies; and
|
264.15
|
|
|
(b) the service is performed for the exclusion of acute
or recurrent pulmonary embolism, acute symptomatic arterial occlusion, post
operative complication of arterial surgery, acute ruptured aneurysm, or acute
dissection of the aorta, carotid or vertebral artery; and
|
|
|
|
(c) the service to which item 57350 or 57355 applies
has been performed on the same patient within the previous 12 months;
and
(d) the service is not a study performed to image the
coronary arteries (R) (NK) (Anaes.)
|
|
|
Group I3 — Diagnostic radiology
|
|
Subgroup 1 —
Radiographic examination of extremities
|
|
57506
|
Hand, wrist, forearm, elbow or humerus (NR)
|
29.75
|
|
57509
|
Hand, wrist, forearm, elbow or humerus (R)
|
39.75
|
|
57512
|
Hand and wrist, or hand, wrist and forearm, or forearm and
elbow, or elbow and humerus (NR)
|
40.50
|
|
57515
|
Hand and wrist, or hand, wrist and forearm, or forearm and
elbow, or elbow and humerus (R)
|
54.00
|
|
57518
|
Foot, ankle, leg, knee or femur (NR)
|
32.50
|
|
57521
|
Foot, ankle, leg, knee or femur (R)
|
43.40
|
|
57524
|
Foot and ankle, or ankle and leg, or leg and knee, or knee
and femur (NR)
|
49.40
|
|
57527
|
Foot and ankle, or ankle and leg, or leg and knee, or knee
and femur (R)
|
65.75
|
|
Subgroup 2 —
Radiographic examination of shoulder or pelvis
|
|
57700
|
Shoulder or scapula (NR)
|
40.50
|
|
57703
|
Shoulder or scapula (R)
|
54.00
|
|
57706
|
Clavicle (NR)
|
32.50
|
|
57709
|
Clavicle (R)
|
43.40
|
|
57712
|
Hip joint (R)
|
47.15
|
|
57715
|
Pelvic girdle (R)
|
60.90
|
|
57721
|
Femur, internal fixation of neck or intertrochanteric
(pertrochanteric) fracture (R)
|
99.25
|
|
Subgroup 3 —
Radiographic examination of head
|
|
57901
|
Skull, not in association with item 57902 (R)
|
64.50
|
|
57902
|
Cephalometry, not in association with item 57901 (R)
|
64.50
|
|
57903
|
Sinuses (R)
|
47.30
|
|
57906
|
Mastoids (R)
|
64.50
|
|
57909
|
Petrous temporal bones (R)
|
64.50
|
|
57912
|
Facial bones — orbit, maxilla or malar, any or all
(R)
|
47.15
|
|
57915
|
Mandible, not by orthopantomography technique (R)
|
47.15
|
|
57918
|
Salivary calculus (R)
|
47.15
|
|
57921
|
Nose (R)
|
47.15
|
|
57924
|
Eye (R)
|
47.15
|
|
57927
|
Temporo‑mandibular joints (R)
|
49.65
|
|
57930
|
Teeth — single area (R)
|
32.90
|
|
57933
|
Teeth — full mouth (R)
|
78.25
|
|
57939
|
Palato‑pharyngeal studies with fluoroscopic
screening (R)
|
64.50
|
|
57942
|
Palato‑pharyngeal studies without fluoroscopic
screening (R)
|
49.65
|
|
57945
|
Larynx, lateral airways and soft tissues of the neck, not
being a service associated with a service to which item 57939 or 57942
applies (R)
|
43.40
|
|
57960
|
Orthopantomography for diagnosis or management (or both)
of trauma, infection, tumour or a congenital or surgical condition of the
teeth or maxillofacial region (R)
|
47.40
|
|
57963
|
Orthopantomography for diagnosis or management (or both)
of any of the following conditions, if the signs and symptoms of the
condition is present:
(a) impacted teeth;
(b) caries;
(c) periodontal pathology;
(d) periapical pathology (R)
|
47.40
|
|
57966
|
Orthopantomography for diagnosis or management (or both)
of missing or crowded teeth, or developmental anomalies of the teeth or jaws
(R)
|
47.40
|
|
57969
|
Orthopantomography for diagnosis or management (or both)
of temporo‑mandibular joint arthroses or dysfunction (R)
|
47.40
|
|
Subgroup 4 —
Radiographic examination of spine
|
|
58100
|
Spine — cervical (R)
|
67.15
|
|
58103
|
Spine — thoracic (R)
|
55.10
|
|
58106
|
Spine — lumbo‑sacral (R)
|
77.00
|
|
58108
|
Spine — 4 regions, cervical, thoracic, lumbosacral
and sacrococcygeal (R)
|
110.00
|
|
58109
|
Spine — sacro‑coccygeal (R)
|
47.00
|
|
58112
|
Spine — 2 examinations of the kind mentioned in items 58100,
58103, 58106 and 58109 (R)
|
97.25
|
|
58115
|
Spine — 3 examinations of the kind mentioned in items 58100,
58103, 58106 and 58109 (R)
|
110.00
|
|
58120
|
Spine — 4 regions, cervical, thoracic, lumbosacral
and sacrococcygeal (R), if the service to which item 58120 or 58121 applies
has not been performed on the same patient within the same calendar year
|
110.00
|
|
58121
|
Spine — 3 examinations of the kind mentioned in items 58100,
58103, 58106 and 58109 (R), if the service to which item 58120 or 58121
applies has not been performed on the same patient within the same calendar
year
|
110.00
|
|
Subgroup 5 — Bone age
study and skeletal survey
|
|
58300
|
Bone age study (R)
|
40.10
|
|
58306
|
Skeletal survey (R)
|
89.40
|
|
Subgroup 6 —
Radiographic examination of thoracic region
|
|
58500
|
Chest (lung fields) by direct radiography (NR)
|
35.35
|
|
58503
|
Chest (lung fields) by direct radiography (R)
|
47.15
|
|
58506
|
Chest (lung fields) by direct radiography with
fluoroscopic screening (R)
|
60.75
|
|
58509
|
Thoracic inlet or trachea (R)
|
39.75
|
|
58521
|
Left ribs, right ribs or sternum (R)
|
43.40
|
|
58524
|
Left and right ribs, left ribs and sternum, or right ribs
and sternum (R)
|
56.50
|
|
58527
|
Left ribs, right ribs and sternum (R)
|
69.40
|
|
Subgroup 7 —
Radiographic examination of urinary tract
|
|
58700
|
Plain renal only (R)
|
46.05
|
|
58706
|
Intravenous pyelography, with or without preliminary plain
films and with or without tomography (R)
|
157.90
|
|
58715
|
Antegrade or retrograde pyelography with or without
preliminary plain films and with preparation and contrast injection, 1 side
(R)
|
151.55
|
|
58718
|
Retrograde cystography or retrograde urethrography with or
without preliminary plain films and with preparation and contrast injection
(R) (Anaes.)
|
126.10
|
|
58721
|
Retrograde micturating cysto‑urethrography, with
preparation and contrast injection (R) (Anaes.)
|
138.25
|
|
Subgroup 8 —
Radiographic examination of alimentary tract and biliary system
|
|
58900
|
Plain abdominal only, not being a service associated with
a service to which item 58909, 58912, 58915 or 58924 applies (NR)
|
35.70
|
|
58903
|
Plain abdominal only, not being a service associated with
a service to which item 58909, 58912, 58915 or 58924 applies (R)
|
47.60
|
|
58909
|
Barium or other opaque meal of 1 or more of pharynx,
oesophagus, stomach or duodenum, with or without preliminary plain films of
pharynx, chest or duodenum, not being a service associated with a service to
which item 57939, 57942 or 57945 applies (R)
|
89.95
|
|
58912
|
Barium or other opaque meal of oesophagus, stomach,
duodenum and follow through to colon, with or without screening of chest and
with or without preliminary plain film (R)
|
110.25
|
|
58915
|
Barium or other opaque meal, small bowel series only, with
or without preliminary plain film (R)
|
78.95
|
|
58916
|
Small bowel enema, barium or other opaque study of the
small bowel, including duodenal intubation, with or without preliminary plain
films, not being a service associated with a service to which item 30488
applies (R) (Anaes.)
|
138.50
|
|
58921
|
Opaque enema, with or without air contrast study and with
or without preliminary plain films (R)
|
135.25
|
|
58924
|
Graham’s test (cholecystography), with preliminary plain
films and with or without tomography (R)
|
84.05
|
|
58927
|
Cholegraphy direct, with or without preliminary plain
films and with preparation and contrast injection, not being a service
associated with a service to which item 30439 applies (R)
|
76.45
|
|
58933
|
Cholegraphy, percutaneous transhepatic, with or without
preliminary plain films and with preparation and contrast injection (R)
|
205.60
|
|
58936
|
Cholegraphy, drip infusion, with or without preliminary
plain films, with preparation and contrast injection and with or without
tomography (R)
|
195.95
|
|
58939
|
Defaecogram (R)
|
139.30
|
|
Subgroup 9 —
Radiographic examination for localisation of foreign bodies
|
|
59103
|
Localisation of foreign body, if provided in conjunction
with a service described in Subgroups 1 to 12 of Group I3 (R)
|
21.30
|
|
Subgroup
10 — Radiographic examination of breasts
|
|
59300
|
Mammography of both breasts if there is reason to suspect
the presence of malignancy because of:
(a) the past occurrence of breast malignancy in the
patient or members of the patient’s family; or
|
89.50
|
|
|
(b) symptoms or indications of malignancy found on
examination of the patient by a medical practitioner (R)
|
|
|
59303
|
Mammography of 1 breast if:
(a) the patient is referred with a specific request for
a unilateral mammogram; and
(b) there is reason to suspect the presence of
malignancy because of:
(i) the past occurrence of breast malignancy in
the patient or members of the patient’s family; or
|
53.95
|
|
|
(ii) symptoms or indications of malignancy found
on examination of the patient by a medical practitioner (R)
|
|
|
59306
|
Mammary ductogram (galactography) — 1 breast (R)
|
100.30
|
|
59309
|
Mammary ductogram (galactography) — 2 breasts
(R)
|
200.60
|
|
59312
|
Radiographic examination of both breasts, in conjunction
with a surgical procedure on each breast, using interventional techniques (R)
|
87.00
|
|
59314
|
Radiographic examination of 1 breast, in conjunction with
a surgical procedure using interventional techniques (R)
|
52.50
|
|
59318
|
Radiographic examination of excised breast tissue to
confirm satisfactory excision of 1 or more lesions in 1 breast or both
following pre‑operative localisation in conjunction with a service
under item 31536 (R)
|
47.05
|
|
Subgroup 11 —
Radiographic examination in connection with pregnancy
|
|
59503
|
Pelvimetry, not being a service associated with a service
to which item 57201 applies (R)
|
89.40
|
|
Subgroup 12 —
Radiographic examination with opaque or contrast media
|
|
59700
|
Discography, each disc, with or without preliminary plain
films and with preparation and contrast injection (R) (Anaes.)
|
96.55
|
|
59703
|
Dacryocystography, 1 side, with or without preliminary
plain film and with preparation and contrast injection (R)
|
75.90
|
|
59712
|
Hysterosalpingography, with or without preliminary plain
films and with preparation and contrast injection (R) (Anaes.)
|
113.70
|
|
59715
|
Bronchography, 1 side, with or without preliminary plain
films and with preparation and contrast injection (R) (Anaes.)
|
143.55
|
|
59718
|
Phlebography, 1 side, with or without preliminary plain
films and with preparation and contrast injection (R) (Anaes.)
|
134.65
|
|
59724
|
Myelography, 1 or more regions, with or without
preliminary plain films and with preparation and contrast injection, not
being a service associated with a service to which item 56219 applies
(R) (Anaes.)
|
226.45
|
|
59733
|
Sialography, 1 side, with preparation and contrast
injection, not being a service associated with a service to which item 57918
applies (R)
|
107.70
|
|
59736
|
Vasoepididymography, 1 side (R)
|
62.00
|
|
59739
|
Sinogram or fistulogram, 1 or more regions, with or
without preliminary plain films and with preparation and contrast injection (R)
|
73.75
|
|
59751
|
Arthrography, each joint, excluding the facet
(zygapophyseal) joints of the spine, single or double contrast study, with or
without preliminary plain films and with preparation and contrast injection (R)
|
139.15
|
|
59754
|
Lymphangiography, 1 or both sides, with preliminary plain
films and follow‑up radiography and with preparation and contrast
injection (R)
|
219.35
|
|
59760
|
Peritoneogram (herniography) with or without contrast
medium including preparation — performed on a person over 14 years of
age (R)
|
115.15
|
|
59763
|
Air insufflation during video — fluoroscopic imaging
including associated consultation (R)
|
133.90
|
|
Subgroup 13 —
Angiography
|
|
59903
|
Angiocardiography, including the service described in item
59970, 59974 or 61109, not being a service to which item 59912 or 59925
applies (R) (K) (Anaes.)
|
114.55
|
|
59912
|
Selective coronary arteriography, including the service
described in item 59970, 59974 or 61109, not being a service to which item
59903 or 59925 applies (R) (K) (Anaes.)
|
305.20
|
|
59925
|
Selective coronary arteriography and angiocardiography,
including a service described in item 59903, 59912, 59970, 59974 or 61109 (R)
(K) (Anaes.)
|
362.45
|
|
59970
|
Angiography or digital
subtraction angiography, or both, with fluoroscopy and image
acquisition, using a mobile image intensifier, including any preliminary
plain films, preparation and contrast injection — 1 or more regions (R) (K)
(Anaes.)
|
168.30
|
|
59971
|
Angiocardiography, including the service described in item
59970, 59974 or 61109, not being a service to which item 59972 or 59973
applies (R) (NK) (Anaes.)
|
57.30
|
|
59972
|
Selective coronary arteriography, including the service
described in item 59970, 59974 or 61109, not being a service to which item
59971 or 59973 applies (R) (NK) (Anaes.)
|
152.60
|
|
59973
|
Selective coronary arteriography and angiocardiography,
including a service described in item 59970, 59971, 59972, 59974 or 61109 (R)
(NK) (Anaes.)
|
181.25
|
|
59974
|
Angiography or digital subtraction angiography, or both,
with fluoroscopy and image acquisition using a mobile image intensifier,
including any preliminary plain films, preparation and contrast injection —
1 or more regions (R) (NK) (Anaes.)
|
84.20
|
|
60000
|
Digital subtraction angiography, examination of head and
neck with or without arch aortography — 1 to 3 data acquisition runs (R)
(Anaes.)
|
564.00
|
|
60003
|
Digital subtraction angiography, examination of head and
neck with or without arch aortography — 4 to 6 data acquisition runs (R)
(Anaes.)
|
827.10
|
|
60006
|
Digital subtraction angiography, examination of head and
neck with or without arch aortography — 7 to 9 data acquisition runs (R)
(Anaes.)
|
1 176.10
|
|
60009
|
Digital subtraction angiography, examination of head and
neck with or without arch aortography — 10 or more data acquisition runs
(R) (Anaes.)
|
1 376.30
|
|
60012
|
Digital subtraction angiography, examination of thorax —
1 to 3 data acquisition runs (R) (Anaes.)
|
564.00
|
|
60015
|
Digital subtraction angiography, examination of thorax —
4 to 6 data acquisition runs (R) (Anaes.)
|
827.10
|
|
60018
|
Digital subtraction angiography, examination of thorax —
7 to 9 data acquisition runs (R) (Anaes.)
|
1 176.10
|
|
60021
|
Digital subtraction angiography, examination of thorax —
10 or more data acquisition runs (R) (Anaes.)
|
1 376.30
|
|
60024
|
Digital subtraction angiography, examination of abdomen —
1 to 3 data acquisition runs (R) (Anaes.)
|
564.00
|
|
60027
|
Digital subtraction angiography, examination of abdomen —
4 to 6 data acquisition runs (R) (Anaes.)
|
827.10
|
|
60030
|
Digital subtraction angiography, examination of abdomen —
7 to 9 data acquisition runs (R) (Anaes.)
|
1 176.10
|
|
60033
|
Digital subtraction
angiography, examination of abdomen — 10 or more data acquisition runs
(R) (Anaes.)
|
1 376.30
|
|
60036
|
Digital subtraction angiography, examination of upper limb
or limbs — 1 to 3 data acquisition runs (R) (Anaes.)
|
564.00
|
|
60039
|
Digital subtraction angiography, examination of upper limb
or limbs — 4 to 6 data acquisition runs (R) (Anaes.)
|
827.10
|
|
60042
|
Digital subtraction angiography, examination of upper limb
or limbs — 7 to 9 data acquisition runs (R) (Anaes.)
|
1 176.10
|
|
60045
|
Digital subtraction angiography, examination of upper limb
or limbs — 10 or more data acquisition runs (R) (Anaes.)
|
1 376.30
|
|
60048
|
Digital subtraction angiography, examination of lower limb
or limbs — 1 to 3 data acquisition runs (R) (Anaes.)
|
564.00
|
|
60051
|
Digital subtraction angiography, examination of lower limb
or limbs — 4 to 6 data acquisition runs (R) (Anaes.)
|
827.10
|
|
60054
|
Digital subtraction angiography, examination of lower limb
or limbs — 7 to 9 data acquisition runs (R) (Anaes.)
|
1 176.10
|
|
60057
|
Digital subtraction angiography, examination of lower limb
or limbs — 10 or more data acquisition runs (R) (Anaes.)
|
1 376.30
|
|
60060
|
Digital subtraction angiography, examination of aorta and
lower limb or limbs — 1 to 3 data acquisition runs (R) (Anaes.)
|
564.00
|
|
60063
|
Digital subtraction angiography, examination of aorta and
lower limb or limbs — 4 to 6 data acquisition runs (R) (Anaes.)
|
827.10
|
|
60066
|
Digital subtraction angiography, examination of aorta and
lower limb or limbs — 7 to 9 data acquisition runs (R) (Anaes.)
|
1 176.10
|
|
60069
|
Digital subtraction angiography, examination of aorta and
lower limb or limbs — 10 or more data acquisition runs (R) (Anaes.)
|
1 376.30
|
|
60072
|
Selective arteriography or selective venography by digital
subtraction angiography technique — 1 vessel (NR) (Anaes.)
|
48.10
|
|
60075
|
Selective arteriography or selective venography by digital
subtraction angiography technique — 2 vessels (NR) (Anaes.)
|
96.10
|
|
60078
|
Selective arteriography or selective venography by digital
subtraction angiography technique — 3 or more vessels (NR) (Anaes.)
|
144.25
|
|
Subgroup 14 —
Tomography
|
|
60100
|
Tomography of any region (R) (Anaes.)
|
60.75
|
|
Subgroup 15 —
Fluoroscopic examination
|
|
60500
|
Fluoroscopy, with general anaesthesia (not being a service
associated with a radiographic examination) (R) (Anaes.)
|
43.40
|
|
60503
|
Fluoroscopy, without general anaesthesia (not being a
service associated with a radiographic examination) (R)
|
29.75
|
|
60506
|
Fluoroscopy using a mobile image intensifier, in
conjunction with a surgical procedure lasting less than 1 hour, not
being a service associated with a service to which another item in this table
applies (R)
|
63.75
|
|
60509
|
Fluoroscopy using a mobile image intensifier, in
conjunction with a surgical procedure lasting 1 hour or more, not being a
service associated with a service to which another item in this table applies
(R)
|
98.90
|
|
Subgroup 16 —
Preparation for radiological procedure
|
|
60918
|
Arteriography (peripheral) or phlebography — 1 vessel,
when used in association with a service to which item 59903, 59912,
59925, 59970, 59971, 59972, 59973 or 59974 applies, not being a service
associated with a service to which any of items 60000 to 60078 apply (NR) (Anaes.)
|
47.15
|
|
60927
|
Selective arteriogram or phlebogram, when used in association
with a service to which item 59903, 59912, 59925, 59970, 59971, 59972, 59973
or 59974 applies, not being a service associated with a service to which
any of items 60000 to 60078 apply (NR) (Anaes.)
|
38.05
|
|
Subgroup 17 —
Interventional techniques
|
|
61109
|
Fluoroscopy in an angiography suite with image
intensification, in conjunction with a surgical procedure using
interventional techniques, not being a service associated with a service to
which another item in this table applies (R)
|
258.90
|
|
Group I4 — Nuclear medicine imaging
|
|
61302
|
Single stress or rest
myocardial perfusion study — planar imaging (R)
|
448.85
|
|
61303
|
Single stress or rest myocardial perfusion study —
with single photon emission tomography and with planar imaging when performed
(R)
|
565.30
|
|
61306
|
Combined stress and rest, stress and re‑injection or
rest and redistribution myocardial perfusion study, including delayed imaging
or re‑injection protocol on a subsequent occasion — planar imaging
(R)
|
709.70
|
|
61307
|
Combined stress and rest, stress and re‑injection or
rest and redistribution myocardial perfusion study, including delayed imaging
or re‑injection protocol on a subsequent occasion — with single
photon emission tomography and with planar imaging when performed (R)
|
834.90
|
|
61310
|
Myocardial infarct‑avid‑study, with planar
imaging and single photon emission tomography, or planar imaging or single
photon emission tomography (R)
|
367.30
|
|
61313
|
Gated cardiac blood pool study, (equilibrium), with planar
imaging and single photon emission tomography, or planar imaging or single
photon emission tomography (R)
|
303.35
|
|
61314
|
Gated cardiac blood pool study, and first pass blood flow
or cardiac shunt study, with planar imaging and single photon emission
tomography, or planar imaging, or single photon emission tomography (R)
|
420.00
|
|
61316
|
Gated cardiac blood pool study, with intervention, with
planar imaging and single photon emission tomography, or planar imaging, or
single photon emission tomography (R)
|
381.15
|
|
61317
|
Gated cardiac blood pool study, with intervention and
first pass blood flow study or cardiac shunt study, with planar imaging and
single photon emission tomography or planar imaging, or single photon
emission tomography (R)
|
492.40
|
|
61320
|
Cardiac first pass blood flow study or cardiac shunt
study, not being a service to which another item in this group applies (R)
|
228.90
|
|
61328
|
Lung perfusion study, with planar imaging and single
photon emission tomography or planar imaging, or single photon emission
tomography (R)
|
227.65
|
|
61340
|
Lung ventilation study using aerosol, technegas or xenon
gas, with planar imaging and single photon emission tomography or planar
imaging or single photon emission tomography (R)
|
253.00
|
|
61348
|
Lung perfusion study and lung ventilation study using
aerosol, technegas or xenon gas, with planar imaging and single photon
emission tomography, or planar imaging, or single photon emission tomography
(R)
|
443.35
|
|
61352
|
Liver and spleen study (colloid) — planar imaging (R)
|
259.35
|
|
61353
|
Liver and spleen study (colloid), with single photon
emission tomography and with planar imaging when performed (R)
|
386.60
|
|
61356
|
Red blood cell spleen or liver study, including single
photon emission tomography when performed (R)
|
392.80
|
|
61360
|
Hepatobiliary study, including morphine administration or
pre‑treatment with cholecystokinin (CCK) when performed (R)
|
403.35
|
|
61361
|
Hepatobiliary study with formal quantification following
baseline imaging, using an infusion of cholecystokinin (CCK) (R)
|
461.40
|
|
61364
|
Bowel haemorrhage study (R)
|
496.95
|
|
61368
|
Meckel’s diverticulum study (R)
|
223.10
|
|
61369
|
Indium-labelled octreotide study, including single photon
emission tomography when undertaken, if:
(a) a gastro-entero-pancreatic endocrine tumour is
suspected, based on biochemical evidence, with negative or equivocal
conventional imaging; or
(b) a surgically amenable gastro-entero-pancreatic
endocrine tumour has been identified based on conventional techniques, to
exclude additional disease sites (R)
|
2 015.75
|
|
61372
|
Salivary study (R)
|
223.10
|
|
61373
|
Gastro‑oesophageal reflux study, including delayed
imaging on a separate occasion when performed (R)
|
489.70
|
|
61376
|
Oesophageal clearance study
(R)
|
143.35
|
|
61381
|
Gastric emptying study, using single tracer (R)
|
574.35
|
|
61383
|
Combined solid and liquid gastric emptying study using
dual isotope technique or the same isotope on separate days (R)
|
624.95
|
|
61384
|
Radionuclide colonic transit study (R)
|
687.70
|
|
61386
|
Renal study, including perfusion and renogram images
and computer analysis or cortical study with planar imaging (R)
|
332.50
|
|
61387
|
Renal cortical study, with single photon emission
tomography and planar quantification (R)
|
430.75
|
|
61389
|
Single renal study with pre‑procedural
administration
of a diuretic or angiotensin converting enzyme (ACE) inhibitor (R)
|
370.55
|
|
61390
|
Renal study with diuretic administration following a
baseline study (R)
|
409.95
|
|
61393
|
Combined examination involving a renal study following
angiotensin converting enzyme (ACE) inhibitor provocation and a baseline
study, in either order and related to a single referral episode (R)
|
605.50
|
|
61397
|
Cystoureterogram (R)
|
246.85
|
|
61401
|
Testicular study (R)
|
162.30
|
|
61402
|
Cerebral perfusion study, with single photon emission
tomography and with planar imaging when performed (R)
|
605.05
|
|
61405
|
Brain study with blood brain barrier agent, with planar
imaging and single photon emission tomography, or planar imaging, or single
photon emission tomography (R)
|
346.00
|
|
61409
|
Cerebro‑spinal fluid transport study, with imaging
on 2 or more separate occasions (R)
|
873.50
|
|
61413
|
Cerebro‑spinal fluid shunt patency study (R)
|
225.95
|
|
61417
|
Dynamic blood flow study or regional blood volume
quantitative study, not being a service associated with a service to which
another item in this group applies (R)
|
118.85
|
|
61421
|
Bone study — whole body, with, when undertaken, blood
flow, blood pool and delayed imaging on a separate occasion (R)
|
479.80
|
|
61425
|
Bone study — whole body and single photon emission
tomography, with, when undertaken, blood flow, blood pool and delayed imaging
on a separate occasion (R)
|
600.70
|
|
61426
|
Whole body study using iodine (R)
|
554.80
|
|
61429
|
Whole body study using gallium (R)
|
543.00
|
|
61430
|
Whole body study using gallium, with single photon
emission tomography (R)
|
659.45
|
|
61433
|
Whole body study using cells labelled with technetium (R)
|
496.95
|
|
61434
|
Whole body study using cells labelled with technetium,
with single photon emission tomography (R)
|
615.40
|
|
61437
|
Whole body study using thallium (R)
|
542.75
|
|
61438
|
Whole body study using thallium, with single photon
emission tomography (R)
|
672.95
|
|
61441
|
Bone marrow study — whole body using technetium
labelled bone marrow agents (R)
|
489.70
|
|
61442
|
Whole body study, using gallium — with single photon
emission tomography of 2 or more body regions acquired separately (R)
|
752.35
|
|
61445
|
Bone marrow study — localised using technetium
labelled agent (R)
|
286.80
|
|
61446
|
Localised bone or joint study, including when undertaken,
blood flow, blood pool and repeat imaging on a separate occasion (R)
|
333.55
|
|
61449
|
Localised bone or joint study and single photon emission
tomography, including when undertaken, blood flow, blood pool and imaging on
a separate occasion (R)
|
456.20
|
|
61450
|
Localised study using gallium (R)
|
397.55
|
|
61453
|
Localised study using gallium, with single photon emission
tomography (R)
|
514.70
|
|
61454
|
Localised study using cells
labelled with technetium (R)
|
348.10
|
|
61457
|
Localised study using cells labelled with technetium, with
single photon emission tomography (R)
|
470.45
|
|
61458
|
Localised study using thallium (R)
|
396.95
|
|
61461
|
Localised study using thallium, with single photon
emission tomography (R)
|
527.85
|
|
61462
|
Repeat planar and single photon emission tomography
imaging, or repeat planar imaging or single photon emission tomography
imaging on an occasion subsequent to the performance of item 61364, 61426,
61429, 61430, 61442, 61450, 61453, 61469, 61484 or 61485, if there is no
additional administration of radiopharmaceutical and if the previous
radionuclide scan was abnormal or equivocal (R)
|
129.00
|
|
61465
|
Venography (R)
|
265.50
|
|
61469
|
Lymphoscintigraphy (R)
|
348.10
|
|
61473
|
Thyroid study including uptake measurement when performed
(R)
|
175.40
|
|
61480
|
Parathyroid study, planar imaging and single photon
emission tomography when performed (R)
|
386.85
|
|
61484
|
Adrenal study (R)
|
880.85
|
|
61485
|
Adrenal study, with single photon emission tomography (R)
|
999.20
|
|
61495
|
Tear duct study (R)
|
223.10
|
|
61499
|
Particle perfusion study (infra‑arterial) or Le Veen
shunt study (R)
|
253.00
|
|
61505
|
CT scan performed at the
same time and covering the same body area as single photon emission
tomography for the purpose of anatomic localisation or attenuation correction
if no separate diagnostic CT report is issued and only in association with
items 61302 to 61650 (R)
|
100.00
|
|
61523
|
Whole body FDG PET study, performed for evaluation of a
solitary pulmonary nodule, if:
(a) the nodule is considered unsuitable for
transthoracic fine needle aspiration biopsy; or
(b) an attempt at pathological characterisation has
failed (R)
|
953.00
|
|
61529
|
Whole body FDG PET study,
performed for the staging of proven non-small cell lung cancer, if curative
surgery or radiotherapy is planned (R)
|
953.00
|
|
61541
|
Whole body FDG PET study,
following initial therapy, performed for the evaluation of suspected
residual, metastatic or recurrent colorectal carcinoma in a patient
considered suitable for active therapy (R)
|
953.00
|
|
61544
|
Whole body FDG PET study,
following initial therapy, performed for the evaluation of suspected
residual, metastatic or recurrent colorectal carcinoma in a patient
considered suitable for active therapy, with catheterisation of the bladder
(R)
|
975.00
|
|
61553
|
Whole body FDG PET study,
following initial therapy, performed for the evaluation of suspected
metastatic or recurrent malignant melanoma in a patient considered suitable
for active therapy (R)
|
999.00
|
|
61556
|
Whole body FDG PET study,
following initial therapy, performed for the evaluation of suspected
metastatic or recurrent malignant melanoma in a patient considered suitable
for active therapy, with catheterisation of the bladder (R)
|
1 021.00
|
|
61559
|
FDG PET study of the brain,
performed for the evaluation of refractory epilepsy, that is being evaluated
for surgery (R)
|
918.00
|
|
61565
|
Whole body FDG PET study,
following initial therapy, performed for the evaluation of suspected
residual, metastatic or recurrent ovarian carcinoma in a patient considered
suitable for active therapy (R)
|
953.00
|
|
61568
|
Whole body FDG PET study,
following initial therapy, performed for the evaluation of suspected
residual, metastatic or recurrent ovarian carcinoma in a patient considered
suitable for active therapy, with catheterisation of the bladder (R)
|
975.00
|
|
61577
|
Whole body FDG PET study,
performed for the staging of proven oesophageal or GEJ carcinoma, in a
patient considered suitable for active therapy (R)
|
953.00
|
|
61580
|
Whole
body FDG PET study, performed for the staging of proven oesophageal or GEJ
carcinoma, in a patient considered suitable for active therapy, with
catheterisation of the bladder (R)
|
975.00
|
|
61598
|
Whole
body FDG PET study performed for the staging of biopsy-proven,
newly-diagnosed or recurrent head and neck cancer (R)
|
953.00
|
|
61604
|
Whole
body FDG PET study performed for the evaluation of a patient with suspected
residual head and neck cancer after definitive treatment, and who is suitable
for active therapy (R)
|
953.00
|
|
61610
|
Whole
body FDG PET study performed for the evaluation of metastatic squamous cell
carcinoma of unknown primary site involving cervical nodes (R)
|
953.00
|
|
61613
|
Whole body FDG PET study
performed for the evaluation of metastatic squamous cell carcinoma from an
unknown primary site involving cervical nodes, with catheterisation of the
bladder (R)
|
975.00
|
|
61650
|
LeukoScan study of the long
bones and feet for suspected osteomyelitis, if patient does not have access
to ex-vivo white blood cell scanning (R)
Note LeukoScan
is only indicated for diagnostic imaging in a patient suspected of infection
of the long bones and feet, including those with diabetic ulcers. The
descriptor does not cover a patient who is being investigated for other sites
of infection.
|
878.70
|
|
Group I5 — Magnetic resonance imaging
|
|
Subgroup 1 — Scan of
head — for specified conditions
|
|
63001
|
MRI — scan of head (including MRA, if performed) for
tumour of the brain or meninges (R) (Anaes.) (Contrast)
|
403.20
|
|
63004
|
MRI — scan of head (including MRA, if performed) for
inflammation of brain or meninges (R) (Anaes.) (Contrast)
|
403.20
|
|
63007
|
MRI — scan of head (including MRA, if performed) for
skull base or orbital tumour (R) (Anaes.) (Contrast)
|
403.20
|
|
63010
|
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 2 — Scan of
head — for specified conditions
|
|
63040
|
MRI — scan of head (including MRA, if performed) for
acoustic neuroma (R) (Anaes.) (Contrast)
|
336.00
|
|
63043
|
MRI — scan of head (including MRA, if performed) for
pituitary tumour (R) (Anaes.) (Contrast)
|
358.40
|
|
63046
|
MRI — scan of head (including MRA, if performed) for
toxic or metabolic or ischaemic encephalopathy (R) (Anaes.) (Contrast)
|
403.20
|
|
63049
|
MRI — scan of head (including MRA, if performed) for
demyelinating disease of the brain (R) (Anaes.) (Contrast)
|
403.20
|
|
63052
|
MRI — scan of head (including MRA, if performed) for
congenital malformation of the brain or meninges (R) (Anaes.) (Contrast)
|
403.20
|
|
63055
|
MRI — scan of head (including MRA, if performed) for
venous sinus thrombosis (R) (Anaes.) (Contrast)
|
403.20
|
|
63058
|
MRI — scan of head (including MRA, if performed) for
head trauma (R) (Anaes.) (Contrast)
|
403.20
|
|
63061
|
MRI — scan of head (including MRA, if performed) for
epilepsy (R) (Anaes.) (Contrast)
|
403.20
|
|
63064
|
MRI — scan of head (including MRA, if performed) for
stroke (R) (Anaes.) (Contrast)
|
403.20
|
|
63067
|
MRI — scan of head (including MRA, if performed) for
carotid or vertebral artery dissection (R) (Anaes.) (Contrast)
|
403.20
|
|
63070
|
MRI — scan of head (including MRA, if performed) for
intracranial aneurysm (R) (Anaes.) (Contrast)
|
403.20
|
|
63073
|
MRI — scan of head (including MRA, if performed) for
intracranial arteriovenous malformation (R) (Anaes.) (Contrast)
|
403.20
|
|
Subgroup 3 — Scan of
head and neck vessels — for specified conditions
|
|
63101
|
MRI and MRA of extracranial or intracranial
circulation (or both) — scan of head and neck vessels for stroke (R) (Anaes.)
(Contrast)
|
492.80
|
|
Subgroup 4 — Scan of
head and cervical spine — for specified conditions
|
|
63111
|
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
|
|
63114
|
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 5 — Scan of
head and cervical spine — for specified conditions
|
|
63125
|
MRI — scan of head and cervical spine (including MRA,
if performed) for demyelinating disease of the central nervous system (R)
(Anaes.) (Contrast)
|
492.80
|
|
63128
|
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
|
|
63131
|
MRI — scan of head and cervical spine (including MRA,
if performed) for syrinx (congenital or acquired) (R) (Anaes.) (Contrast)
|
492.80
|
|
Subgroup 6 — Scan of
spine — 1 region or 2 contiguous regions — for specified conditions
|
|
63151
|
MRI — scan of 1 region or 2 contiguous regions of the
spine for infection (R) (Anaes.) (Contrast)
|
358.40
|
|
63154
|
MRI — scan of 1 region or 2 contiguous regions of the
spine for tumour (R) (Anaes.) (Contrast)
|
358.40
|
|
Subgroup 7 — Scan of
spine — 1 region or 2 contiguous regions — for specified conditions
|
|
63161
|
MRI — scan of 1 region or 2 contiguous regions of the
spine for demyelinating disease (R) (Anaes.) (Contrast)
|
358.40
|
|
63164
|
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
|
|
63167
|
MRI — scan of 1 region or 2 contiguous regions of the
spine for myelopathy (R) (Anaes.) (Contrast)
|
358.40
|
|
63170
|
MRI — scan of 1 region or 2 contiguous regions of the
spine for syrinx (congenital or acquired) (R) (Anaes.) (Contrast)
|
358.40
|
|
63173
|
MRI — scan of 1 region or 2 contiguous regions of the
spine for cervical radiculopathy (R) (Anaes.) (Contrast)
|
358.40
|
|
63176
|
MRI — scan of 1 region or 2 contiguous regions of the
spine for sciatica (R) (Anaes.) (Contrast)
|
358.40
|
|
63179
|
MRI — scan of 1 region or 2 contiguous regions of the
spine for spinal canal stenosis (R) (Anaes.) (Contrast)
|
358.40
|
|
63182
|
MRI — scan of 1 region or 2 contiguous regions of the
spine for previous spinal surgery (R) (Anaes.) (Contrast)
|
358.40
|
|
63185
|
MRI — scan of 1 region or 2 contiguous regions of the
spine for trauma (R) (Anaes.)
|
358.40
|
|
Subgroup 8 — Scan of
spine — 3 contiguous or 2 non‑contiguous regions — for
specified conditions
|
|
63201
|
MRI — scan of 3 contiguous or 2 non‑contiguous
regions of the spine for infection (R) (Anaes.) (Contrast)
|
448.00
|
|
63204
|
MRI — scan of 3 contiguous or 2 non‑contiguous
regions of the spine for tumour (R) (Anaes.) (Contrast)
|
448.00
|
|
Subgroup 9 — Scan of
spine — 3 contiguous or 2 non‑contiguous regions — for
specified conditions
|
|
63219
|
MRI — scan of 3 contiguous or 2 non‑contiguous
regions of the spine for demyelinating disease (R) (Anaes.) (Contrast)
|
448.00
|
|
63222
|
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
|
|
63225
|
MRI — scan of 3 contiguous or 2 non‑contiguous
regions of the spine for myelopathy (R) (Anaes.) (Contrast)
|
448.00
|
|
63228
|
MRI — scan of 3 contiguous or 2 non‑contiguous
regions of the spine for syrinx (congenital or acquired) (R) (Anaes.)
(Contrast)
|
448.00
|
|
63231
|
MRI — scan of 3 contiguous or 2 non‑contiguous
regions of the spine for cervical radiculopathy (R) (Anaes.) (Contrast)
|
448.00
|
|
63234
|
MRI — scan of 3 contiguous or 2 non‑contiguous
regions of the spine for sciatica (R) (Anaes.) (Contrast)
|
448.00
|
|
63237
|
MRI — scan of 3 contiguous or 2 non‑contiguous
regions of the spine for spinal canal stenosis (R) (Anaes.) (Contrast)
|
448.00
|
|
63240
|
MRI — scan of 3 contiguous or 2 non‑contiguous
regions of the spine for previous spinal surgery (R) (Anaes.) (Contrast)
|
448.00
|
|
63243
|
MRI — scan of 3 contiguous or 2 non‑contiguous
regions of the spine for trauma (R) (Anaes.)
|
448.00
|
|
Subgroup 10 — Scan of
cervical spine and brachial plexus — for specified conditions
|
|
63271
|
MRI — Scan of cervical spine and brachial plexus for
tumour (R) (Anaes.) (Contrast)
|
492.80
|
|
63274
|
MRI — Scan of cervical spine and brachial plexus for
trauma (R) (Anaes.) (Contrast)
|
492.80
|
|
63277
|
MRI — Scan of cervical spine and brachial plexus for
cervical radiculopathy (R) (Anaes.) (Contrast)
|
492.80
|
|
63280
|
MRI — Scan of cervical spine and brachial plexus for
previous surgery (R) (Anaes.) (Contrast)
|
492.80
|
|
Subgroup 11 — Scan of
musculoskeletal system — for specified conditions
|
|
63301
|
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
|
|
63304
|
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
|
|
63307
|
MRI — scan of musculoskeletal system for
osteonecrosis (R) (Anaes.) (Contrast)
|
380.80
|
|
Subgroup 12 — Scan of
musculoskeletal system — for specified conditions
|
|
63322
|
MRI — scan of musculoskeletal system for derangement
of hip or its supporting structures (R) (Anaes.) (Contrast)
|
403.20
|
|
63325
|
MRI — scan of musculoskeletal system for derangement
of shoulder or its supporting structures (R) (Anaes.) (Contrast)
|
403.20
|
|
63328
|
MRI — scan of musculoskeletal system for derangement
of knee or its supporting structures (R) (Anaes.) (Contrast)
|
403.20
|
|
63331
|
MRI — scan of musculoskeletal system for derangement
of ankle or foot (or both) or its supporting structures (R) (Anaes.)
(Contrast)
|
403.20
|
|
63334
|
MRI — scan of musculoskeletal system for derangement
of 1 or both temporomandibular joints or their supporting structures (R)
(Anaes.) (Contrast)
|
336.00
|
|
63337
|
MRI — scan of musculoskeletal system for derangement
of wrist or hand (or both) or its supporting structures (R) (Anaes.)
(Contrast)
|
448.00
|
|
63340
|
MRI — scan of musculoskeletal system for derangement
of elbow or its supporting structures (R) (Anaes.) (Contrast)
|
403.20
|
|
Subgroup 13 — Scan of
musculoskeletal system — for specified conditions
|
|
63361
|
MRI — scan of musculoskeletal system for Gaucher
disease (R) (Anaes.)
|
403.20
|
|
Subgroup 14 — Scan of
cardiovascular system — for specified conditions
|
|
63385
|
MRI — scan of cardiovascular system for congenital
disease of the heart or a great vessel (R) (Anaes.) (Contrast)
|
448.00
|
|
63388
|
MRI — scan of cardiovascular system for tumour of the
heart or a great vessel (R) (Anaes.) (Contrast)
|
448.00
|
|
63391
|
MRI — scan of cardiovascular system for abnormality
of thoracic aorta (R) (Anaes.) (Contrast)
|
403.20
|
|
Subgroup 15 —
Magnetic resonance angiography — scan of cardiovascular system —
for specified conditions
|
|
63401
|
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
|
|
63404
|
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 16 —
Magnetic resonance angiography — for specified conditions — person
under the age of 16 years
|
|
63416
|
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 17 —
Magnetic resonance imaging — for specified conditions — person
under the age of 16 years
|
|
63425
|
MRI — scan of person under the age of 16 for post‑inflammatory
or post‑traumatic physeal fusion (R) (Anaes.)
|
403.20
|
|
63428
|
MRI — scan of person under the age of 16 for Gaucher
disease (R) (Anaes.)
|
403.20
|
|
Subgroup 18 —
Magnetic resonance imaging — for specified conditions — person
under the age of 16 years
|
|
63440
|
MRI — scan of person under the age of 16 for pelvic
or abdominal mass (R) (Anaes.) (Contrast)
|
403.20
|
|
63443
|
MRI — scan of person under the age of 16 for
mediastinal mass (R) (Anaes.) (Contrast)
|
403.20
|
|
63446
|
MRI — scan of person under the age of 16 for
congenital uterine or anorectal abnormality (R) (Anaes.) (Contrast)
|
403.20
|
|
Subgroup 19 — Scan of
body — for specified conditions
|
|
63461
|
MRI — scan of the body for adrenal mass in a patient
with a malignancy that is otherwise resectable (R) (Anaes.)
|
358.40
|
|
63464
|
MRI — scan of both breasts for the detection of
cancer, if a dedicated breast coil is used, the request for 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;
|
690.00
|
|
|
(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 been diagnosed with breast cancer;
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(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
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(b) that genetic testing has identified the presence of
a high risk breast cancer gene mutation (R) (Anaes.)
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63467
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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 performed in the previous 12
months (R) (Anaes.)
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690.00
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Subgroup 20 — Scan of
pelvis and upper abdomen — for specified conditions
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63470
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MRI — scan of the pelvis 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)
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403.20
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63473
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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)
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627.20
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63476
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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)
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403.20
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Subgroup 21 — Scan of
body — for specified conditions
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63482
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MRI — scan of pancreas and biliary tree for suspected
biliary or pancreatic pathology (R) (Anaes.)
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403.20
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Subgroup 22 — Modifying
items
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63491
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MRI or MRA service to which an item in this Group (other
than an item in this Subgroup) applies if:
(a) the service is performed in accordance with rule
31; and
(b) the item for the service includes in its
description ‘(Contrast)’; and
(c) the service is performed using a contrast agent
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44.80
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63494
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MRI or MRA service to which an item in this Group (other
than an item in this Subgroup) applies if:
(a) the service is performed in accordance with rule
31; and
(b) the service is performed on a person using
intravenous or intra muscular sedation
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44.80
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63497
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MRI or MRA service to which an item in this Group (other
than an item in this Subgroup) applies if:
(a) the service is performed in accordance with rule
31; and
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156.80
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(b) the service is performed on a person under
anaesthetic in the presence of a medical practitioner who is qualified to
perform an anaesthetic
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Group I6 — Management of bulk‑billed services
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64990
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A diagnostic imaging
service to which an item in this table (other than this item or item
64991) applies if:
(a) the service is
an unreferred service; and
(b) the service is
provided to a person who is under the age of 16 or is a Commonwealth
concession card holder; and
(c) the person is
not an admitted patient of a hospital; and
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6.50
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(d) the service is
bulk‑billed for the fees for:
(i) this
item; and
(ii) the
other item in this table applying to the service
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64991
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A diagnostic imaging
service to which an item in this table (other than this item or item 64990)
applies if:
(a) the service is
an unreferred service; and
(b) the service is
provided to a person who is under the age of 16 or is a Commonwealth
concession card holder; and
(c) the person is
not an admitted patient of a hospital; and
(d) the service is bulk‑billed
for the fees for:
(i) this
item; and
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9.80
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(ii) the
other item in this table applying to the service; and
(e) the service is
provided at, or from, a practice location in:
(i) a
regional, rural or remote area; or
(ii) Tasmania;
or
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(iii) a
geographical area included in any
of the following SSD spatial units:
(A) Beaudesert
Shire Part A
(B) Belconnen
(C) Darwin City
(D) Eastern Outer Melbourne
(E) East Metropolitan
(F) Frankston City
(G) Gosford‑Wyong
(H) Greater Geelong City Part A
(I) Gungahlin‑Hall
(J) Ipswich City (Part in BSD)
(K) Litchfield Shire
(L) Melton‑Wyndham
(M) Mornington Peninsula Shire
(N) Newcastle
(O) North Canberra
(P) Palmerston‑East Arm
(Q) Pine Rivers Shire
(R) Queanbeyan
(S) South Canberra
(T) South Eastern Outer Melbourne
(U) Southern Adelaide
(V) South West Metropolitan
(W) Thuringowa City Part A
(X) Townsville City Part A
(Y) Tuggeranong
(Z) Weston Creek‑Stromlo
(ZA) Woden Valley
(ZB) Yarra Ranges Shire Part A; or
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(iv) the geographical area included in the SLA
spatial unit of Palm Island (AC)
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