Group I1 — Ultrasound | ||
Item | Health service | Fee ($) (for each State) |
Subgroup 1 — General | ||
55005 | 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) (NK) | 54.55 |
55007 | 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) (NK) | 18.95 |
55008 | 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) (NK) | 54.55 |
55010 | 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) (NK) | 18.95 |
55011 | 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) (NK) | 54.55 |
55013 | 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) (NK) | 18.95 |
55014 | Abdomen, ultrasound scan of (including scan of urinary tract when performed), if: (a) the patient is referred by a medical practitioner or participating nurse practitioner for ultrasonic examination; and | 55.65 |
(b) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (c) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner; and (d) the service is not a service associated with a service to which an item in Subgroup 2 or 3 applies; and | ||
(e) the service is not solely a transrectal ultrasonic examination of the prostate gland, bladder base and urethra, or any of those organs; and | ||
(f) within 24 hours of the service, a service described in item 55017, 55020, 55038, 55044, 55731 or 55732 is not performed on the same patient by the providing practitioner (R) (NK) | ||
55016 | Abdomen, ultrasound scan of (including scan of urinary tract when performed), if: (a) the patient is not referred by a medical practitioner or participating nurse practitioner; and | 18.95 |
(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) (NK) | ||
55017 | 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 | 54.55 |
(c) the service is not a service associated with a service to which an item in Subgroup 2 or 3 applies; and | ||
(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 55014, 55020, 55036, 55044, 55731 or 55732 is not performed on the same patient by the providing practitioner (R) (NK) | ||
55019 | 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) (NK) | 18.95 |
55020 | 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 | 55.65 |
(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 55014, 55017, 55036 or 55038 is not performed on the same patient by the providing practitioner (R) (NK) | ||
55022 | 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) (NK) | 18.95 |
55023 | 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) (NK) | 54.75 |
55025 | 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) (NK) | 18.95 |
55026 | 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) (NK) | 54.55 |
55059 | Breast, one, ultrasound scan of, if: (a) the patient is referred by a medical practitioner or participating nurse practitioner; and (b) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK) | 49.15 |
55060 | Breast, one, ultrasound scan of, if: (a) the patient is not referred by a medical practitioner or participating nurse practitioner; and (b) the service is not associated with a service to which an item in Subgroup 2 or 3 applies (NR) (NK) | 17.05 |
55061 | Breasts, both, ultrasound scan of, if: (a) the patient is referred by a medical practitioner or participating nurse practitioner; and (b) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK) | 54.55 |
55062 | Breasts, both, ultrasound scan of, if: (a) the patient is not referred by a medical practitioner or participating nurse practitioner; and (b) the service is not associated with a service to which an item in Subgroup 2 or 3 applies (NR) (NK) | 18.95 |
55063 | 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 | 49.15 |
(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, 55014, 55017, 55020, 55036, 55038, 55044, 55600, 55601, 55603, 55604, 55731 or 55732 is not performed on the same patient by the providing practitioner (R) (NK) | ||
55064 | 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 | 17.05 |
(c) within 24 hours of the service, a service described in item 11917, 55016, 55019, 55022, 55037, 55039, 55045, 55600, 55601, 55603, 55604, 55733 or 55734 is not performed on the same patient by the providing practitioner (NR) (NK) | ||
Subgroup 2 — Cardiac | ||
55119 | 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: | 115.35 |
(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 items 55026 and 55054) or 3, or another item in this Subgroup (except items 55118, 55125, 55130 and 55131), applies (R) (NK) | ||
55120 | 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 (ii) real time colour flow mapping from at least 2 acoustic windows; and (iii) recordings on video tape or digital media; and | 115.35 |
(b) not being a service associated with a service to which an item in Subgroup 1 (except items 55026 and 55054) or 3, or another item in this Subgroup (except items 55118, 55125, 55130 and 55131), applies (R) (NK) | ||
55121 | 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 | 115.35 |
(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 items 55026 and 55054) or 3, or another item in this Subgroup (except items 55118, 55125, 55130 and 55131), applies (R) (NK) | ||
55122 | 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 | 130.85 |
(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 items 55026 and 55054) or 3, or another item in this Subgroup (except items 55118, 55125, 55130 and 55131), applies (R) (NK) | ||
55123 | 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 | 130.85 |
(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 items 55026 and 55054) or 3, or another item in this Subgroup (except items 55118, 55125, 55130 and 55131), applies (R) (NK) | ||
55125 | 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 | 137.75 |
(b) not being an intra‑operative service or a service associated with a service to which an item in Subgroup 1 (except items 55026 and 55054) or 3 applies (R) (NK) (Anaes.) | ||
55131 | 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 or 55136 applies (R) (NK) (Anaes.) | 85.00 |
55136 | 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 or 55131 applies (R) (NK) (Anaes.) | 176.80 |
Subgroup 3 — Vascular | ||
55220 | 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 items 55026 and 55054) or 4 applies (R) (NK) | 84.75 |
55221 | 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 items 55026 and 55054) or 4 applies (R) (NK) | 84.75 |
55222 | 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 items 55026 and 55054) or 4 applies (R) (NK) | 84.75 |
55223 | 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 items 55026 and 55054) or 4 applies (R) (NK) | 84.75 |
55224 | 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 items 55026 and 55054) or 4 applies (R) (NK) | 84.75 |
55226 | 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 items 55026 and 55054) or 4 applies (R) (NK) | 84.75 |
55227 | 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 items 55026 and 55054) or 4 applies (R) (NK) | 84.75 |
55228 | 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 items 55026 and 55054) or 4 applies (R) (NK) | 84.75 |
55229 | 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 items 55026 and 55054) or 4 applies (R) (NK) | 84.75 |
55230 | 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 | 84.75 |
(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 items 55026 and 55054) or 4 applies (R) (NK) | ||
55232 | 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 (b) if indicated, assess the progress and management of: (i) priapism; or (ii) fibrosis of any type; or | 84.75 |
(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 items 55026 and 55054) or 4 applies (R) (NK) | ||
55233 | 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 items 55026 and 55054) or 4 applies (R) (NK) | 84.75 |
55235 | 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 items 55026 and 55054), 3 or 4 applies (R) (NK) | 84.75 |
55236 | 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 items 55026 and 55054), 3 or 4 applies (R) (NK) | 55.55 |
Subgroup 4 — Urological | ||
55601 | 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 | 54.55 |
(c) on a patient who has been assessed by a specialist in urology, radiation oncology or medical oncology, a consultant physician in medical oncology, or a participating nurse practitioner, 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) (NK) | ||
55604 | 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 | 54.55 |
(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) (NK) |
Group I1 — Ultrasound | ||
Item | Health service | Fee ($) (for each State) |
Subgroup 5 — Obstetric and gynaecological | ||
55701 | 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 or participating midwife; 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) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (e) if the patient is referred by a participating midwife — the referring midwife does not have a business or financial arrangement with the providing practitioner; and | 30.00 |
(f) 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) (NK) | ||
55702 | 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 or participating midwife; 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) 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; | 17.50 |
(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) (NK) | ||
55710 | 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 or participating midwife; 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) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (e) if the patient is referred by a participating midwife — the referring midwife does not have a business or financial arrangement with the providing practitioner; and | ||
(f) 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) (NK) | ||
55711 | 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 or participating midwife; 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 | 17.50 |
(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) (NK) | ||
55713 | 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 or participating midwife; 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 | 50.00 |
(d) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (e) if the patient is referred by a participating midwife — the referring midwife does not have a business or financial arrangement with the providing practitioner; and (f) the service is not performed in the same pregnancy as item 55709 or 55717 (R) (NK) | ||
55714 | 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 or participating midwife; and (b) the pregnancy (as confirmed by ultrasound) is dated by a fetal crown rump length of 45 to 84 mm; and | 35.00 |
(c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and (d) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (e) if the patient is referred by a participating midwife — the referring midwife does not have a business or financial arrangement with the providing practitioner; and (f) at least 1 condition mentioned in paragraph (f) of item 55704 or 55710 is present; and | ||
(g) nuchal translucency measurement is performed to assess the risk of fetal abnormality; and | ||
(h) the service is not performed with item 55700, 55701, 55702, 55703, 55704, 55705, 55710 or 55711 on the same patient within 24 hours (R) (NK) | ||
55716 | 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 or participating midwife; 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 (f) of item 55704 or 55710 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, 55701, 55702, 55703, 55704, 55705, 55710 or 55711on the same patient within 24 hours (NR) (NK) | 17.50 |
55717 | 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) the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks of gestation; and | 19.00 |
(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 or 55713 (NR) (NK) | ||
55719 | 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 | 57.50 |
(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, 55709, 55713 or 55717 (R) (NK) | ||
55720 | 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: | 20.00 |
(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, 55709, 55713 or 55717 (NR) (NK) | ||
55722 | 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 or participating midwife; 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 | 50.00 |
(d) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (e) if the patient is referred by a participating midwife — the referring midwife does not have a business or financial arrangement with the providing practitioner; and (f) the service is not performed in the same pregnancy as item 55723 or 55726; and (g) 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) (NK) (Item is subject to subclause 2.1.5(2) of the diagnostic imaging services table) | ||
55724 | 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 | 57.50 |
(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, 55722, 55723 or 55726 applies (R) (NK) | ||
55726 | 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 | 19.00 |
(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 or 55722; 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) (NK) (Item is subject to subclause 2.1.5(2) of the diagnostic imaging services table) | ||
55727 | 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 | 20.00 |
(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, 55722, 55723 or 55726 applies (NR) (NK) | ||
55730 | 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) (NK) | 13.65 |
55732 | 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 | 49.00 |
(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 55014, 55017, 55036 or 55038 on the same patient within 24 hours (R) (NK) | ||
55734 | 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) (NK) | 17.50 |
55735 | 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 | 63.50 |
(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) (NK) | ||
55737 | 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) (NK) | 28.50 |
55760 | 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 | 75.00 |
(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, 55713, 55715, 55717, 55719, 55720, 55762 or 55763 is not performed in conjunction with the scan during the same pregnancy (R) (NK) | ||
55763 | 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 | 30.00 |
(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, 55713, 55715, 55717, 55719, 55720, 55759 or 55760 is not performed in conjunction with the scan during the same pregnancy (NR) (NK) | ||
55765 | 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: | 80.00 |
(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, 55760, 55762 or 55763 has been performed; and | ||
(g) the service described in item 55706, 55709, 55712, 55713, 55715, 55717, 55719 or 55720 is not performed in conjunction with the scan during the same pregnancy (R) (NK) | ||
55767 | 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 | 32.50 |
(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, 55760, 55762 or 55763 has been performed; and | ||
(f) the service described in item 55706, 55709, 55712, 55713, 55715, 55717, 55719 or 55720 is not performed in conjunction with the scan during the same pregnancy (NR) (NK) | ||
55769 | 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 or participating nurse practitioner; and | 75.00 |
(d) the service is not performed in the same pregnancy as item 55770 or 55771; and (e) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and | ||
(f) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (g) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner; and | ||
(h) the service described in item 55718, 55721, 55722, 55723, 55724, 55725, 55726 or 55727 is not performed in conjunction with the scan during the same pregnancy (R) (NK) | ||
55771 | 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 or participating nurse practitioner; and | 30.00 |
(c) the service is not performed in the same pregnancy as item 55768 or 55769; 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, 55722, 55723, 55724, 55725, 55726 or 55727 is not performed in conjunction with the scan during the same pregnancy (NR) (NK) | ||
55773 | 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 | 80.00 |
(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 | ||
(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, 55769, 55770 or 55771 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, 55722, 55723, 55724, 55725, 55726 or 55727 is not performed in conjunction with the scan during the same pregnancy (R) (NK) | ||
55775 | 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 (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, 55769, 55770 or 55771 has been performed; and (d) the pregnancy as confirmed by ultrasound is a multiple pregnancy; and | 32.50 |
(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, 55722, 55723, 55724, 55725, 55726 or 55727 is not performed in conjunction with the scan during the same pregnancy (NR) (NK) |
Group I1 — Ultrasound | |||
Item | Health service | Fee ($) (for each State) | |
Subgroup 6 — Musculoskeletal ultrasound | |||
55801 | 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 or participating nurse practitioner; and (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK) | 54.55 | |
55803 | 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 or participating nurse practitioner (NR) (NK) | 18.95 | |
55805 | 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 or participating nurse practitioner; and (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK) | 54.55 | |
55807 | 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 | 18.95 | |
(b) the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK) | |||
55809 | 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 or participating nurse practitioner; and (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner; and (e) 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); | 54.55 | |
(iii) biceps subluxation; (iv) capsulitis and bursitis; (v) a mass, including a ganglion; | |||
(vi) an occult fracture; (vii) acromioclavicular joint pathology (R) (NK) | |||
55811 | 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 or participating nurse 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; (ii) rotator cuff tear, calcification or tendinosis (biceps, subscapular, supraspinatus, infraspinatus); (iii) biceps subluxation; | 18.95 | |
(iv) capsulitis and bursitis; (v) a mass, including a ganglion; (vi) an occult fracture; (vii) acromioclavicular joint pathology (NR) (NK) | |||
55813 | 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 or participating nurse practitioner; and (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK) | 54.55 | |
55815 | 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 or participating nurse practitioner (NR) (NK) | 18.95 | |
55817 | 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 or participating nurse practitioner; and (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and | 54.55 | |
(d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK) | |||
55819 | 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 or participating nurse practitioner (NR) (NK) | 18.95 | |
55821 | 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 or participating nurse practitioner; and (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK) | 54.55 | |
55823 | 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 or participating nurse practitioner (NR) (NK) | 18.95 | |
55825 | 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 or participating nurse practitioner; and (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and | 54.55 | |
(d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK) | |||
55827 | 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 or participating nurse practitioner (NR) (NK) | 18.95 | |
55829 | 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 or participating nurse practitioner; and (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner; and | 54.55 | |
(e) 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) (NK) | |||
55831 | 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 or participating nurse practitioner; and | 18.95 | |
(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) (NK) | |||
55833 | 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 or participating nurse practitioner; and (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK) | 54.55 | |
55835 | 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 or participating nurse practitioner (NR) (NK) | 18.95 | |
55837 | 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 or participating nurse practitioner; and (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and | 54.55 | |
(d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK) | |||
55839 | 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 or participating nurse practitioner (NR) (NK) | 18.95 | |
55841 | 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 or participating nurse practitioner; and (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK) | 54.55 | |
55843 | 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 or participating nurse practitioner (NR) (NK) | 18.95 | |
55845 | 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 or participating nurse practitioner; and | 43.70 | |
(c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK) | |||
55847 | 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 or participating nurse practitioner (NR) (NK) | 18.95 | |
55849 | 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 55026 or 55054 (R) (NK) | 54.55 | |
55851 | Musculoskeletal cross‑sectional echography, in conjunction with a surgical procedure using interventional techniques, inclusive of a diagnostic musculoskeletal ultrasound service, if: (a) the patient is referred by a medical practitioner or participating nurse practitioner; and (b) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (c) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial relationship with the providing practitioner; and (d) the referring medical practitioner or nurse practitioner has indicated on a referral for a musculoskeletal ultrasound that an ultrasound guided intervention be performed if clinically indicated; and | 76.45 | |
(e) the service is not performed in conjunction with items 55026, 55054, or 55800 to 55849 (R) (NK) | |||
55853 | 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 or participating nurse practitioner; and (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK) | 54.55 | |
55855 | 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 or participating nurse practitioner (NR) (NK) | 18.95 | |
Group I3 — Diagnostic radiology | ||||
Item | Health service | Fee ($) (for each State) | ||
Subgroup 1 — Radiographic examination of extremities | ||||
57529 | Hand, wrist, forearm, elbow or humerus (NR) (NK) | 14.90 | ||
57530 | Hand, wrist, forearm, elbow or humerus (R) (NK) | 19.90 | ||
57532 | Hand and wrist, or hand, wrist and forearm, or forearm and elbow, or elbow and humerus (NR) (NK) | 20.25 | ||
57533 | Hand and wrist, or hand, wrist and forearm, or forearm and elbow, or elbow and humerus (R) (NK) | 27.00 | ||
57535 | Foot, ankle, leg, knee or femur (NR) (NK) | 16.25 | ||
57536 | Foot, ankle, leg, knee or femur (R) (NK) | 21.70 | ||
57538 | Foot and ankle, or ankle and leg, or leg and knee, or knee and femur (NR) (NK) | 24.70 | ||
57539 | Foot and ankle, or ankle and leg, or leg and knee, or knee and femur (R) (NK) | 32.90 | ||
Subgroup 2 — Radiographic examination of shoulder or pelvis | ||||
57702 | Shoulder or scapula (NR) (NK) | 20.25 | ||
57705 | Shoulder or scapula (R) (NK) | 27.00 | ||
57708 | Clavicle (NR) (NK) | 16.25 | ||
57711 | Clavicle (R) (NK) | 21.70 | ||
57714 | Hip joint (R) (NK) | 23.60 | ||
57717 | Pelvic girdle (R) (NK) | 30.45 | ||
57723 | Femur, internal fixation of neck or intertrochanteric (pertrochanteric) fracture (R) (NK) | 49.65 | ||
Subgroup 3 — Radiographic examination of head | ||||
57911 | Skull, not in association with item 57902 or 57914 (R) (NK) | 32.25 | ||
57914 | Cephalometry, not in association with item 57901 or 57911 (R) (NK) | 32.25 | ||
57917 | Sinuses (R) (NK) | 23.65 | ||
57920 | Mastoids (R) (NK) | 32.25 | ||
57923 | Petrous temporal bones (R) (NK) | 32.25 | ||
57926 | Facial bones — orbit, maxilla or malar, any or all (R) (NK) | 23.60 | ||
57929 | Mandible, not by orthopantomography technique (R) (NK) | 23.60 | ||
57932 | Salivary calculus (R) (NK) | 23.60 | ||
57935 | Nose (R) (NK) | 23.60 | ||
57938 | Eye (R) (NK) | 23.60 | ||
57941 | Temporo‑mandibular joints (R) (NK) | 24.85 | ||
57944 | Teeth — single area (R) (NK) | 16.45 | ||
57947 | Teeth — full mouth (R) (NK) | 39.15 | ||
57950 | Palato‑pharyngeal studies with fluoroscopic screening (R) (NK) | 32.25 | ||
57953 | Palato‑pharyngeal studies without fluoroscopic screening (R) (NK) | 24.85 | ||
57956 | Larynx, lateral airways and soft tissues of the neck, not being a service associated with a service to which item 57939, 57942, 57950 or 57953 applies (R) (NK) | 21.70 | ||
57959 | Orthopantomography for diagnosis or management (or both) of trauma, infection, tumour or a congenital or surgical condition of the teeth or maxillofacial region (R) (NK) | 23.70 | ||
57962 | 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) (NK) | 23.70 | ||
57965 | Orthopantomography for diagnosis or management (or both) of missing or crowded teeth, or developmental anomalies of the teeth or jaws (R) (NK) | 23.70 | ||
57968 | Orthopantomography for diagnosis or management (or both) of temporo‑mandibular joint arthroses or dysfunction (R) (NK) | 23.70 | ||
Subgroup 4 — Radiographic examination of spine | ||||
58102 | Spine — cervical (R) (NK) | 33.60 | ||
58105 | Spine — thoracic (R) (NK) | 27.55 | ||
58111 | Spine — lumbo‑sacral (R) (NK) | 38.50 | ||
58114 | Spine — 4 regions, cervical, thoracic, lumbosacral and sacrococcygeal (R) (NK) | 55.00 | ||
58117 | Spine — sacro‑coccygeal (R) (NK) | 23.50 | ||
58123 | Spine — 2 examinations of the kind mentioned in items 58100, 58102, 58103, 58105, 58106, 58109, 58111 and 58117 (R) (NK) | 48.65 | ||
58124 | Spine — 3 examinations of the kind mentioned in items 58100, 58102, 58103, 58105, 58106, 58109, 58111 and 58117 (R) (NK) | 55.00 | ||
58126 | Spine — 4 regions, cervical, thoracic, lumbosacral and sacrococcygeal (R) (NK), if the service to which item 58120, 58121, 58126 or 58127 applies has not been performed on the same patient within the same calendar year | 55.00 | ||
58127 | Spine — 3 examinations of the kind mentioned in items 58100, 58102, 58103, 58105, 58106, 58109, 58111 and 58117 (R) (NK), if the service to which item 58120, 58121, 58126 or 58127 applies has not been performed on the same patient within the same calendar year | 55.00 | ||
Subgroup 5 — Bone age study and skeletal survey | ||||
58302 | Bone age study (R) (NK) | 20.05 | ||
58308 | Skeletal survey (R) (NK) | 44.70 | ||
Subgroup 6 — Radiographic examination of thoracic region | ||||
58502 | Chest (lung fields) by direct radiography (NR) (NK) | 17.70 | ||
58505 | Chest (lung fields) by direct radiography (R) (NK) | 23.60 | ||
58508 | Chest (lung fields) by direct radiography with fluoroscopic screening (R) (NK) | 30.40 | ||
58511 | Thoracic inlet or trachea (R) (NK) | 19.90 | ||
58523 | Left ribs, right ribs or sternum (R) (NK) | 21.70 | ||
58526 | Left and right ribs, left ribs and sternum, or right ribs and sternum (R) (NK) | 28.25 | ||
58529 | Left ribs, right ribs and sternum (R) (NK) | 34.70 | ||
Subgroup 7 — Radiographic examination of urinary tract | ||||
58702 | Plain renal only (R) (NK) | 23.05 | ||
58708 | Intravenous pyelography, with or without preliminary plain films and with or without tomography (R) (NK) | 78.95 | ||
58717 | Antegrade or retrograde pyelography with or without preliminary plain films and with preparation and contrast injection, 1 side (R) (NK) | 75.80 | ||
58720 | Retrograde cystography or retrograde urethrography with or without preliminary plain films and with preparation and contrast injection (R) (NK) (Anaes.) | 63.05 | ||
58723 | Retrograde micturating cysto‑urethrography, with preparation and contrast injection (R) (NK) (Anaes.) | 69.15 | ||
Subgroup 8 — Radiographic examination of alimentary tract and biliary system | ||||
58902 | Plain abdominal only, not being a service associated with a service to which item 58909, 58911, 58912, 58914, 58915, 58917, 58924 or 58926 applies (NR) (NK) | 17.85 | ||
58905 | Plain abdominal only, not being a service associated with a service to which item 58909, 58911,58912, 58914, 58915, 58917, 58924 or 58926 applies (R) (NK) | 23.80 | ||
58911 | 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, 57945, 57950, 57953 or 57956 applies (R) (NK) | 45.00 | ||
58914 | 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) (NK) | 55.15 | ||
58917 | Barium or other opaque meal, small bowel series only, with or without preliminary plain film (R) (NK) | 39.50 | ||
58920 | 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) (NK) (Anaes.) | 69.25 | ||
58923 | Opaque enema, with or without air contrast study and with or without preliminary plain films (R) (NK) | 67.65 | ||
58926 | Graham’s test (cholecystography), with preliminary plain films and with or without tomography (R) (NK) | 42.05 | ||
58929 | 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) (NK) | 38.25 | ||
58935 | Cholegraphy, percutaneous transhepatic, with or without preliminary plain films and with preparation and contrast injection (R) (NK) | 102.80 | ||
58938 | Cholegraphy, drip infusion, with or without preliminary plain films, with preparation and contrast injection and with or without tomography (R) (NK) | 98.00 | ||
58941 | Defaecogram (R) (NK) | 69.65 | ||
Subgroup 9 — Radiographic examination for localisation of foreign bodies | ||||
59104 | Localisation of foreign body, if provided in conjunction with a service described in Subgroups 1 to 12 of Group I3 (R) (NK) | 10.65 | ||
Group I3 — Diagnostic radiology | ||
Item | Health service | Fee ($) (for each State) |
Subgroup 10 — Radiographic examination of breasts | ||
59301 | Mammography of both breasts if there is reason to suspect the presence of malignancy because of: (a) the past occurrence of breast malignancy in the patient or members of the patient’s family; or | 44.75 |
(b) symptoms or indications of malignancy found on examination of the patient by a medical practitioner (R) (NK) | ||
59304 | Mammography of 1 breast if: (a) the patient is referred with a specific request for a unilateral mammogram; and (b) there is reason to suspect the presence of malignancy because of: (i) the past occurrence of breast malignancy in the patient or members of the patient’s family; or | 27.00 |
(ii) symptoms or indications of malignancy found on examination of the patient by a medical practitioner (R) (NK) | ||
59307 | Mammary ductogram (galactography) — 1 breast (R) (NK) | 50.15 |
59310 | Mammary ductogram (galactography) — 2 breasts (R) (NK) | 100.30 |
59313 | Radiographic examination of both breasts, in conjunction with a surgical procedure on each breast, using interventional techniques (R) (NK) | 43.50 |
59315 | Radiographic examination of 1 breast, in conjunction with a surgical procedure using interventional techniques (R) (NK) | 26.25 |
59319 | Radiographic examination of excised breast tissue to confirm satisfactory excision of 1 or more lesions in 1 breast or both following pre‑operative localisation in conjunction with a service under item 31536 (R) (NK) | 23.55 |
Group I3 — Diagnostic radiology | ||
Item | Health service | Fee ($) (for each State) |
Subgroup 11 — Radiographic examination in connection with pregnancy | ||
59504 | Pelvimetry, not being a service associated with a service to which item 57201 or 57247 applies (R) (NK) | 44.70 |
Subgroup 12 — Radiographic examination with opaque or contrast media | ||
59701 | Discography, each disc, with or without preliminary plain films and with preparation and contrast injection (R) (NK) (Anaes.) | 48.30 |
59704 | Dacryocystography, 1 side, with or without preliminary plain film and with preparation and contrast injection (R) (NK) | 37.95 |
59713 | Hysterosalpingography, with or without preliminary plain films and with preparation and contrast injection (R) (NK) (Anaes.) | 56.85 |
59716 | Bronchography, 1 side, with or without preliminary plain films and with preparation and contrast injection (R) (NK) (Anaes.) | 71.80 |
59719 | Phlebography, 1 side, with or without preliminary plain films and with preparation and contrast injection (R) (NK) (Anaes.) | 67.35 |
59725 | 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 or 56259 applies (R) (NK) (Anaes.) | 113.25 |
59734 | Sialography, 1 side, with preparation and contrast injection, not being a service associated with a service to which item 57918 or 57932 applies (R) (NK) | 53.85 |
59737 | Vasoepididymography, 1 side (R) (NK) | 31.00 |
59740 | Sinogram or fistulogram, 1 or more regions, with or without preliminary plain films and with preparation and contrast injection (R) (NK) | 36.90 |
59752 | 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) (NK) | 69.60 |
59755 | Lymphangiography, 1 or both sides, with preliminary plain films and follow‑up radiography and with preparation and contrast injection (R) (NK) | 109.70 |
59761 | Peritoneogram (herniography) with or without contrast medium including preparation — performed on a person over 14 years of age (R) (NK) | 57.60 |
59764 | Air insufflation during video — fluoroscopic imaging including associated consultation (R) (NK) | 66.95 |
Subgroup 14 — Tomography | ||
60101 | Tomography of any region (R) (NK) (Anaes.) | 30.40 |
Group I3 — Diagnostic radiology | ||
Item | Health service | Fee ($) (for each State) |
Subgroup 15 — Fluoroscopic examination | ||
60501 | Fluoroscopy, with general anaesthesia (not being a service associated with a radiographic examination) (R) (NK) (Anaes.) | 21.70 |
60504 | Fluoroscopy, without general anaesthesia (not being a service associated with a radiographic examination) (R) (NK) | 14.90 |
60507 | Fluoroscopy using a mobile image intensifier, in conjunction with a surgical procedure lasting less than 1 hour, not being a service associated with a service to which another item in this table applies (R) (NK) | 31.90 |
60510 | Fluoroscopy using a mobile image intensifier, in conjunction with a surgical procedure lasting 1 hour or more, not being a service associated with a service to which another item in this table applies (R) (NK) | 49.45 |
Group I3 — Diagnostic radiology | ||
Item | Health service | Fee ($) (for each State) |
Subgroup 17 — Interventional techniques | ||
61110 | 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) (NK) | 129.45 |
Group I4 — Nuclear medicine imaging | ||
Item | Health service | Fee ($) (for each State) |
61651 | Single stress or rest myocardial perfusion study — planar imaging (R) (NK) | 224.45 |
61652 | Single stress or rest myocardial perfusion study — with single photon emission tomography and with planar imaging when performed (R) (NK) | 282.65 |
61653 | 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) (NK) | 354.85 |
61654 | 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) (NK) | 417.45 |
61655 | Myocardial infarct‑avid‑study, with planar imaging and single photon emission tomography, or planar imaging or single photon emission tomography (R) (NK) | 183.65 |
61656 | Gated cardiac blood pool study, (equilibrium), with planar imaging and single photon emission tomography, or planar imaging or single photon emission tomography (R) (NK) | 151.70 |
61657 | 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) (NK) | 210.00 |
61658 | Gated cardiac blood pool study, with intervention, with planar imaging and single photon emission tomography, or planar imaging, or single photon emission tomography (R) (NK) | 190.60 |
61659 | 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) (NK) | 246.20 |
61660 | Cardiac first pass blood flow study or cardiac shunt study, not being a service to which another item in this group applies (R) (NK) | 114.45 |
61661 | Lung perfusion study, with planar imaging and single photon emission tomography or planar imaging, or single photon emission tomography (R) (NK) | 113.85 |
61662 | 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) (NK) | 126.50 |
61663 | 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) (NK) | 221.70 |
61664 | Liver and spleen study (colloid) — planar imaging (R) (NK) | 129.70 |
61665 | Liver and spleen study (colloid), with single photon emission tomography and with planar imaging when performed (R) (NK) | 193.30 |
61666 | Red blood cell spleen or liver study, including single photon emission tomography when performed (R) (NK) | 196.40 |
61667 | Hepatobiliary study, including morphine administration or pre‑treatment with cholecystokinin (CCK) when performed (R) (NK) | 201.70 |
61668 | Hepatobiliary study with formal quantification following baseline imaging, using an infusion of cholecystokinin (CCK) (R) (NK) | 230.70 |
61669 | Bowel haemorrhage study (R) (NK) | 248.50 |
61670 | Meckel’s diverticulum study (R) (NK) | 111.55 |
61671 | 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) (NK) | 1,007.90 |
61672 | Salivary study (R) (NK) | 111.55 |
61673 | Gastro‑oesophageal reflux study, including delayed imaging on a separate occasion when performed (R) (NK) | 244.85 |
61674 | Oesophageal clearance study (R) (NK) | 71.70 |
61675 | Gastric emptying study, using single tracer (R) (NK) | 287.20 |
61676 | Combined solid and liquid gastric emptying study using dual isotope technique or the same isotope on separate days (R) (NK) | 312.50 |
61677 | Radionuclide colonic transit study (R) (NK) | 343.85 |
61678 | Renal study, including perfusion and renogram images and computer analysis or cortical study with planar imaging (R) (NK) | 166.25 |
61679 | Renal cortical study, with single photon emission tomography and planar quantification (R) (NK) | 215.40 |
61680 | Single renal study with pre‑procedural administration of a diuretic or angiotensin converting enzyme (ACE) inhibitor (R) (NK) | 185.30 |
61681 | Renal study with diuretic administration following a baseline study (R) (NK) | 205.00 |
61682 | 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) (NK) | 302.75 |
61683 | Cystoureterogram (R) (NK) | 123.45 |
61684 | Testicular study (R) (NK) | 81.15 |
61685 | Cerebral perfusion study, with single photon emission tomography and with planar imaging when performed (R) (NK) | 302.55 |
61686 | Brain study with blood brain barrier agent, with planar imaging and single photon emission tomography, or planar imaging, or single photon emission tomography (R) (NK) | 173.00 |
61687 | Cerebro‑spinal fluid transport study, with imaging on 2 or more separate occasions (R) (NK) | 436.75 |
61688 | Cerebro‑spinal fluid shunt patency study (R) (NK) | 113.00 |
61689 | 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) (NK) | 59.45 |
61690 | Bone study — whole body, with, when undertaken, blood flow, blood pool and delayed imaging on a separate occasion (R) (NK) | 239.90 |
61691 | Bone study — whole body and single photon emission tomography, with, when undertaken, blood flow, blood pool and delayed imaging on a separate occasion (R) (NK) | 300.35 |
61692 | Whole body study using iodine (R) (NK) | 277.40 |
61693 | Whole body study using gallium (R) (NK) | 271.50 |
61694 | Whole body study using gallium, with single photon emission tomography (R) (NK) | 329.75 |
61695 | Whole body study using cells labelled with technetium (R) (NK) | 248.50 |
61696 | Whole body study using cells labelled with technetium, with single photon emission tomography (R) (NK) | 307.70 |
61697 | Whole body study using thallium (R) (NK) | 271.40 |
61698 | Whole body study using thallium, with single photon emission tomography (R) (NK) | 336.50 |
61699 | Bone marrow study — whole body using technetium labelled bone marrow agents (R) (NK) | 244.85 |
61700 | Whole body study, using gallium — with single photon emission tomography of 2 or more body regions acquired separately (R) (NK) | 376.20 |
61701 | Bone marrow study — localised using technetium labelled agent (R) (NK) | 143.40 |
61702 | Localised bone or joint study, including when undertaken, blood flow, blood pool and repeat imaging on a separate occasion (R) (NK) | 166.80 |
61703 | Localised bone or joint study and single photon emission tomography, including when undertaken, blood flow, blood pool and imaging on a separate occasion (R) (NK) | 228.10 |
61704 | Localised study using gallium (R) (NK) | 198.80 |
61705 | Localised study using gallium, with single photon emission tomography (R) (NK) | 257.35 |
61706 | Localised study using cells labelled with technetium (R) (NK) | 174.05 |
61707 | Localised study using cells labelled with technetium, with single photon emission tomography (R) (NK) | 235.25 |
61708 | Localised study using thallium (R) (NK) | 198.50 |
61709 | Localised study using thallium, with single photon emission tomography (R) (NK) | 263.95 |
61710 | 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, 61485, 61669, 61692, 61693, 61694, 61700, 61704, 61705, 61712, 61715 or 61716, if there is no additional administration of radiopharmaceutical and if the previous radionuclide scan was abnormal or equivocal (R) (NK) | 64.50 |
61711 | Venography (R) (NK) | 132.75 |
61712 | Lymphoscintigraphy (R) (NK) | 174.05 |
61713 | Thyroid study including uptake measurement when performed (R) (NK) | 87.70 |
61714 | Parathyroid study, planar imaging and single photon emission tomography when performed (R) (NK) | 193.45 |
61715 | Adrenal study (R) (NK) | 440.45 |
61716 | Adrenal study, with single photon emission tomography (R) (NK) | 499.60 |
61717 | Tear duct study (R) (NK) | 111.55 |
61718 | Particle perfusion study (infra‑arterial) or Le Veen shunt study (R) (NK) | 126.50 |
61719 | 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 61729 (R) (NK) | 50.00 |
61729 | 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) (NK) 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. | 439.35 |
Group I5 — Magnetic resonance imaging | |||
Item | Health service | Fee ($) (for each State) | |
Subgroup 1 — Scan of head — for specified conditions | |||
63013 | MRI — scan of head (including MRA, if performed) for tumour of the brain or meninges (R) (NK) (Anaes.) (Contrast) | 201.60 | |
63014 | MRI — scan of head (including MRA, if performed) for inflammation of brain or meninges (R) (NK) (Anaes.) (Contrast) | 201.60 | |
63016 | MRI — scan of head (including MRA, if performed) for skull base or orbital tumour (R) (NK) (Anaes.) (Contrast) | 201.60 | |
63017 | 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) (NK) (Anaes.) (Contrast) | 168.00 | |
Subgroup 2 — Scan of head — for specified conditions | |||
63074 | MRI — scan of head (including MRA, if performed) for acoustic neuroma (R) (NK) (Anaes.) (Contrast) | 168.00 | |
63075 | MRI — scan of head (including MRA, if performed) for pituitary tumour (R) (NK) (Anaes.) (Contrast) | 179.20 | |
63076 | MRI — scan of head (including MRA, if performed) for toxic or metabolic or ischaemic encephalopathy (R) (NK) (Anaes.) (Contrast) | 201.60 | |
63077 | MRI — scan of head (including MRA, if performed) for demyelinating disease of the brain (R) (NK) (Anaes.) (Contrast) | 201.60 | |
63078 | MRI — scan of head (including MRA, if performed) for congenital malformation of the brain or meninges (R) (NK) (Anaes.) (Contrast) | 201.60 | |
63079 | MRI — scan of head (including MRA, if performed) for venous sinus thrombosis (R) (NK) (Anaes.) (Contrast) | 201.60 | |
63080 | MRI — scan of head (including MRA, if performed) for head trauma (R) (NK) (Anaes.) (Contrast) | 201.60 | |
63081 | MRI — scan of head (including MRA, if performed) for epilepsy (R) (NK) (Anaes.) (Contrast) | 201.60 | |
63082 | MRI — scan of head (including MRA, if performed) for stroke (R) (NK) (Anaes.) (Contrast) | 201.60 | |
63083 | MRI — scan of head (including MRA, if performed) for carotid or vertebral artery dissection (R) (NK) (Anaes.) (Contrast) | 201.60 | |
63084 | MRI — scan of head (including MRA, if performed) for intracranial aneurysm (R) (NK) (Anaes.) (Contrast) | 201.60 | |
63085 | MRI — scan of head (including MRA, if performed) for intracranial arteriovenous malformation (R) (NK) (Anaes.) (Contrast) | 201.60 | |
Subgroup 3 — Scan of head and neck vessels — for specified conditions | |||
63104 | MRI and MRA of extracranial or intracranial circulation (or both) — scan of head and neck vessels for stroke (R) (NK) (Anaes.) (Contrast) | 246.40 | |
Subgroup 4 — Scan of head and cervical spine — for specified conditions | |||
63117 | MRI — scan of head and cervical spine (including MRA, if performed) for tumour of the central nervous system or meninges (R) (NK) (Anaes.) (Contrast) | 246.40 | |
63119 | MRI — scan of head and cervical spine (including MRA, if performed) for inflammation of the central nervous system or meninges (R) (NK) (Anaes.) (Contrast) | 246.40 | |
Subgroup 5 — Scan of head and cervical spine — for specified conditions | |||
63134 | MRI — scan of head and cervical spine (including MRA, if performed) for demyelinating disease of the central nervous system (R) (NK) (Anaes.) (Contrast) | 246.40 | |
63135 | MRI — scan of head and cervical spine (including MRA, if performed) for congenital malformation of the central nervous system or meninges (R) (NK) (Anaes.) (Contrast) | 246.40 | |
63136 | MRI — scan of head and cervical spine (including MRA, if performed) for syrinx (congenital or acquired) (R) (NK) (Anaes.) (Contrast) | 246.40 | |
Subgroup 6 — Scan of spine — 1 region or 2 contiguous regions — for specified conditions | |||
63157 | MRI — scan of 1 region or 2 contiguous regions of the spine for infection (R) (NK) (Anaes.) (Contrast) | 179.20 | |
63158 | MRI — scan of 1 region or 2 contiguous regions of the spine for tumour (R) (NK) (Anaes.) (Contrast) | 179.20 | |
Subgroup 7 — Scan of spine — 1 region or 2 contiguous regions — for specified conditions | |||
63186 | MRI — scan of 1 region or 2 contiguous regions of the spine for demyelinating disease (R) (NK) (Anaes.) (Contrast) | 179.20 | |
63187 | 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) (NK) (Anaes.) (Contrast) | 179.20 | |
63188 | MRI — scan of 1 region or 2 contiguous regions of the spine for myelopathy (R) (NK) (Anaes.) (Contrast) | 179.20 | |
63189 | MRI — scan of 1 region or 2 contiguous regions of the spine for syrinx (congenital or acquired) (R) (NK) (Anaes.) (Contrast) | 179.20 | |
63190 | MRI — scan of 1 region or 2 contiguous regions of the spine for cervical radiculopathy (R) (NK) (Anaes.) (Contrast) | 179.20 | |
63191 | MRI — scan of 1 region or 2 contiguous regions of the spine for sciatica (R) (NK) (Anaes.) (Contrast) | 179.20 | |
63192 | MRI — scan of 1 region or 2 contiguous regions of the spine for spinal canal stenosis (R) (NK) (Anaes.) (Contrast) | 179.20 | |
63193 | MRI — scan of 1 region or 2 contiguous regions of the spine for previous spinal surgery (R) (NK) (Anaes.) (Contrast) | 179.20 | |
63194 | MRI — scan of 1 region or 2 contiguous regions of the spine for trauma (R) (NK) (Anaes.) | 179.20 | |
Subgroup 8 — Scan of spine — 3 contiguous or 2 non‑contiguous regions — for specified conditions | |||
63207 | MRI — scan of 3 contiguous or 2 non‑contiguous regions of the spine for infection (R) (NK) (Anaes.) (Contrast) | 224.00 | |
63208 | MRI — scan of 3 contiguous or 2 non‑contiguous regions of the spine for tumour (R) (NK) (Anaes.) (Contrast) | 224.00 | |
Subgroup 9 — Scan of spine — 3 contiguous or 2 non‑contiguous regions — for specified conditions | |||
63257 | MRI — scan of 3 contiguous or 2 non‑contiguous regions of the spine for demyelinating disease (R) (NK) (Anaes.) (Contrast) | 224.00 | |
63258 | 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) (NK) (Anaes.) (Contrast) | 224.00 | |
63259 | MRI — scan of 3 contiguous or 2 non‑contiguous regions of the spine for myelopathy (R) (NK) (Anaes.) (Contrast) | 224.00 | |
63260 | MRI — scan of 3 contiguous or 2 non‑contiguous regions of the spine for syrinx (congenital or acquired) (R) (NK) (Anaes.) (Contrast) | 224.00 | |
63261 | MRI — scan of 3 contiguous or 2 non‑contiguous regions of the spine for cervical radiculopathy (R) (NK) (Anaes.) (Contrast) | 224.00 | |
63262 | MRI — scan of 3 contiguous or 2 non‑contiguous regions of the spine for sciatica (R) (NK) (Anaes.) (Contrast) | 224.00 | |
63263 | MRI — scan of 3 contiguous or 2 non‑contiguous regions of the spine for spinal canal stenosis (R) (NK) (Anaes.) (Contrast) | 224.00 | |
63264 | MRI — scan of 3 contiguous or 2 non‑contiguous regions of the spine for previous spinal surgery (R) (NK) (Anaes.) (Contrast) | 224.00 | |
63265 | MRI — scan of 3 contiguous or 2 non‑contiguous regions of the spine for trauma (R) (NK) (Anaes.) | 224.00 | |
Subgroup 10 — Scan of cervical spine and brachial plexus — for specified conditions | |||
63282 | MRI — Scan of cervical spine and brachial plexus for tumour (R) (NK) (Anaes.) (Contrast) | 246.40 | |
63283 | MRI — Scan of cervical spine and brachial plexus for trauma (R) (NK) (Anaes.) (Contrast) | 246.40 | |
63284 | MRI — Scan of cervical spine and brachial plexus for cervical radiculopathy (R) (NK) (Anaes.) (Contrast) | 246.40 | |
63285 | MRI — Scan of cervical spine and brachial plexus for previous surgery (R) (NK) (Anaes.) (Contrast) | 246.40 | |
Subgroup 11 — Scan of musculoskeletal system — for specified conditions | |||
63310 | MRI — scan of musculoskeletal system for tumour arising in bone or musculoskeletal system, excluding tumours arising in breast, prostate or rectum (R) (NK) (Anaes.) (Contrast) | 190.40 | |
63311 | MRI — scan of musculoskeletal system for infection arising in bone or musculoskeletal system, excluding infection arising in breast, prostate or rectum (R) (NK) (Anaes.) (Contrast) | 190.40 | |
63313 | MRI — scan of musculoskeletal system for osteonecrosis (R) (NK) (Anaes.) (Contrast) | 190.40 | |
Subgroup 12 — Scan of musculoskeletal system — for specified conditions | |||
63341 | MRI — scan of musculoskeletal system for derangement of hip or its supporting structures (R) (NK) (Anaes.) (Contrast) | 201.60 | |
63342 | MRI — scan of musculoskeletal system for derangement of shoulder or its supporting structures (R) (NK) (Anaes.) (Contrast) | 201.60 | |
63343 | MRI — scan of musculoskeletal system for derangement of knee or its supporting structures (R) (NK) (Anaes.) (Contrast) | 201.60 | |
63345 | MRI — scan of musculoskeletal system for derangement of ankle or foot (or both) or its supporting structures (R) (NK) (Anaes.) (Contrast) | 201.60 | |
63346 | MRI — scan of musculoskeletal system for derangement of 1 or both temporomandibular joints or their supporting structures (R) (NK) (Anaes.) (Contrast) | 168.00 | |
63347 | MRI — scan of musculoskeletal system for derangement of wrist or hand (or both) or its supporting structures (R) (NK) (Anaes.) (Contrast) | 224.00 | |
63348 | MRI — scan of musculoskeletal system for derangement of elbow or its supporting structures (R) (NK) (Anaes.) (Contrast) | 201.60 | |
Subgroup 13 — Scan of musculoskeletal system — for specified conditions | |||
63364 | MRI — scan of musculoskeletal system for Gaucher disease (R) (NK) (Anaes.) | 201.60 | |
Subgroup 14 — Scan of cardiovascular system — for specified conditions | |||
63392 | MRI — scan of cardiovascular system for congenital disease of the heart or a great vessel (R) (NK) (Anaes.) (Contrast) | 224.00 | |
63393 | MRI — scan of cardiovascular system for tumour of the heart or a great vessel (R) (NK) (Anaes.) (Contrast) | 224.00 | |
63394 | MRI — scan of cardiovascular system for abnormality of thoracic aorta (R) (NK) (Anaes.) (Contrast) | 201.60 | |
Subgroup 15 — Magnetic resonance angiography — scan of cardiovascular system — for specified conditions | |||
63407 | 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) (NK) (Anaes.) (Contrast) | 201.60 | |
63408 | 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) (NK) (Anaes.) (Contrast) | 201.60 | |
Subgroup 16 — Magnetic resonance angiography — for specified conditions — person under the age of 16 years | |||
63419 | 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) (NK) (Anaes.) (Contrast) | 201.60 | |
Subgroup 17 — Magnetic resonance imaging — for specified conditions — person under the age of 16 years | |||
63432 | MRI — scan of person under the age of 16 for post‑inflammatory or post‑traumatic physeal fusion (R) (NK) (Anaes.) | 201.60 | |
63433 | MRI — scan of person under the age of 16 for Gaucher disease (R) (NK) (Anaes.) | 201.60 | |
Subgroup 18 — Magnetic resonance imaging — for specified conditions — person under the age of 16 years | |||
63447 | MRI — scan of person under the age of 16 for pelvic or abdominal mass (R) (NK) (Anaes.) (Contrast) | 201.60 | |
63448 | MRI — scan of person under the age of 16 for mediastinal mass (R) (NK) (Anaes.) (Contrast) | 201.60 | |
63449 | MRI — scan of person under the age of 16 for congenital uterine or anorectal abnormality (R) (NK) (Anaes.) (Contrast) | 201.60 | |
Subgroup 19 — Scan of body — for specified conditions | |||
63455 | MRI — scan of the body for adrenal mass in a patient with a malignancy that is otherwise resectable (R) (NK) (Anaes.) | 179.20 | |
63457 | 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; | 345.00 | |
(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; | |||
(iii) 1 first or second degree relative diagnosed with breast cancer at age 45 years or younger, plus another first or second degree relative on the same side of the family with bone or soft tissue sarcoma at age 45 years or younger; or | |||
(b) that genetic testing has identified the presence of a high risk breast cancer gene mutation (R) (NK) (Anaes.) | |||
63458 | MRI — scan of both breasts for the detection of cancer, if: (a) a dedicated breast coil is used; and (b) the woman has had an abnormality detected as a result of a service described in item 63464 or 63457 performed in the previous 12 months (R) (NK) (Anaes.) | 345.00 | |
Group I5 — Magnetic resonance imaging | ||
Item | Health service | Fee ($) (for each State) |
Subgroup 20 — Scans of pelvis and upper abdomen — for specified conditions | ||
63479 | MRI — scan of the pelvis for the staging of histologically diagnosed cervical cancer at FIGO stage 1B or greater, if the request for scan identifies that: (a) a histological diagnosis of carcinoma of the cervix has been made; and (b) the patient has been diagnosed with cervical cancer at FIGO stage 1B or greater (R) (NK) (Anaes.) (Contrast) | 201.60 |
63481 | MRI — scan of the pelvis and upper abdomen, in a single examination, for the staging of histologically diagnosed cervical cancer at FIGO stage 1B or greater, if the request for scan identifies that: (a) a histological diagnosis of carcinoma of the cervix has been made; and (b) the patient has been diagnosed with cervical cancer at FIGO stage 1B or greater (R) (NK) (Anaes.) (Contrast) | 313.60 |
63484 | MRI — scan of the pelvis for the initial staging of rectal cancer, if: (a) a phased array body coil is used; and (b) the request for scan identifies that the indication is for the initial staging of rectal cancer (including cancer of the rectosigmoid and anorectum) (R) (NK) (Anaes.) (Contrast) | 201.60 |
Group I5 — Magnetic resonance imaging | ||
Item | Health service | Fee ($) (for each State) |
Subgroup 21 — Scan of body — for specified conditions | ||
63486 | MRI — scan of pancreas and biliary tree for suspected biliary or pancreatic pathology (R) (NK) (Anaes.) | 201.60 |
Group I5—Magnetic resonance imaging | ||||||||
Item | Health service | Fee ($) (for each state) | ||||||
___________________________________________________________________________ Subgroup 33 —Scan of body—for specified conditions | ||||||||
63508 | MRI—scan of head for a patient under 16 years if the service is for: (a) an unexplained seizure (R) (NK) (Anaes.) (Contrast); or (b) an unexplained headache if significant pathology is suspected (R) (NK) (Anaes.) (Contrast); or (c) paranasal sinus pathology that has not responded to conservative therapy (R) (NK) (Anaes.) (Contrast) | 201.60 | ||||||
63511 | MRI—scan of spine following radiographic examination for a patient under 16 years if the service is for: (a) significant trauma (R) (NK) (Anaes.) (Contrast); or (b) unexplained neck or back pain with associated neurological signs (R) (NK) (Anaes.) (Contrast); or (c) unexplained back pain if significant pathology is suspected (R) (NK) (Anaes.) (Contrast) | 224.00 | ||||||
63514 | MRI—scan of knee following radiographic examination for internal joint derangement for a patient under 16 years (NK) (R) (Anaes.) (Contrast) | 201.60 | ||||||
63517 | MRI—scan of hip following radiographic examination for a patient under 16 years if any of the following is suspected: (a) septic arthritis (R) (NK) (Anaes.) (Contrast); (b) slipped capital femoral epiphysis (R) (NK) (Anaes.) (Contrast); (c) Perthes disease (R) (NK) (Anaes.) (Contrast) | 201.60 | ||||||
63520 | MRI—scan of elbow following radiographic examination for a patient under 16 years if a significant fracture or avulsion injury, which would change the way in which the patient is managed, is suspected (R)(NK) (Anaes.) (Contrast) | 201.60 | ||||||
63523 | MRI—scan of wrist following radiographic examination for a patient under 16 years if a scaphoid fracture is suspected (R)(NK) (Anaes.) (Contrast) | 224.00 | ||||||
Group I5—Magnetic resonance imaging | ||
Item | Health service | Fee ($) (for each State) |
Subgroup 34 — Scan of body — for specified conditions | ||
63552 | Scan of head for a patient 16 years or older, after referral by a medical practitioner (other than a specialist or consultant physician), for any of the following: (a) unexplained seizure(s); (b) unexplained chronic headache with suspected intracranial pathology (R) (NK) (Contrast) (Anaes.) | 201.60 |
63555 | Scan of spine for a patient 16 years or older, after referral by a medical practitioner (other than a specialist or consultant physician), for suspected cervical radiculopathy (R) (NK) (Contrast) (Anaes.) | 179.20 |
63558 | Scan of spine for a patient 16 years or older, after referral by a medical practitioner (other than a specialist or consultant physician), for suspected cervical spinal trauma (R) (NK) (Contrast) (Anaes.) | 246.40 |
63561 | Scan of knee following acute knee trauma, after referral by a medical practitioner (other than a specialist or consultant physician), for a patient 16 years or older with: (a) inability to extend the knee suggesting the possibility of acute meniscal tear; or (b) clinical findings suggesting acute anterior cruciate ligament tear (R) (NK) (Contrast) (Anaes.) | 201.60 |
Column 1 | Column 2 | Column 3 | |
Provision of diagnostic imaging services table | Existing item reference of diagnostic imaging services table | Additional item reference | |
Preliminary | |||
(a) | Clause 1.1.1 and subclause 1.2.3(1) | Item in Part 2 | The items in Schedule 1 |
(b) | Paragraph 1.2.3(2)(a) | 55054, 55130, 55135, 55848, 55850, 57341, 57345, 59312, 59314, 60506, 60509 and 61109 | 55026, 55131, 55136, 55849, 55851, 59313, 59315, 60507, 60510, 61110 |
(c) | Subclause 1.2.5(4) | 61369 | 61671 |
(d) | Subclause 1.2.7(10) | 59103, 64990 or 64991 | 59104 |
Ultrasound | |||
(e) | Clause 2.1.1 and subclause 2.1.2 (1) | 55600 and 55603 | 55601, 55604 |
(f) | Clause 2.1.3 | 55028, 55030 and 55032 | 55005, 55008, 55011 |
(g) | Subclause 2.1.4(2) | 55706, 55707, 55708, 55709, 55718, 55723, 55759, 55762, 55768 and 55770 | 55713, 55714, 55716, 55717, 55722, 55726, 55760, 55763, 55769, 55771 |
(h) | Subclause 2.1.5 (1) | 55700, 55704, 55707, 55718, 55759 and 55768 | 55701, 55710, 55714, 55722, 55760, 55769 |
(i) | Subclause 2.1.5(1) | 55712, 55721, 55764 and 55772 | 55719, 55724, 55765, 55773 |
(j) | Subclause 2.1.5(2) | 55703, 55705, 55708, 55715, 55723, 55725, 55762, 55766, 55770 and 55774 | 55702, 55711, 55716, 55720, 55726, 55727, 55763, 55767, 55771, 55775 |
(k) | Clause 2.1.6 | 55712, 55721, 55764 and 55772 | 55719, 55724, 55765, 55773 |
Diagnostic radiology | |||
(l) | Clause 2.3.1(2) | 57901 to 57969 | 57911 to 57968 |
(m) | Clauses 2.3.6 and 2.3.4 | 61109 | 61110 |
Nuclear medicine imaging | |||
(n) | Clause 2.4.1 | 61302 to 61505 and item 61650 | 61651 to 61719, 61729 |
Magnetic resonance imaging | |||
(o) | Subclause 2.5.1(1) and clause 2.5.7 | 63001 to 63482 | 63484, 63486 |
(p) | Subclause 2.5.1(2) and clause 2.5.7 | 63464 to 63476 | 63457 to 63484 |
(q) | Subclause 2.5.1(4) and clause 2.5.7 | 63507 to 63522 | 63523, 63552, 63555, 63558, 63561 |
(r) | Subclause 2.5.9(2) | 63040 to 63073 | 63074 to 63085 |
(s) | Subclause 2.5.9(2) | 63101 | 63104 |
(t) | Subclause 2.5.9(2) | 63125 to 63131 | 63134 to 63136 |
(u) | Subclause 2.5.9(2) | 63161 to 63185 | 63186 to 63194 |
(v) | Subclause 2.5.9(2) | 63219 to 63243 | 63257 to 63265 |
(w) | Subclause 2.5.9(2) | 63271 to 63280 | 63282 to 63285 |
(x) | Subclause 2.5.9(2) | 63322 to 63340 | 63341 to 63348 |
(y) | Subclause 2.5.9(2) | 63361 | 63364 |
(z) | Subclause 2.5.9(2) | 63385 to 63391 | 63392 to 63394 |
(aa) | Subclause 2.5.9(2) | 63401 and 63404 | 63407, 63408 |
(bb) | Subclause 2.5.9(2) | 63416 | 63419 |
(cc) | Subclause 2.5.9(2) | 63425 and 63428 | 63432, 63433 |
(dd) | Subclause 2.5.9(2) | 63461, 63464 and 63467 | 63455, 63457, 63458 |
(ee) | Subclause 2.5.9(2) | 63482 | 63486 |
(ff) | Subclause 2.5.9(2) | 63507 to 63522 | 63508, 63511, 63514, 63517, 63520, 63523, 63552, 63555, 63558, 63561 |
(gg) | Subclauses 2.5.10(1) and (2) | 63470 | 63479 |
(hh) | Subclause 2.5.10(1) and (2) | 63473 | 63481 |
Column 1 | Column 2 | Column 3 | |
Existing DIST item | Existing item reference | Additional item reference | |
Ultrasound | |||
(a) | 55036 | 55038, 55044 or 55731 | 55017, 55020, 55732 |
(b) | 55038 | 55036, 55044 or 55731 | 55014, 55020, 55732 |
(c) | 55044 | 55036 or 55038 | 55014, 55017 |
(d) | 55084 | 11917, 55036, 55038, 55044, 55600, 55603 or 55731 | 55014, 55017, 55020, 55601, 55604, 55732 |
(e) | 55085 | 11917, 55037, 55039, 55045, 55600, 55603 or 55733 | 55016, 55019, 55022, 55601, 55604, 55734 |
(f) | 55113 to 55118 | 55054 | 55026 |
(g) | 55113 to 55117 | 55118 and 55130 | 55125, 55131 |
(h) | 55130 | 55135 | 55136 |
(i) | 55135 | 55130 | 55131 |
(j) | 55238 to 55296 | 55054 | 55026 |
(k) | 55706 | 55709 | 55717 |
(l) | 55707(f) and 55078(d) | 55704 | 55710 |
(m) | 55707 and 55708 | 55700, 55703, 55704 or 55705 | 55701, 55702, 55710, 55711 |
(n) | 55709 | 55706 | 55713 |
(o) | 55712 and 55715 | 55706 or 55709 | 55713, 55717 |
(p) | 55718 | 55723 | 55726 |
(q) | 55721 and 55725 | 55718 or 55723 | 55722, 55726 |
(r) | 55723 | 55718 | 55722 |
(s) | 55731 | 55036 or 55038 | 55014, 55017 |
(t) | 55759 | 55706, 55709, 55712, 55715 or 55762 | 55713, 55717, 55719, 55720, 55763 |
(u) | 55762 | 55706, 55709, 55712, 55715 or 55759 | 55713, 55717, 55719, 55720, 55760 |
(v) | 55764 and 55766 | 55759 or 55762 | 55760, 55763 |
(w) | 55764 and 55766 | 55706, 55709, 55712 or 55715 | 55713, 55717, 55719, 55720 |
(x) | 55768 | 55770 | 55771 |
(y) | 55768, 55770, 55772 and 55774 | 55718, 55721, 55723 or 55725 | 55722, 55724, 55726, 55727 |
(z) | 55770 | 55768 | 55769 |
(aa) | 55772 and 55774 | 55768 or 55770 | 55769, 55771 |
(bb) | 55848 and 55850 | 55054 | 55026 |
(cc) | 55850 | 55800 to 55848 | 55849 |
Computed tomography | |||
(dd) | 56219 and 56259 | 59724 | 59725 |
Diagnostic radiology | |||
(ee) | 57901 | 57902 | 57914 |
(ff) | 57902 | 57901 | 57911 |
(gg) | 57945 | 57939 or 57942 | 57950, 57953 |
(hh) | 58112, 58115 and 58121 | 58100, 58103, 58106 and 58109 | 58102, 58105, 58111, 58117 |
(ii) | 58120 and 58121 | 58120 or 58121 | 58126, 58127 |
(jj) | 58900 and 58903 | 58909, 58912, 58915 or 58924 | 58911, 58914, 58917, 58926 |
(kk) | 58909 | 57939, 57942 or 57945 | 57950, 57953, 57956 |
(ll) | 59733 | 57918 | 57932 |
(mm) | 59903, 59912, 59925, 59971, 59972, and 59973 | 61109 | 61110 |
Nuclear medicine imaging | |||
(nn) | 61462 | 61364, 61426, 61429, 61430, 61442, 61450, 61453, 61469, 61484 or 61485 | 61669, 61692, 61693, 61694, 61700, 61704, 61705, 61712, 61715, 61716 |
(oo) | 61505 | 61302 to 61650 | 61651 to 61729 |
Magnetic resonance imaging | |||
(pp) | 63467 | 63464 | 63457 |