Health Insurance (1991-1992 Diagnostic Imaging Services Table) Regulations (Amendment)
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Statutory Rules 1992 No. 951
__________________
Health Insurance (1991-1992 Diagnostic Imaging Services Table) Regulations 2 (Amendment)
I, THE GOVERNOR-GENERAL of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following Regulations under the Health Insurance Act 1973.
Dated 7 April 1992.
BILL HAYDEN
Governor-General
By His Excellency’s Command,
B. HOWE
Minister of State for Health,
Housing and Community Services
____________
- Commencement
1.1 These Regulations, other than subregulations 3.2, 3.3 and 3.4, commence on 1 May 1992.
1.2 Subregulations 3.2, 3.3 and 3.4 commence on 1 June 1992.
- Amendment
2.1 The Health Insurance (1991-1992 Diagnostic Imaging Services Table) Regulations are amended as set out in these Regulations.
- Schedule (Table of Diagnostic Imaging Services—Rules of Interpretation)
3.1 Rule 5:
Add at the end:
“(3)An item including the symbol ‘(CP)’ is an R-type diagnostic imaging service given by or on behalf of a specialist in diagnostic radiology at:
(a) a comprehensive radiology service facility; or
(b) a hospital or registered day hospital facility to a private patient who is receiving hospital treatment; or
(c) a nursing home to a patient who is accommodated in the nursing home and is receiving nursing home care; or
(d) a radiology practice located not less than 10 kilometres by the most direct road route from the nearest other radiology service facility operated by or on behalf of a specialist in diagnostic radiology, other than a radiology service facility in a hospital.
“(4)An item including the symbol ‘(OP)’ is an R-type diagnostic imaging service given by or on behalf of a specialist in diagnostic radiology at a radiology service facility that is not a comprehensive radiology service facility.
“(5)An item including the symbol ‘(NS)’ is an R-type diagnostic imaging service given by or on behalf of a medical practitioner who is not a specialist in diagnostic radiology.
“(6)An item including the symbol ‘(A)’ is an R-type diagnostic imaging service given by or on behalf of a specialist in diagnostic radiology if:
(a) the specialist has personally:
(i) interviewed the patient at the radiology service facility where the service is given, either immediately before the service is given or during the rendering of the service; or
(ii) examined, at the radiology service facility where the service is given, the radiographic image of the patient made at the facility before the patient leaves the facility; or
(b) the service is given at:
(i) a hospital or registered day hospital facility to a private patient who is receiving hospital treatment; or
(ii) a nursing home to a patient who is accommodated in the nursing home and is receiving nursing home care; or
(iii) a radiology practice located not less than 30 kilometres by the most direct road route from the nearest comprehensive radiology service facility.
“(7)In this rule:
‘comprehensive radiology service facility’ means a radiology service facility at which:
(a) radiology services are provided by or on behalf of a specialist in diagnostic radiology; and
(b) the practice operating the facility provides services using equipment that is permanently installed or permanently located at the facility; and
(c) the practice operating the facility provides plain X-ray services (being services specified in any of items 57501 to 57750 (inclusive), items 57756 to 58009 (inclusive), or items 58018 to 58910 (inclusive) in this table) and at least 2 of the following kinds of service:
(i) ultrasound services (being services specified in any of items 55003 to 55239 in this table);
(ii) X-ray services involving the use of fluoroscopy and image intensification equipment (being services specified in any of the following items in this table: 58012, 58015, 58719, 58722, 58725, 58728, 58913, 58916, 58919, 58922, 58925, 58928, 58931, 58934, 58937, 58940, 58943, 58946, 58961, 58964, 58967, 58970, 58973, 58976, 59700, 59703, 59712, 59724, 59727, 59730, 59739, 59741, 59751, 59753, 59927, or 60500 to 60512 (inclusive));
(iii) mammographic examinations (being services specified in any of items 59300 or 59303 in this table);
(iv) computerised tomography services (being services specified in any of the items in 56000 to 57406 (inclusive) in this table).”.
3.2 Paragraph 5 (3) (a):
Omit the paragraph, substitute:
“(a)a comprehensive radiology service facility at which a specialist in diagnostic radiology was in attendance for not less than 5 hours between 9.00 a.m. and 5.00 p.m. on each of the 20 business days before the day on which the service was given; or”.
3.3 Subrule 5 (4):
Omit the subrule, substitute:
“(4)An item including the symbol ‘(OP)’ is an R-type diagnostic imaging service given by or on behalf of a specialist in diagnostic radiology:
(a) at a radiology service facility that is not a comprehensive radiology service facility; or
(b) at a comprehensive radiology service facility at which a specialist in diagnostic radiology was not in attendance for at least 5 hours between 9.00 a.m. and 5.00 p.m. on each of the 20 business days before the day on which the service was given.”.
3.4 Subrule 5 (7):
Insert the following definition:
“ ‘business day’ means a day which is not a Saturday, Sunday or public holiday in the place at which the radiology service facility is located;”.
3.5 Rule 8:
Omit “55000 to 55106 (inclusive)”, substitute “55000 to 55239 (inclusive)”.
3.6 Rule 8:
Omit “57500 to 60981 (inclusive)”, substitute “57501 to 60703 (inclusive)”.
3.7 Rule 11:
Omit the rule.
3.8 Rule 12:
Omit “60900 to 60981 (inclusive)”, substitute “60903 to 60984 (inclusive)”.
- Schedule (Table of Diagnostic Imaging Services—Services and Fees)
4.1 Items 55000 to 55027 (inclusive):
Omit the items, substitute:
“55000 Ultrasonic cross-sectional echography, not associated with item 55003, 55007 or 55010, if the patient is not referred by a medical practitioner for ultrasonic examination, each ultrasonic examination not exceeding 2 examinations in any 1 pregnancy (NR) 32.00
55003 Ultrasonic cross-sectional echography performed by, or on behalf of, a medical practitioner other than a specialist in diagnostic radiology, if the patient is referred by a medical practitioner for ultrasonic examination not associated with item 55000, 55007 or 55010, and if the referring medical practitioner is not a member of a group of practitioners of which the first-mentioned practitioner is a member (R) 93.00
55007 Ultrasonic echography, unidimensional not associated with item 55000 or 55003 (R) 56.00
55010 Ultrasonic echography, unidimensional, not associated with item 55000 or 55003 (NR) 56.00
55013 Ultrasound scan of head (R) (A) 93.00
55016 Ultrasound scan of 1 or more structures of neck (R) (A) 93.00
55019 Ultrasound scan of 1 or both breasts (R) (A) 93.00
55022 Ultrasound scan of abdomen including urinary tract where performed (R) (A) 93.00
55025 Ultrasound scan of urinary tract (R) (A) 93.00
55028 Ultrasound scan of pelvis by any or all of transabdominal, transvaginal or transrectal approach (R) (A) 93.00
55031 Ultrasound scan of scrotum (R) (A) 93.00
55034 Ultrasound scan of pregnant uterus (R) (A) 93.00
55037 Ultrasound scan of 1 or more joints (R) (A) 93.00
55040 Ultrasound scan not otherwise specified (R) (A) 93.00”.
4.2 Items 55100 to 55106 (inclusive):
Omit the items, substitute:
“55101 M-Mode and 2-dimensional real time echocardiographic examination of the heart from at least 2 thoracic windows, performed using a mechanical sector scanner or phased array transducer, with measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave Doppler techniques, with recordings on video tape, not associated with items in Group I1, Subgroup 1 (R) (NS) 152.00
55104 M-Mode and 2-dimensional real time echocardiographic examination of the heart from at least 2 thoracic windows, performed using a mechanical sector scanner or phased array transducer, with measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave Doppler techniques, with recordings on video tape, not associated with items in Group I1, Subgroup 1 (R) (A) 152.00
55107 M-Mode and 2-dimensional real time echocardiographic examination of the heart from at least 2 thoracic windows, performed using a mechanical sector scanner or phased array transducer, with measurement of cardiac dimensions, with recordings on video tape, not associated with items in Group I1, Subgroup 1 (R) (NS) 86.00
55110 M-Mode and 2-dimensional real time echocardiographic examination of the heart from at least 2 thoracic windows, performed using a mechanical sector scanner or phased array transducer, with measurement of cardiac dimensions, with recordings on video tape, not associated with items in Group I1, Subgroup 1 (R) (A) 86.00
55113 M-Mode and 2-dimensional real time echocardiographic examination of the heart from at least 2 thoracic windows, performed using a mechanical sector scanner or phased array transducer, with measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave Doppler techniques, together with real time colour flow mapping from at least 2 thoracic windows, with recordings on video tape, not associated with items in Group I1, Subgroup 1 (R) (NS) 235.00
55116 M-Mode and 2-dimensional real time echocardiographic examination of the heart from at least 2 thoracic windows, performed using a mechanical sector scanner or phased array transducer, with measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave Doppler techniques, together with real time colour flow mapping from at least 2 thoracic windows, with recordings on video tape, not associated with items in Group I1, Subgroup 1 (R) (A) 235.00
55119 2-dimensional real time transoesophageal echocardiographic examination of the heart, not associated with any other echocardiographic examination (R) (NS) 235.00
55122 2-dimensional real time transoesophageal echocardiographic examination of the heart, not associated with any other echocardiographic examination (R) (A) 235.00
55125 2-dimensional real time transoesophageal echocardiographic examination of the heart, associated with another echocardiographic examination (R) (NS) 118.00
55128 2-dimensional real time transoesophageal echocardiographic examination of the heart, associated with another echocardiographic examination (R) (A) 118.00
55131 Intra-operative 2-dimensional real time transoesophageal echocardiography incorporating Doppler with colour flow mapping with recording onto video tape, performed during cardiac surgery incorporating sequential assessment of cardiac function before and after the surgical procedure (R) 335.00
Subgroup 3—Vascular
55200 Duplex scanning (unilateral or bilateral) involving B mode ultrasound imaging and integrated Doppler flow measurement by spectral analysis of carotid vessels (with or without vertebral arteries), peripheral vessels or intra-thoracic or intra-abdominal vascular structures (excluding cardiac and pregnancy related studies), (not associated with items in Group I1, Subgroup 1)—1 examination and report (R) (NS) 160.00
55203 2 or more examinations of the kind referred to in item 55200 and report (not associated with item in Group I1, Subgroup 1) (R) (NS) 275.00
55206 Duplex ultrasound involving B mode ultrasound imaging and integrated Doppler flow measurement by spectral analysis of 1 or more vessels of the neck (not associated with items in Group I1, Subgroup 1)—examination of 1 region and report (R) (A) 160.00
55209 Duplex ultrasound involving B mode ultrasound imaging and integrated Doppler flow measurement by spectral analysis of 1 or more vessels of the upper limb or limbs (not associated with items in Group I1, Subgroup 1)—examination of 1 region and report (R) (A) 160.00
55212 Duplex ultrasound involving B mode ultrasound imaging and integrated Doppler flow measurement by spectral analysis of 1 or more vessels of the thorax (excluding cardiac studies) (not associated with items in Group I1, Subgroup 1)—examination of 1 region and report (R) (A) 160.00
55215 Duplex ultrasound involving B mode ultrasound imaging and integrated Doppler flow measurement by spectral analysis of 1 or more vessels of the abdomen (excluding pregnancy related studies), (not associated with items in Group I1, Subgroup 1)—examination of 1 region and report (R) (A) 160.00
55218 Duplex ultrasound involving B mode ultrasound imaging and integrated Doppler flow measurement by spectral analysis of 1 or more vessels of the lower limb or limbs, (not associated with items in Group I1, Subgroup 1)—examination of 1 region and report (R) (A) 160.00
55221 Examination of 2 or more regions of the kind referred to in item 55206 to 55218, and report (not associated with item 55003) (R) (A) 275.00
55224 Duplex scanning (unilateral or bilateral) involving B mode ultrasound imaging and integrated Doppler flow measurement by spectral analysis of carotid vessels, with oculoplethysmography (not associated with item 55003)—examination and report (R) (NS) 192.00
55227 Duplex scanning (unilateral or bilateral) involving B mode ultrasound imaging and integrated Doppler flow measurement by spectral analysis of carotid vessels, with oculoplethysmography (not associated with item 55003)—examination and report (R) (A) 192.00
55230 Duplex scanning (unilateral or bilateral) involving B mode ultrasound imaging and integrated Doppler flow measurement by spectral analysis of peripheral vessels and carotid vessels, with oculoplethysmography (not associated with item 55003)—examination and report (R) (NS) 310.00
55233 Duplex scanning (unilateral or bilateral) involving B mode ultrasound imaging and integrated Doppler flow measurement by spectral analysis of peripheral vessels and carotid vessels, with oculoplethysmography (not associated with item 55003)—examination and report (R) (A) 310.00
55236 Duplex scanning (unilateral or bilateral) involving B mode ultrasound imaging and integrated Doppler flow measurement by spectral analysis of peripheral vessels before measured exercise using a treadmill or bicycle ergometer, and measurement of pressure after exercise for 10 minutes or until pressure is normal (unilateral or bilateral), (not associated with item 55003)—examination and report (R) (NS) 205.00
55239 Duplex scanning (unilateral or bilateral) involving B mode ultrasound imaging and integrated Doppler flow measurement by spectral analysis of peripheral vessels before measured exercise using a treadmill or bicycle ergometer, and measurement of pressure after exercise for 10 minutes or until pressure is normal (unilateral or bilateral), (not associated with item 55003)—examination and report (R) (A) 205.00”.
4.3 Items 56000 to 56027 (inclusive):
Omit the items, substitute:
“56000 Computerised tomography—scan of brain with or without scan of internal auditory meatus without intravenous contrast medium (not covered by item 57000 or 57100) (R) (A) 138.00
56003 Computerised tomography—scan of brain with or without scan of internal auditory meatus with intravenous contrast medium (not covered by item 57003 or 57103) (R) (A) 192.00
56006 Computerised tomography—scan of brain with or without scan of internal auditory meatus without intravenous contrast medium (minimum of 8 slices) and with intravenous contrast medium (not covered by item 57006 or 57106) (R) (A) 225.00
56009 Computerised tomography—scan of pituitary fossa by multiple thin slices (including reconstructions) without or with intravenous contrast medium and with or without brain scan (R) (A) 460.00
56012 Computerised tomography—scan of orbits by multiple thin slices (including reconstructions) without or with intravenous contrast medium and with or without brain scan (R) (A) 455.00
56015 Computerised tomography—scan of middle ear and temporal bone, unilateral or bilateral, detailed study by multiple thin slices (including reconstructions) without or with intravenous contrast medium and with or without brain scan (R) (A) 445.00
56018 Computerised tomography—scan of temporal bones with air study (including reconstructions) and including intrathecal injection, not including an associated brain scan (R) (A) 355.00
56021 Computerised tomography—scan of facial bones, sinuses and salivary glands—scan of 1 or more regions without intravenous contrast medium (R) (A) 250.00
56024 Computerised tomography—scan of facial bones, sinuses and salivary glands—scan of 1 or more regions with intravenous contrast medium (R) (A) 265.00
56027 Computerised tomography—scan of facial bones, sinuses and salivary glands—scan of 1 or more regions without and with intravenous contrast medium (R) (A) 375.00
4.4 Items 56100 to 56106 (inclusive):
Omit the items, substitute:
“56100 Computerised tomography—scan of soft tissues of neck including larynx, pharynx and upper oesophagus (not associated with cervical spine)—scan of 1 or more regions without intravenous contrast medium (not covered by item 56900) (R) (A) 355.00
56103 Computerised tomography—scan of soft tissues of neck including larynx, pharynx and upper oesophagus (not associated with cervical spine)—scan of 1 or more regions with intravenous contrast medium (not covered by item 56903) (R) (A) 385.00
56106 Computerised tomography—scan of soft tissues of neck including larynx, pharynx and upper oesophagus (not associated with cervical spine)—scan of 1 or more regions without and with intravenous contrast medium (not covered by item 56906) (R) (A) 420.00”.
4.5 Items 56200 to 56218 (inclusive):
Omit the items, substitute:
“56200 Computerised tomography—scan of spine, 1 or more regions—25 slices or less without intravenous contrast medium (R) (A) 176.00
56203 Computerised tomography—scan of spine, 1 or more regions—25 slices or less with intravenous contrast medium (R) (A) 205.00
56206 Computerised tomography—scan of spine, 1 or more regions—25 slices or less without and with intravenous contrast medium (R) (A) 275.00
56209 Computerised tomography—scan of spine, 1 or more regions—26 or more slices without intravenous contrast medium (R) (A) 250.00
56212 Computerised tomography—scan of spine, 1 or more regions—26 or more slices with intravenous contrast medium (R) (A) 275.00
56215 Computerised tomography—scan of spine, 1 or more regions—26 or more slices without and with intravenous contrast medium (R) (A) 385.00
56218 Computerised tomography—scan of spine, 1 or more regions with intrathecal contrast medium (not including the preparation by intrathecal injection of contrast medium) (R) (A) 250.00”.
4.6 Items 56300 to 56306 (inclusive):
Omit the items, substitute:
“56300 Computerised tomography—scan of chest (including lungs, mediastinum and pleura) without intravenous contrast medium (not covered by item 56700, 56800, 56900, 57000 or 57100) (R) (A) 250.00
56303 Computerised tomography—scan of chest (including lungs, mediastinum and pleura) with intravenous contrast medium (not covered by item 56703, 56803, 56903, 57003 or 57103) (R) (A) 285.00
56306 Computerised tomography—scan of chest (including lungs, mediastinum and pleura) without intravenous contrast medium (minimum of 8 slices) and with intravenous contrast medium (not covered by item 56706, 56806, 56906, 57006 or 57106) (R) (A) 360.00”.
4.7 Items 56400 to 56406 (inclusive):
Omit the items, substitute:
“56400 Computerised tomography—scan of upper abdomen (diaphragm to iliac crest) or pelvis without intravenous contrast medium (not covered by item 56700, 56800, 56900 or 57100) (R) (A) 138.00
56403 Computerised tomography—scan of upper abdomen (diaphragm to iliac crest) or pelvis with intravenous contrast medium (not covered by item 56703, 56803, 56903 or 57103) (R) (A) 168.00
56406 Computerised tomography—scan of upper abdomen (diaphragm to iliac crest) or pelvis without intravenous contrast medium (minimum of 8 slices) and with intravenous contrast medium (not covered by item 56706, 56806, 56906 or 57106) (R) (A) 275.00”.
4.8 Items 56500 to 56506 (inclusive):
Omit the items, substitute:
“56500 Computerised tomography—scan of upper abdomen and pelvis without intravenous contrast medium (not covered by item 56700, 56800, 56900 or 57100) (R) (A) 210.00
56503 Computerised tomography—scan of upper abdomen and pelvis with intravenous contrast medium (not covered by item 56703, 56803, 56903 or 57103) (R) (A) 255.00
56506 Computerised tomography—scan of upper abdomen and pelvis without intravenous contrast medium (minimum of 8 slices) and with intravenous contrast medium (not covered by item 56706, 56806, 56906 or 57106) (R) (A) 360.00”.
4.9 Items 56600 to 56624 (inclusive):
Omit the items, substitute:
“56600 Computerised tomography—scan of extremities, 1 or more regions involving up to 20 slices without intravenous contrast medium (R) (A) 138.00
56603 Computerised tomography—scan of extremities, 1 or more regions involving up to 20 slices with intravenous contrast medium (R) (A) 168.00
56606 Computerised tomography—scan of extremities, 1 or more regions involving up to 20 slices without and with intravenous contrast medium (R) (A) 205.00
56609 Computerised tomography—scan of extremities, 1 or more regions involving more than 20 slices but not more than 40 slices without intravenous contrast medium (R) (A) 176.00
56612 Computerised tomography—scan of extremities, 1 or more regions involving more than 20 slices but not more than 40 slices with intravenous contrast medium (R) (A) 205.00
56615 Computerised tomography—scan of extremities, 1 or more regions involving more than 20 slices but not more than 40 slices without and with intravenous contrast medium (R) (A) 275.00
56618 Computerised tomography—scan of extremities, 1 or more regions involving more than 40 slices without intravenous contrast medium (R) (A) 250.00
56621 Computerised tomography—scan of extremities, 1 or more regions involving more than 40 slices with intravenous contrast medium (R) (A) 275.00
56624 Computerised tomography—scan of extremities, 1 or more regions involving more than 40 slices without and with intravenous contrast medium (R) (A) 350.00”.
4.10 Items 56700 to 56706 (inclusive):
Omit the items, substitute:
“56700 Computerised tomography—scan of chest and upper abdomen (from lung apices to iliac crest) without intravenous contrast medium (not covered by item 56800, 56900 or 57100) (R) (A) 250.00
56703 Computerised tomography—scan of chest and upper abdomen (from lung apices to iliac crest) with intravenous contrast medium (not covered by item 56803, 56903 or 57103) (R) (A) 290.00
56706 Computerised tomography—scan of chest and upper abdomen (from lung apices to iliac crest) without and with intravenous contrast medium (not covered by item 56806, 56906 or 57106) (R) (A) 365.00”.
4.11 Items 56800 to 56806 (inclusive):
Omit the items, substitute:
“56800 Computerised tomography—scan of chest, abdomen and pelvis without intravenous contrast medium (not covered by item 56900) (R) (A) 325.00
56803 Computerised tomography—scan of chest, abdomen and pelvis with intravenous contrast medium (not covered by item 56903) (R) (A) 365.00
56806 Computerised tomography—scan of chest, abdomen and pelvis without and with intravenous contrast medium (not covered by item 56906) (R) (A) 510.00”.
4.12 Items 56900 to 56906 (inclusive):
Omit the items, substitute:
“56900 Computerised tomography—scan of neck, chest, abdomen and pelvis without intravenous contrast medium (R) (A) 465.00
56903 Computerised tomography—scan of neck, chest, abdomen and pelvis with intravenous contrast medium (R) (A) 510.00
56906 Computerised tomography—scan of neck, chest, abdomen and pelvis without and with intravenous contrast medium (R) (A) 615.00”.
4.13 Items 57000 to 57006 (inclusive):
Omit the items, substitute:
“57000 Computerised tomography—scan of brain and chest without intravenous contrast medium (R) (A) 250.00
57003 Computerised tomography—scan of brain and chest with intravenous contrast medium (R) (A) 290.00
57006 Computerised tomography—scan of brain and chest without and with intravenous contrast medium (R) (A) 400.00
4.14 Items 57100 to 57106 (inclusive):
Omit the items, substitute:
“57100 Computerised tomography—scan of chest and upper abdomen (from lung apices to iliac crest) and scan of brain without intravenous contrast medium (R) (A) 355.00
57103 Computerised tomography—scan of chest and upper abdomen (from lung apices to iliac crest) and scan of brain with intravenous contrast medium (R) (A) 400.00
57106 Computerised tomography—scan of chest and upper abdomen (from lung apices to iliac crest) and scan of brain without and with intravenous contrast medium (R) (A) 510.00”.
4.15 Item 57200:
Omit the item, substitute:
“57200 Computerised tomography—pelvimetry (R) (A) 138.00”.
4.16 Items 57300 and 57303:
Omit the items, substitute:
“57300 Computerised tomography—dynamic scan of region not associated with another item in this Group (R) (A) 168.00
57303 Computerised tomography—dynamic scan of region when associated with another item in this Group (R) (A) Amount under rule 13”.
4.17 Items 57400 to 57406 (inclusive):
Omit the items, substitute:
“57400 Computerised tomography—scan of brain without intravenous contrast medium (R) (A) 70.00
57403 Computerised tomography—scan of brain with intravenous contrast medium (R) (A) 85.00
57406 Computerised tomography—scan of brain without and with intravenous contrast medium (R) (A) 132.00”.
4.18 Items 57500 to 57527 (inclusive):
Omit the items, substitute:
“57501 Digits or phalanges—all or any of 1 hand (R) (CP) 40.00
57504 Digits or phalanges—all or any of 1 hand (R) (OP) 29.00
57507 Digits or phalanges—all or any of 1 hand (R) (NS) 29.00
57510 Digits or phalanges—all or any of 1 hand (NR) 29.00
57513 Digits or phalanges—all or any of 1 foot (R) (CP) 40.00
57516 Digits or phalanges—all or any of 1 foot (R) (OP) 29.00
57519 Digits or phalanges—all or any of 1 foot (R) (NS) 29.00
57522 Digits or phalanges—all or any of 1 foot (NR) 29.00
57525 Hand, wrist, forearm, elbow or humerus (R) (CP) 40.00
57528 Hand, wrist, forearm, elbow or humerus (R) (OP) 29.00
57531 Hand, wrist, forearm, elbow or humerus (R) (NS) 29.00
57534 Hand, wrist, forearm, elbow or humerus (NR) 29.00
57537 Hand, wrist and lower forearm or upper forearm and elbow or elbow and humerus (R) (CP) 54.00
57540 Hand, wrist and lower forearm or upper forearm and elbow or elbow and humerus (R) (OP) 39.00
57543 Hand, wrist and lower forearm or upper forearm and elbow or elbow and humerus (R) (NS) 39.00
57546 Hand, wrist and lower forearm or upper forearm and elbow or elbow and humerus (NR) 39.00
57549 Foot, ankle, lower leg, upper leg, knee or femur (R) (CP) 43.50
57552 Foot, ankle, lower leg, upper leg, knee or femur (R) (OP) 31.50
57555 Foot, ankle, lower leg, upper leg, knee or femur (R) (NS) 31.50
57558 Foot, ankle, lower leg, upper leg, knee or femur (NR) 31.50
57561 Foot, ankle and lower leg or upper leg and knee (R) (CP) 66.00
57564 Foot, ankle and lower leg or upper leg and knee (R) (OP) 48.00
57567 Foot, ankle and lower leg or upper leg and knee (R) (NS) 48.00
57570 Foot, ankle and lower leg or upper leg and knee (NR) 48.00”.
4.19 Heading of Subgroup 2—Radiographic Examination of Shoulder or Hip Joint and Report:
Omit “Hip Joint”, substitute “Pelvis”.
4.20 Items 57700 to 57721 (inclusive):
Omit the items, substitute:
“57701 Shoulder or scapula or both (R) (CP) 54.00
57704 Shoulder or scapula or both (R) (OP) 39.00
57707 Shoulder or scapula or both (R) (NS) 39.00
57710 Shoulder or scapula or both (NR) 39.00
57713 Clavicle (R) (CP) 43.50
57716 Clavicle (R) (OP) 31.50
57719 Clavicle (R) (NS) 31.50
57722 Clavicle (NR) 31.50
57725 Hip joint (R) (CP) 53.00
57728 Hip joint (R) (OP) 38.50
57731 Hip joint (R) (NS) 38.50
57734 Pelvic girdle (R) (CP) 53.00
57737 Pelvic girdle (R) (OP) 38.50
57740 Pelvic girdle (R) (NS) 38.50
57743 Sacro-iliac joints, not associated with item 58119, 58128, 58137 or 58146 (R) (CP) 61.00
57747 Sacro-iliac joints, not associated with item 58122, 58131, 58140 or 58149 (R) (OP) 44.00
57750 Sacro-iliac joints, not associated with item 58125, 58134, 58143 or 58152 (R) (NS) 44.00
57753 Femur, internal fixation of neck or intertrochanteric (pertrochanteric) fracture (R) 99.00
57756 Pelvimetry by plain X-ray technique (R) (CP) 90.00
57759 Pelvimetry by plain X-ray technique (R) (OP) 65.00
57762 Pelvimetry by plain X-ray technique (R) (NS) 65.00”.
4.21 Items 57900 to 57945 (inclusive):
Omit the items, substitute:
“57901 Skull or cephalometry (R) (CP) 65.00
57904 Skull or cephalometry (R) (OP) 47.00
57907 Skull or cephalometry (R) (NS) 47.00
57910 Sinuses (R) (CP) 47.50
57913 Sinuses (R) (OP) 34.50
57916 Sinuses (R) (NS) 34.50
57919 Mastoids (R) (CP) 65.00
57922 Mastoids (R) (OP) 47.00
57925 Mastoids (R) (NS) 47.00
57928 Petrous temporal bones (R) (CP) 65.00
57931 Petrous temporal bones (R) (OP) 47.00
57934 Petrous temporal bones (R) (NS) 47.00
57937 Facial bones—orbit, maxilla or malar, any or all (R) (CP) 47.50
57940 Facial bones—orbit, maxilla or malar, any or all (R) (OP) 34.50
57943 Facial bones—orbit, maxilla or malar, any or all (R) (NS) 34.50
57946 Mandible, not by orthopantomography technique (R) (CP) 47.50
57949 Mandible, not by orthopantomography technique (R) (OP) 34.50
57952 Mandible, not by orthopantomography technique (R) (NS) 34.50
57955 Salivary calculus (R) (CP) 47.50
57958 Salivary calculus (R) (OP) 34.50
57961 Salivary calculus (R) (NS) 34.50
57964 Nose (R) (CP) 47.50
57967 Nose (R) (OP) 34.50
57970 Nose (R) (NS) 34.50
57973 Eye, 1 or both with or without foreign body localisation (R) (CP) 47.50
57976 Eye, 1 or both with or without foreign body localisation (R) (OP) 34.50
57979 Eye, 1 or both with or without foreign body localisation (R) (NS) 34.50
57982 Temporo-mandibular joints, 1 or both (R) (CP) 49.50
57985 Temporo-mandibular joints, 1 or both (R) (OP) 36.00
57988 Temporo-mandibular joints, 1 or both (R)(NS) 36.00
57991 Teeth—single area (R)(CP) 33.00
57994 Teeth—single area (R)(OP) 24.00
57997 Teeth—single area (R)(NS) 24.00
58000 Teeth—full mouth, not by orthopantomography technique (R) (CP) 78.00
58003 Teeth—full mouth, not by orthopantomography technique (R) (OP) 57.00
58006 Teeth—full mouth, not by orthopantomography technique (R) (NS) 57.00
58009 Orthopantomography (R) 47.50
58012 Palato-pharyngeal studies with screening by fluoroscopy with image intensification (R) (A) 65.00
58015 Palato-pharyngeal studies with screening by fluoroscopy with image intensification (R) (NS) 47.00
58018 Palato-pharyngeal studies without fluoroscopic screening (R) (CP) 49.50
58021 Palato-pharyngeal studies without fluoroscopic screening (R) (OP) 36.00
58024 Palato-pharyngeal studies without fluoroscopic screening (R) (NS) 36.00
58027 Larynx or pharynx (R) (CP) 43.50
58030 Larynx or pharynx (R) (OP) 31.50
58033 Larynx or pharynx (R) (NS) 31.50”.
4.22 Items 58100 to 58118:
Omit the items, substitute:
“58101 Cervical spine (R) (CP) 74.00
58104 Cervical spine (R) (OP) 54.00
58107 Cervical spine (R) (NS) 54.00
58110 Thoracic spine (R) (CP) 56.00
58113 Thoracic spine (R) (OP) 40.50
58116 Thoracic spine (R) (NS) 40.50
58119 Lumbo-sacral spine (R) (CP) 83.00
58122 Lumbo-sacral spine (R) (OP) 60.00
58125 Lumbo-sacral spine (R) (NS) 60.00
58128 Sacro-coccygeal spine (R) (CP) 46.50
58131 Sacro-coccygeal spine (R) (OP) 33.50
58134 Sacro-coccygeal spine (R) (NS) 33.50
58137 2 regions of the spine (R) (CP) 102.00
58140 2 regions of the spine (R) (OP) 75.00
58143 2 regions of the spine (R) (NS) 75.00
58146 3 or more regions of the spine (R) (CP) 138.00
58149 3 or more regions of the spine (R) (OP) 100.00
58152 3 or more regions of the spine (R) (NS) 100.00”.
4.23 Heading of Subgroup 5—Bone Age Study and Skeletal Surveys:
Omit “Skeletal Surveys”, substitute “Report”.
4.24 Items 58300 to 58306 (inclusive):
Omit the items, substitute:
“58301 Bone age study (R) (CP) 40.00
58304 Bone age study (R) (OP) 29.00
58307 Bone age study (R) (NS) 29.00
4.25 Items 58500 to 58527 (inclusive):
Omit the items, substitute:
“58501 Chest (R) (CP) 47.50
58504 Chest (R) (OP) 34.50
58507 Chest (R) (NS) 34.50
58510 Chest (NR) 34.50
58513 Thoracic inlet or trachea (R) (CP) 40.00
58516 Thoracic inlet or trachea (R) (OP) 29.00
58519 Thoracic inlet or trachea (R) (NS) 29.00
58522 Sternum or ribs on 1 side (R) (CP) 43.50
58525 Sternum or ribs on 1 side (R) (OP) 31.50
58528 Sternum or ribs on 1 side (R) (NS) 31.50
58531 Sternum and ribs on 1 side, or ribs on both sides (R) (CP) 57.00
58534 Sternum and ribs on 1 side, or ribs on both sides (R) (OP) 41.00
58537 Sternum and ribs on 1 side, or ribs on both sides (R) (NS) 41.00
58540 Sternum and ribs on both sides (R) (CP) 69.00
58543 Sternum and ribs on both sides (R) (OP) 50.00
58546 Sternum and ribs on both sides (R) (NS) 50.00”.
4.26 Items 58700 to 58724 (inclusive):
Omit the items, substitute:
“58701 Intravenous pyelography without tomography, including preliminary plain film (R) (CP) 136.00
58704 Intravenous pyelography without tomography, including preliminary plain film (R) (OP) 99.00
58707 Intravenous pyelography without tomography, including preliminary plain film (R) (NS) 99.00
58710 Intravenous pyelography with tomography, including preliminary plain film (R) (CP) 168.00
58713 Intravenous pyelography with tomography, including preliminary plain film (R) (OP) 122.00
58716 Intravenous pyelography with tomography, including preliminary plain film (R) (NS) 122.00
58719 Antegrade or retrograde pyelography including preliminary plain film, each side (R) 99.00
58722 Cystography, by urethral catheter or percutaneous bladder puncture, not associated with micturating cystourethrography (R) 66.00
58725 Retrograde urethrography (R) 66.00
58728 Micturating cystourethrography, by urethral catheter or percutaneous bladder puncture (R) 78.00”.
4.27 Items 58900 to 58936 (inclusive):
Omit the items, substitute:
“58901 Plain abdomen only (R) (CP) 47.50
58904 Plain abdomen only (R) (OP) 34.50
58907 Plain abdomen only (R) (NS) 34.50
58910 Plain abdomen only (NR) 34.50
58913 Barium or other opaque contrast examination of oesophagus or pharynx (R) (A) 67.00
58916 Barium or other opaque contrast examination of oesophagus or pharynx (R) (NS) 48.50
58919 Barium or other opaque contrast examination of oesophagus, stomach and duodenum, with or without chest fluoroscopy, with or without preliminary plain film (R) (A) 92.00
58922 Barium or other opaque contrast examination of oesophagus, stomach and duodenum, with or without chest fluoroscopy, with or without preliminary plain film (R) (NS) 67.00
58925 Barium or other opaque contrast examination of oesophagus, stomach, duodenum and small intestine to colon, with or without preliminary plain film (R) (A) 110.00
58928 Barium or other opaque contrast examination of oesophagus, stomach, duodenum and small intestine to colon, with or without preliminary plain film (R) (NS) 79.00
58931 Small bowel series (follow through examination of the small bowel) with or without preliminary plain film (R) (A) 78.00
58934 Small bowel series (follow through examination of the small bowel) with or without preliminary plain film (R) (NS) 57.00
58937 Opaque enema, with or without preliminary plain film (R) (A) 112.00
58940 Opaque enema, with or without preliminary plain film (R) (NS) 82.00
58943 Opaque enema, with air contrast, with or without preliminary plain film (R) (A) 130.00
58946 Opaque enema, with air contrast, with or without preliminary plain film (R) (NS) 94.00
58949 Oral cholecystogram, with or without preliminary plain film, without tomography (R) (A) 78.00
58952 Oral cholecystogram, with or without preliminary plain film, without tomography (R) (NS) 57.00
58955 Oral cholecystogram, with or without preliminary plain film, with tomography (R) (A) 110.00
58958 Oral cholecystogram, with or without preliminary plain film, with tomography (R) (NS) 79.00
58961 Cholegraphy, direct, endoscopic, operative or post-operative (R) (A) 76.00
58964 Cholegraphy, direct, endoscopic, operative or post-operative (R) (NS) 55.00
58967 Cholegraphy—percutaneous transhepatic (R) (A) 90.00
58970 Cholegraphy—percutaneous transhepatic (R) (NS) 65.00
58973 Cholegraphy—drip infusion or intravenous (R) (A) 148.00
58976 Cholegraphy—drip infusion or intravenous (R) (NS) 108.00”.
4.28 Heading of Subgroup 9—Radiographic Examination for Localisation of Foreign Bodies and Report:
Omit the heading.
4.29 Items 59100 and 59103:
Omit the items.
4.30 Heading of Subgroup 10—Radiographic Examination of Breasts and Report:
Omit “10”, substitute “9”.
4.31 Items 59300 to 59309:
Omit the items, substitute:
“59300 Radiographic examination of both breasts, if the patient has a clinical sign or symptom of breast disease or if an asymptomatic patient has a family history of breast cancer (R) (S) (A) 78.00
59303 Radiographic examination of 1 breast, if the patient has a clinical sign or symptom of breast disease or if an asymptomatic patient has a family history of breast cancer (R) (S) (A) 47.50
59306 Mammary ductogram, 1 side (R) (A) 91.00
59309 Mammary ductogram, both sides (R) (A) 182.00
59312 Radiographic examination of an operative breast specimen, using dedicated mammographic or specimen equipment (R) (A) 47.50”.
4.32 Heading Subgroup 11—Radiographic Examination in Connection with Pregnancy and Report:
Omit the heading.
4.33 Items 59500 to 59506:
Omit the items.
4.34 Heading subgroup 12—Radiographic Examination with Opaque or Contrast Media and Report
Omit the heading, substitute:
“Subgroup 10—Radiographic Examination with Contrast Media and Report”.
4.35 Items 59700 to 59757 (inclusive):
Omit the items, substitute:
“59700 Discography—each disc (R) 69.00
59703 Dacryocystography—each side (R) 47.50
59712 Hysterosalpingography (R) 67.00
59724 Myelography, 1 region (R) 120.00
59727 Myelography, 2 regions (R) 198.00
59730 Myelography, 3 regions (R) 270.00
59733 Sialography—1 gland (R) (A) 67.00
59735 Sialography—1 gland (R)(NS) 48.50
59739 Sinuses and fistulae (R) (A) 21.50
59741 Sinuses and fistulae (R)(NS) 15.80
59751 Arthrography—1 joint (R) (A) 67.00
59753 Arthrography—1 joint (R)(NS) 49.00
59754 Lymphangiography, including initial and delayed radiography (R) 66.00
Subgroup 11—Tomography and Report
“59800 Tomography of any part, not including preliminary plain films and not associated with intravenous pyelography or oral cholecystogram (R)(CP)(A) 61.00
59803 Tomography of any part, not including preliminary plain films and not associated with intravenous pyelography or oral cholecystogram (R)(OP)(A) 44.00
59806 Tomography of any part, not including preliminary plain films and not associated with intravenous pyelography or oral cholecystogram (R)(NS) 44.00”.
4.36 Heading of Subgroup 13—Angiography and Report:
Omit the heading, substitute:
“Subgroup 12—Angiography by Film Technique and Report”.
4.37 Items 59900 to 59924:
Omit the items, substitute:
“59903 Serial angiocardiography—each series (R) (A) (AU 8) 116.00
59912 Selective coronary arteriography (R) 305.00
59915 Cerebral angiography—1 side (R) 78.00
59921 Aortography (R) 99.00
59923 Peripheral arteriography, 1 side (R) 99.00
59924 Selective arteriography or selective venography, each injection and film run (R) 99.00
59927 Venography, 1 side (R) 99.00”.
4.38 Heading of Subgroup 14—Tomography and Report:
Omit the heading.
4.39 Item 60100:
Omit the item.
4.40 Heading of Subgroup 15—Stereoscopic Examination and Report:
Omit the heading, substitute:
“Subgroup 13—Angiography by Digital Subtraction Technique (DSA) and Report (including Preparation for Non-Selective Contrast Injection)”.
4.41 Item 60300:
Omit the item, substitute:
“60200 Digital subtraction angiography examination of head and neck with or without arch aortography, 1 to 3 data acquisition runs (R) 490.00
60203 Digital subtraction angiography examination of head and neck with or without arch aortography, 4 to 6 data acquisition runs (R) 720.00
60206 Digital subtraction angiography examination of head and neck with or without arch aortography, 7 to 9 data acquisition runs (R) 1,025.00
60209 Digital subtraction angiography examination of head and neck with or without arch aortography, 10 or more data acquisition runs (R) 1,200.00
60212 Digital subtraction angiography examination of thorax, 1 to 3 data acquisition runs (R) 490.00
60215 Digital subtraction angiography examination of thorax, 4 to 6 data acquisition runs (R) 720.00
60218 Digital subtraction angiography examination of thorax, 7 to 9 data acquisition runs (R) 1,025.00
60221 Digital subtraction angiography examination of thorax, 10 or more data acquisition runs (R) 1,200.00
60224 Digital subtraction angiography examination of abdomen, 1 to 3 data acquisition runs (R) 490.00
60227 Digital subtraction angiography examination of abdomen, 4 to 6 data acquisition runs (R) 720.00
60230 Digital subtraction angiography examination of abdomen, 7 to 9 data acquisition runs (R) 1,025.00
60233 Digital subtraction angiography examination of abdomen, 10 or more data acquisition runs (R) 1,200.00
60236 Digital subtraction angiography examination of upper limb or limbs, 1 to 3 data acquisition runs (R) 490.00
60239 Digital subtraction angiography examination of upper limb or limbs, 4 to 6 data acquisition runs (R) 720.00
60242 Digital subtraction angiography examination of upper limb or limbs, 7 to 9 data acquisition runs (R) 1,025.00
60245 Digital subtraction angiography examination of upper limb or limbs, 10 or more data acquisition runs (R) 1,200.00
60248 Digital subtraction angiography examination of lower limb or limbs, 1 to 3 data acquisition runs (R) 490.00
60251 Digital subtraction angiography examination of lower limb or limbs, 4 to 6 data acquisition runs (R) 720.00
60254 Digital subtraction angiography examination of lower limb or limbs, 7 to 9 data acquisition runs (R) 1,025.00
60257 Digital subtraction angiography examination of lower limb or limbs, 10 or more data acquisition runs (R) 1,200.00
60260 Digital subtraction angiography examination of aorta and lower limb or limbs, 1 to 3 data acquisition runs (R) 490.00
60263 Digital subtraction angiography examination of aorta and lower limb or limbs, 4 to 6 data acquisition runs (R) 720.00
60266 Digital subtraction angiography examination of aorta and lower limb or limbs, 7 to 9 data acquisition runs (R) 1,025.00
60269 Digital subtraction angiography examination of aorta and lower limb, or limbs, 10 or more data acquisition runs 1,200.00
60272 Selective arteriography or selective venography by digital subtraction angiography technique, 1 vessel (NR) (AU 6) 42.00
60275 Selective arteriography or selective venography by digital subtraction angiography technique, 2 vessels (NR) (AU 6) 84.00
60278 Selective arteriography or selective venography by digital subtraction angiography technique, 3 or more vessels (NR) (AU 6) 126.00”.
4.42 Heading of Subgroup 16—Fluoroscopic Examination and Report:
Omit the heading, substitute:
“Subgroup 14—Fluoroscopic Examination with Image Intensification and Report”.
4.43 Items 60500 and 60503:
Omit the items, substitute:
“60500 Fluoroscopy, with general anaesthesia (R) (A) (AU 7) 43.50
60502 Fluoroscopy, with general anaesthesia (R) (NS) (AU 7) 31.50
60503 Fluoroscopy, without general anaesthesia (R) (A) 30.00
60506 Fluoroscopy, without general anaesthesia (R) (NS) 21.50
60509 Fluoroscopy, using a mobile image intensifier, for a surgical procedure lasting less than 1 hour (R) 64.00
60512 Fluoroscopy, using a mobile image intensifier, for a surgical procedure lasting more than 1 hour (R) 99.00”.
4.44 Heading of Subgroup 17—Examination not Otherwise Covered and Report
Omit “17”, substitute “15”.
4.45 Item 60700:
Omit the item, substitute:
“60700 Radiographic examination of any part and report not covered by another item in this Group (R) 5.00
60703 Radiographic examination of any part and report not covered by another item in this Group (NR) 5.00”.
4.46 Heading Subgroup 18—Preparation for Radiological Procedure
Omit “18”, substitute “16”.
4.47 Items 60900 to 60981 (inclusive):
Omit the items, substitute:
“60903 Cerebral angiography by film technique, each side (NR) 124.00
60908 Peripheral arteriography or venography by film technique, each side (NR) (AU 6) 51.00
60911 Selective arteriography or selective venography by film technique, 1 vessel (NR) (AU 6) 42.00
60923 Aortography by film technique (NR) (AU 8) 69.00
60926 Dacryocystography—1 side (NR) 38.50
60930 Percutaneous injection of opaque contrast into renal cyst (including aspiration) or renal pelvis for antegrade pyelography (NR) 59.00
60932 Cholegraphy (NR) 35.50
60936 Arthrography excluding arthrography of the vertebral apophyseal and costovertebral joints, each joint (NR) 47.00
60942 Retrograde or percutaneous micturating cystourethrography or cystography or urethrography (NR) 66.00
60945 Hysterosalpingography (NR) (AU 6) 59.00
60948 Discography—1 disc (NR) (AU 5) 38.50
60957 Myelography (NR) (AU 11) 132.00
60963 Cisternal puncture (NR) 76.00
60966 Sinus or fistula (NR) 20.00
60969 Sialography, each gland (NR) 53.00
60972 Lymphangiography—each side (NR) 116.00
60981 Percutaneous transhepatic cholangiogram (NR) (AU 11) 116.00
60984 Mammary ductogram—1 side (NR) 20.00”.
4.48 Heading of Group I4—Magnetic resonance imaging:
Omit the heading.
4.49 Item 61200:
Omit the item.
NOTES
-
Notified in the Commonwealth of Australia Gazette on 14 April 1992.
-
Statutory Rules 1991 No. 352.