11Items in Groups P10 (Patient episode initiation) and P11 (Specimen referred) not to apply in certain circumstances

11 Items in Groups P10 (Patient episode initiation) and P11 (Specimen referred) not to apply in certain circumstances

(1) For the purposes of this rule and items in Groups P10 (Patient episode initiation) and P11 (Specimen referred):

institution means a place at which residential accommodation or day care is, or both residential accommodation and day care are, made available to:

(a) disadvantaged children; or

(b) juvenile offenders; or

(c) aged persons; or

(d) chronically ill psychiatric patients; or

(e) homeless persons; or

(f) unemployed persons; or

(g) persons suffering from alcoholism; or

(h) persons addicted to drugs; or

(i) physically or mentally handicapped persons;

but does not include:

(j) a hospital; or

(k) a nursing home; or

(l) accommodation for aged persons that is attached to a nursing home or situated within a nursing home complex.

licensed collection centre has the same meaning as in Part IIa of the Act.

prescribed laboratory means a laboratory operated by:

(a) the Commonwealth; or

(b) a State or internal Territory; or

(c) an authority of a State or internal Territory; or

(d) an Australian tertiary education institution.

specimen collection centre has the same meaning as in Part IIA of the Act.

treating practitioner has the same meaning as in paragraph 16A (1) (a) of the Act.

(2) If a service described in an item in Group P10 or P11 is rendered by, or on behalf of, an approved pathology practitioner who is a recognised pathologist, the relevant one of those items does not apply to the service if:

(a) the service is rendered upon a request made in the course of an out-patient service at a recognised hospital; or

(b) the service is rendered upon a request made for a patient who is a private patient in a recognised hospital when the request is made; or

(c) the pathology equipment of a recognised hospital, or a prescribed laboratory, is used rendering the service; or

(d) a member of the staff of a recognised hospital, or a prescribed laboratory, participates in the service in the course of the member’s employment with the hospital or laboratory.

(3) An item in Group P10 or P11 does not apply to a pathology service to which subsection 16A (7) of the Act applies.