6Certain items not to apply to a service referred by one pathology practitioner to another

6 Certain items not to apply to a service referred by one pathology practitioner to another

(1) In this rule:

designated pathology service means a pathology service in respect of tests relating to a single patient episode that are:

(a) tests of the kind described in item 66235; or

(b) tests of the kind described in item 66405; or

(c) tests of the kind described in item 69229.

(2) This rule applies in respect of a designated pathology service where:

(a) an approved pathology practitioner (practitioner A) in an approved pathology authority:

(i) has been requested to render the designated pathology service; and

(ii) is unable, because of the lack of facilities in, or expertise or experience of the staff of, the laboratory of the authority, to render 1 or more (but not all) of the tests included in the service; and

(iii) requests an approved pathology practitioner (practitioner B) in another approved pathology authority to render the test or tests that practitioner A is unable to render; and

(iv) renders each test included in the service, other than the test or tests in respect of which the request mentioned in subparagraph (iii) is made; and

(b) the tests mentioned in subparagraph (a) (iv) that practitioner A renders are not tests constituting a service described in item 66239, 66415 or 69239.

(3) Where this rule applies in respect of a designated pathology service:

(a) item 66235, 66237, 66405, 66407, 66409, 66411, 66413, 69229, 69231, 69233, 69235 or 69237 (as the case requires) applies in respect of the test or tests rendered by practitioner A; and

(b) where practitioner B renders a service under a request referred to in subparagraph (2) (a) (iii) — subject to subrule (4), the amount specified in item 66241, 66417 or 69241 (as the case requires) is payable for each test that the service comprises.

(4) For paragraph (3) (b), the maximum number of tests to which item 66241, 66417 or 69241 applies is:

(a) for item 66241:

3 – X; or

(b) for item 66417 or 69241:

6 – X;

where X is the number of tests rendered by practitioner A in relation to the designated pathology service in respect of which the request mentioned in that paragraph is made.

(5) Items in Group P10 (Patient episode initiation) do not apply to the second-mentioned approved pathology practitioner in subrule (2).