Division 1.1Services and fees — ultrasound services

Division 1.1 – Services and fees – ultrasound services

1.1.1 Application of ultrasound items

(1) For the purpose of subclause 1.1.1(2), if one or more services in paragraph (a) is rendered with one or more services in paragraph (b) for the same patient on the same day by the same medical practitioner, the fees that are set out in the items, other than the item with the highest fee, are reduced by 40%.

(2) The items applicable to the multiple services fee reduction rule are:

(a) a service to which one or more of items 55126, 55127, 55128, 55129, 55132, 55133, 55134 or 55137 apply; and

(b) a service to which one or more of items 55141, 55143, 55145 or 55146 apply.

(3) For any particular patient, item 55141, 55143, 55145 or 55146 applies if one or more of the following is applicable:

(a) if the patient displays one or more of the following symptoms of typical or atypical angina:

(i) constricting discomfort in the:

a. front of the chest; or

b. neck; or

c. shoulders; or

d. jaw; or

e. arms; or

(ii) the patient’s symptoms, as described in subparagraph (3)(a)(i), are precipitated by physical exertion; or

(iii) the patient’s symptoms, as described in subparagraph (3)(a)(i), are relieved by rest or glyceryl trinitrate within 5 minutes or less; or

(b) if the patient has known coronary artery disease and displays one or more symptoms that are suggestive of ischaemia:

(i) which are not adequately controlled with medical therapy; or

(ii) have evolved since the last functional study; or

(c) if the patient qualifies for one or more of the following indications:

(i) assessment of myocardial ischaemia with exercise is required if a patient with congenital heart lesions has undergone surgery and reversal of ischemia is considered possible; or

(ii) assessment indicates that resting 12 lead electrocardiogram changes are consistent with coronary artery disease or ischaemia, in a patient that is without known coronary artery disease; or

(iii) coronary artery disease related lesions, of uncertain functional significance, which have previously been identified on computed tomography coronary angiography or invasive coronary angiography; or

(iv) an assessment by a specialist or consultant physician indicates that the patient has potential non‑coronary artery disease, where a stress echocardiography study is likely to assist the diagnosis; or

(v) assessment indicates that the patient has undue exertional dyspnoea of uncertain aetiology; or

(vi) a pre‑operative assessment of a patient with functional capacity of less than 4 metabolic equivalents confirming that surgery is intermediate to high risk, and the patient has at least one of following conditions: