Health Insurance (Section 3C General Medical Services – Cardiac Services) Determination 2020
7. Application of items7. Application of items
Start here
Get a plain-English read of 7. Application of items
Turn the raw legal text into a practical explanation grounded in Health Insurance (Section 3C General Medical Services – Cardiac Services) Determination 2020.
7. Application of items
(1) Items 11716, 11717, 11723, 11729 or 11735 do not apply to a service unless:
(a) the patient is referred to the specialist or consultant physician; or
(b) the service is requested by a requesting practitioner.
(2) A service to which items 11716, 11717, 11723, 11729, or 11735 applies is considered to be referred if the specialist or consultant physician who renders the service:
(a) manages the ongoing care of the patient; or
(b) performs an attendance to determine that testing is necessary, where the need for the test has not otherwise been scheduled; or
(c) performs an attendance immediately after the test has been performed, at which clinical management decisions are discussed with the patient.
(3) A service to which items 11716, 11717, 11723, 11729 or 11735 applies is taken to be requested if rendered in circumstances other than described in subsection 7(2).