Division 4. Advanced surgical patient - Private Health Insurance (Benefit Requirements) Rules 2011 - 4. Advanced surgical patient

4. Advanced surgical patient

(1) In this Schedule, advanced surgical patient has the meaning given by this clause.

(2) A patient is taken to be an advanced surgical patient upon admission to a hospital:

(a) from and including the day before a professional service of the type identified by the item number in the MBS which is specified in subclause (3) is rendered to the patient at that hospital, unless the particular advanced surgical procedure to be rendered is recognised as requiring a longer pre‑operative period; or

(b) if a longer pre‑operative period than that referred to in paragraph (a) is required, from and including the day of admission of the patient for the purpose of providing the professional service of the type mentioned in paragraph (a); or

(c) if the advanced surgery is rendered to a patient during an admission, from the day the advanced surgery involving a professional service of the type mentioned in paragraph (a) is performed (not the day before).

Note: The effect of the reference in subclause (1)(a) to a professional service, being a service for which a Medicare benefit is payable, is that a professional service must have been provided to the patient for the minimum benefit to apply.

(3) The MBS item numbers for this clause are those set out in the following table, but only where those items have a fee in the MBS greater than $994.97:

Type A procedures: Advanced surgical patient – list of MBS items
30175, 30176, 30177, 30179, 30250, 30251, 30255, 30275, 30294, 30296, 30297, 30315, 30317, 30318, 30320, 30323, 30324, 30336, 30382, 30384, 30388, 30396, 30415, 30417, 30418, 30421, 30425, 30427, 30428, 30430, 30448, 30449, 30454, 30455, 30457, 30458, 30460, 30461, 30463, 30464, 30469, 30472, 30517, 30518, 30521, 30526, 30529, 30532, 30533, 30560, 30565, 30577, 30583, 30584, 30589, 30590, 30593, 30594, 30596, 30599, 30601, 30606, 30608, 30619, 30640, 30655, 30657, 30680, 30682, 30684, 30686, 30725, 30730, 30732, 30750, 30751, 30752, 30753, 30754, 30755, 30756, 30762, 30771, 30780, 30792, 30810, 31002, 31005, 31409, 31412, 31429, 31432, 31435, 31438, 31466, 31468, 31472, 31514, 31516, 31520, 31522, 31523, 31526, 31528, 31529, 31572, 31581, 31584, 32000, 32003, 32004, 32005, 32006, 32009, 32012, 32015, 32018, 32024, 32025, 32026, 32028, 32030, 32033, 32036, 32039, 32042, 32047, 32051, 32054, 32060, 32063, 32069, 32106, 32108, 32117, 32118, 32221, 32232, 32514, 32517, 32700, 32703, 32708, 32710, 32711, 32712, 32715, 32718, 32721, 32724, 32730, 32733, 32739, 32742, 32745, 32748, 32751, 32754, 32763, 33050, 33055, 33075, 33080, 33100, 33103, 33109, 33112, 33115, 33116, 33118, 33119, 33121, 33124, 33127, 33130, 33133, 33136, 33139, 33142, 33145, 33148, 33151, 33154, 33157, 33160, 33163, 33166, 33169, 33172, 33175, 33178, 33181, 33500, 33506, 33509, 33512, 33515, 33518, 33521, 33524, 33527, 33530, 33533, 33536, 33539, 33542, 33800, 33803, 33811, 33812, 33815, 33818, 33821, 33824, 33827, 33830, 33833, 33836, 33839, 33842, 34112, 34115, 34118, 34121, 34124, 34127, 34136, 34139, 34142, 34148, 34151, 34154, 34157, 34160, 34163, 34166, 34169, 34172, 34175, 34509, 34512, 34518, 34533, 34803, 34806, 34809, 34812, 34815, 34818, 34821, 34833, 35003, 35006, 35009, 35307, 35312, 35315, 35320, 35412, 35414, 35548, 35551, 35552, 35561, 35562, 35585, 35591, 35592, 35596, 35597, 35632, 35641, 35661, 35667, 35668, 35669, 35671, 35717, 35720, 35721, 35723, 35724, 35753, 35754, 35756, 36503, 36506, 36516, 36519, 36522, 36525, 36528, 36529, 36531, 36532, 36533, 36543, 36564, 36567, 36570, 36573, 36576, 36588, 36591, 36594, 36597, 36600, 36603, 36606, 36610, 36611, 36645, 36656, 37014, 37015, 37016, 37018, 37019, 37021, 37029, 37040, 37042, 37045, 37047, 37048, 37053, 37200, 37203, 37207, 37209, 37210, 37211, 37213, 37214, 37220, 37245, 37309, 37338, 37340, 37341, 37343, 37344, 37372, 37375, 37384, 37390, 37405, 37411, 37423, 37426, 37432, 37607, 37610, 37822, 37824, 37825, 37831, 37842, 37848, 37851, 38212, 38244, 38247, 38248, 38249, 38251, 38252, 38270, 38272, 38273, 38276, 38287, 38290, 38293, 38307, 38308, 38309, 38310, 38311, 38313, 38314, 38316, 38317, 38319, 38320, 38322, 38323, 38358, 38368, 38375, 38429, 38431, 38461, 38463, 38467, 38471, 38474, 38477, 38484, 38487, 38493, 38495, 38499, 38502, 38508, 38509, 38512, 38514, 38515, 38516, 38517, 38518, 38522, 38550, 38553, 38554, 38555, 38556, 38557, 38558, 38568, 38571, 38600, 38615, 38616, 38618, 38620, 38624, 38653, 38670, 38673, 38677, 38680, 38700, 38703, 38706, 38709, 38715, 38718, 38721, 38724, 38727, 38730, 38733, 38736, 38739, 38742, 38745, 38748, 38751, 38754, 38757, 38760, 38764, 38766, 38816, 38817, 38818, 38820, 38821, 38822, 38823, 38824, 38831, 38832, 38833, 38834, 38838, 38840, 38841, 38842, 38846, 38848, 38852, 38853, 38857, 38858, 38859, 38864, 39109, 39113, 39124, 39139, 39315, 39503, 39604, 39610, 39612, 39615, 39638, 39639, 39641, 39651, 39654, 39656, 39700, 39703, 39710, 39712, 39715, 39718, 39720, 39801, 39803, 39815, 39818, 39821, 39900, 39903, 40004, 40012, 40104, 40106, 40109, 40112, 40119, 40600, 40700, 40703, 40706, 40709, 40712, 40801, 40803, 40804, 40805, 40806, 40850, 40851, 40860, 41518, 41521, 41530, 41533, 41536, 41539, 41542, 41551, 41554, 41557, 41560, 41563, 41564, 41566, 41569, 41572, 41575, 41576, 41578, 41579, 41581, 41584, 41587, 41590, 41593, 41596, 41599, 41608, 41614, 41615, 41617, 41618, 41623, 41635, 41638, 41703, 41705, 41728, 41734, 41785, 41834, 41837, 41840, 41843, 41879, 41887, 41888, 41890, 42521, 42539, 42543, 42545, 42557, 42569, 42626, 42653, 42656, 42662, 42672, 42705, 42710, 42716, 42725, 42731, 42746, 42749, 42752, 42767, 42773, 42776, 42779, 42801, 42842, 42851, 42860, 43801, 43804, 43807, 43810, 43813, 43816, 43819, 43822, 43825, 43828, 43831, 43834, 43837, 43838, 43840, 43843, 43846, 43852, 43855, 43861, 43864, 43870, 43873, 43876, 43879, 43882, 43900, 43903, 43906, 43909, 43912, 43915, 43936, 43945, 43951, 43954, 43957, 43963, 43966, 43969, 43972, 43975, 43978, 43984, 43987, 43990, 43993, 43996, 44334, 44373, 45006, 45036, 45060, 45061, 45062, 45500, 45501, 45502, 45503, 45504, 45505, 45507, 45520, 45523, 45527, 45528, 45529, 45530, 45531, 45535, 45538, 45539, 45540, 45541, 45558, 45561, 45562, 45563, 45564, 45565, 45566, 45567, 45571, 45587, 45588, 45596, 45597, 45599, 45624, 45641, 45644, 45646, 45660, 45661, 45686, 45717, 45718, 45767, 45773, 45776, 45779, 45782, 45785, 45788, 45791, 45871, 45873, 45874, 46060, 46062, 46064, 46066, 46068, 46070, 46072, 46080, 46082, 46084, 46086, 46088, 46090, 46104, 46105, 46106, 46107, 46108, 46109, 46110, 46111, 46112, 46116, 46117, 46118, 46119, 46120, 46121, 46122, 46123, 46124, 46128, 46129, 46133, 46134, 46135, 46136, 46150, 46151, 46152, 46153, 46154, 46155, 46156, 46157, 46158, 46159, 46160, 46161, 46170, 46171, 46172, 46173, 46174, 46175, 46176, 46177, 46178, 46179, 46180, 46181, 46182, 46183, 46184, 46185, 46315, 46318, 46321, 46324, 46325, 46380, 46393, 46394, 46395, 46477, 46504, 46507, 47486, 47489, 47491, 47501, 47511, 47519, 47531, 47534, 47558, 47566, 47588, 47591, 47956, 47983, 47984, 48254, 48421, 48422, 48426, 48427, 48433, 48446, 48448, 48450, 48452, 48512, 48918, 48919, 48921, 48924, 48939, 48942, 48951, 48954, 48958, 48959, 48960, 49106, 49115, 49116, 49117, 49210, 49230, 49306, 49318, 49319, 49321, 49372, 49374, 49376, 49378, 49380, 49382, 49384, 49386, 49388, 49390, 49392, 49394, 49396, 49398, 49512, 49516, 49517, 49518, 49519, 49521, 49524, 49525, 49527, 49530, 49533, 49536, 49542, 49544, 49548, 49551, 49554, 49564, 49565, 49592, 49594, 49712, 49715, 49716, 49717, 49740, 49742, 49744, 49763, 49764, 49765, 49766, 49767, 49768, 49769, 49770, 49776, 49778, 49779, 49780, 49781, 49784, 49785, 49786, 49787, 49788, 49789, 49790, 49797, 49798, 49814, 49815, 49836, 49838, 50212, 50215, 50218, 50221, 50224, 50233, 50236, 50239, 50245, 50300, 50303, 50306, 50321, 50324, 50336, 50351, 50354, 50372, 50378, 50384, 50394, 50395, 50399, 50411, 50414, 50417, 50420, 50423, 50450, 50451, 50455, 50456, 50460, 50461, 50465, 50466, 50470, 50471, 50475, 50476, 50592, 50604, 50608, 50612, 50620, 50624, 50628, 50632, 50636, 50640, 50644, 51011, 51012, 51013, 51014, 51015, 51021, 51022, 51023, 51024, 51025, 51026, 51031, 51032, 51033, 51034, 51035, 51036, 51041, 51042, 51043, 51044, 51045, 51051, 51052, 51053, 51054, 51055, 51056, 51057, 51058, 51059, 51061, 51062, 51063, 51064, 51065, 51066, 51071, 51072, 51073, 51102, 51103, 51130, 51131, 51160, 51165, 51170, 51171, 52123, 52126, 52129, 52158, 52337, 52342, 52345, 52348, 52351, 52354, 52357, 52360, 52363, 52366, 52369, 52372, 52375, 52379, 52380, 52382, 52430, 52446, 52821, 53209, 53212, 53221, 53224, 53227, 53230, 53233

Type A procedures: Advanced surgical patient – list of MBS items

30175, 30176, 30177, 30179, 30250, 30251, 30255, 30275, 30294, 30296, 30297, 30315, 30317, 30318, 30320, 30323, 30324, 30336, 30382, 30384, 30388, 30396, 30415, 30417, 30418, 30421, 30425, 30427, 30428, 30430, 30448, 30449, 30454, 30455, 30457, 30458, 30460, 30461, 30463, 30464, 30469, 30472, 30517, 30518, 30521, 30526, 30529, 30532, 30533, 30560, 30565, 30577, 30583, 30584, 30589, 30590, 30593, 30594, 30596, 30599, 30601, 30606, 30608, 30619, 30640, 30655, 30657, 30680, 30682, 30684, 30686, 30725, 30730, 30732, 30750, 30751, 30752, 30753, 30754, 30755, 30756, 30762, 30771, 30780, 30792, 30810, 31002, 31005, 31409, 31412, 31429, 31432, 31435, 31438, 31466, 31468, 31472, 31514, 31516, 31520, 31522, 31523, 31526, 31528, 31529, 31572, 31581, 31584, 32000, 32003, 32004, 32005, 32006, 32009, 32012, 32015, 32018, 32024, 32025, 32026, 32028, 32030, 32033, 32036, 32039, 32042, 32047, 32051, 32054, 32060, 32063, 32069, 32106, 32108, 32117, 32118, 32221, 32232, 32514, 32517, 32700, 32703, 32708, 32710, 32711, 32712, 32715, 32718, 32721, 32724, 32730, 32733, 32739, 32742, 32745, 32748, 32751, 32754, 32763, 33050, 33055, 33075, 33080, 33100, 33103, 33109, 33112, 33115, 33116, 33118, 33119, 33121, 33124, 33127, 33130, 33133, 33136, 33139, 33142, 33145, 33148, 33151, 33154, 33157, 33160, 33163, 33166, 33169, 33172, 33175, 33178, 33181, 33500, 33506, 33509, 33512, 33515, 33518, 33521, 33524, 33527, 33530, 33533, 33536, 33539, 33542, 33800, 33803, 33811, 33812, 33815, 33818, 33821, 33824, 33827, 33830, 33833, 33836, 33839, 33842, 34112, 34115, 34118, 34121, 34124, 34127, 34136, 34139, 34142, 34148, 34151, 34154, 34157, 34160, 34163, 34166, 34169, 34172, 34175, 34509, 34512, 34518, 34533, 34803, 34806, 34809, 34812, 34815, 34818, 34821, 34833, 35003, 35006, 35009, 35307, 35312, 35315, 35320, 35412, 35414, 35548, 35551, 35552, 35561, 35562, 35585, 35591, 35592, 35596, 35597, 35632, 35641, 35661, 35667, 35668, 35669, 35671, 35717, 35720, 35721, 35723, 35724, 35753, 35754, 35756, 36503, 36506, 36516, 36519, 36522, 36525, 36528, 36529, 36531, 36532, 36533, 36543, 36564, 36567, 36570, 36573, 36576, 36588, 36591, 36594, 36597, 36600, 36603, 36606, 36610, 36611, 36645, 36656, 37014, 37015, 37016, 37018, 37019, 37021, 37029, 37040, 37042, 37045, 37047, 37048, 37053, 37200, 37203, 37207, 37209, 37210, 37211, 37213, 37214, 37220, 37245, 37309, 37338, 37340, 37341, 37343, 37344, 37372, 37375, 37384, 37390, 37405, 37411, 37423, 37426, 37432, 37607, 37610, 37822, 37824, 37825, 37831, 37842, 37848, 37851, 38212, 38244, 38247, 38248, 38249, 38251, 38252, 38270, 38272, 38273, 38276, 38287, 38290, 38293, 38307, 38308, 38309, 38310, 38311, 38313, 38314, 38316, 38317, 38319, 38320, 38322, 38323, 38358, 38368, 38375, 38429, 38431, 38461, 38463, 38467, 38471, 38474, 38477, 38484, 38487, 38493, 38495, 38499, 38502, 38508, 38509, 38512, 38514, 38515, 38516, 38517, 38518, 38522, 38550, 38553, 38554, 38555, 38556, 38557, 38558, 38568, 38571, 38600, 38615, 38616, 38618, 38620, 38624, 38653, 38670, 38673, 38677, 38680, 38700, 38703, 38706, 38709, 38715, 38718, 38721, 38724, 38727, 38730, 38733, 38736, 38739, 38742, 38745, 38748, 38751, 38754, 38757, 38760, 38764, 38766, 38816, 38817, 38818, 38820, 38821, 38822, 38823, 38824, 38831, 38832, 38833, 38834, 38838, 38840, 38841, 38842, 38846, 38848, 38852, 38853, 38857, 38858, 38859, 38864, 39109, 39113, 39124, 39139, 39315, 39503, 39604, 39610, 39612, 39615, 39638, 39639, 39641, 39651, 39654, 39656, 39700, 39703, 39710, 39712, 39715, 39718, 39720, 39801, 39803, 39815, 39818, 39821, 39900, 39903, 40004, 40012, 40104, 40106, 40109, 40112, 40119, 40600, 40700, 40703, 40706, 40709, 40712, 40801, 40803, 40804, 40805, 40806, 40850, 40851, 40860, 41518, 41521, 41530, 41533, 41536, 41539, 41542, 41551, 41554, 41557, 41560, 41563, 41564, 41566, 41569, 41572, 41575, 41576, 41578, 41579, 41581, 41584, 41587, 41590, 41593, 41596, 41599, 41608, 41614, 41615, 41617, 41618, 41623, 41635, 41638, 41703, 41705, 41728, 41734, 41785, 41834, 41837, 41840, 41843, 41879, 41887, 41888, 41890, 42521, 42539, 42543, 42545, 42557, 42569, 42626, 42653, 42656, 42662, 42672, 42705, 42710, 42716, 42725, 42731, 42746, 42749, 42752, 42767, 42773, 42776, 42779, 42801, 42842, 42851, 42860, 43801, 43804, 43807, 43810, 43813, 43816, 43819, 43822, 43825, 43828, 43831, 43834, 43837, 43838, 43840, 43843, 43846, 43852, 43855, 43861, 43864, 43870, 43873, 43876, 43879, 43882, 43900, 43903, 43906, 43909, 43912, 43915, 43936, 43945, 43951, 43954, 43957, 43963, 43966, 43969, 43972, 43975, 43978, 43984, 43987, 43990, 43993, 43996, 44334, 44373, 45006, 45036, 45060, 45061, 45062, 45500, 45501, 45502, 45503, 45504, 45505, 45507, 45520, 45523, 45527, 45528, 45529, 45530, 45531, 45535, 45538, 45539, 45540, 45541, 45558, 45561, 45562, 45563, 45564, 45565, 45566, 45567, 45571, 45587, 45588, 45596, 45597, 45599, 45624, 45641, 45644, 45646, 45660, 45661, 45686, 45717, 45718, 45767, 45773, 45776, 45779, 45782, 45785, 45788, 45791, 45871, 45873, 45874, 46060, 46062, 46064, 46066, 46068, 46070, 46072, 46080, 46082, 46084, 46086, 46088, 46090, 46104, 46105, 46106, 46107, 46108, 46109, 46110, 46111, 46112, 46116, 46117, 46118, 46119, 46120, 46121, 46122, 46123, 46124, 46128, 46129, 46133, 46134, 46135, 46136, 46150, 46151, 46152, 46153, 46154, 46155, 46156, 46157, 46158, 46159, 46160, 46161, 46170, 46171, 46172, 46173, 46174, 46175, 46176, 46177, 46178, 46179, 46180, 46181, 46182, 46183, 46184, 46185, 46315, 46318, 46321, 46324, 46325, 46380, 46393, 46394, 46395, 46477, 46504, 46507, 47486, 47489, 47491, 47501, 47511, 47519, 47531, 47534, 47558, 47566, 47588, 47591, 47956, 47983, 47984, 48254, 48421, 48422, 48426, 48427, 48433, 48446, 48448, 48450, 48452, 48512, 48918, 48919, 48921, 48924, 48939, 48942, 48951, 48954, 48958, 48959, 48960, 49106, 49115, 49116, 49117, 49210, 49230, 49306, 49318, 49319, 49321, 49372, 49374, 49376, 49378, 49380, 49382, 49384, 49386, 49388, 49390, 49392, 49394, 49396, 49398, 49512, 49516, 49517, 49518, 49519, 49521, 49524, 49525, 49527, 49530, 49533, 49536, 49542, 49544, 49548, 49551, 49554, 49564, 49565, 49592, 49594, 49712, 49715, 49716, 49717, 49740, 49742, 49744, 49763, 49764, 49765, 49766, 49767, 49768, 49769, 49770, 49776, 49778, 49779, 49780, 49781, 49784, 49785, 49786, 49787, 49788, 49789, 49790, 49797, 49798, 49814, 49815, 49836, 49838, 50212, 50215, 50218, 50221, 50224, 50233, 50236, 50239, 50245, 50300, 50303, 50306, 50321, 50324, 50336, 50351, 50354, 50372, 50378, 50384, 50394, 50395, 50399, 50411, 50414, 50417, 50420, 50423, 50450, 50451, 50455, 50456, 50460, 50461, 50465, 50466, 50470, 50471, 50475, 50476, 50592, 50604, 50608, 50612, 50620, 50624, 50628, 50632, 50636, 50640, 50644, 51011, 51012, 51013, 51014, 51015, 51021, 51022, 51023, 51024, 51025, 51026, 51031, 51032, 51033, 51034, 51035, 51036, 51041, 51042, 51043, 51044, 51045, 51051, 51052, 51053, 51054, 51055, 51056, 51057, 51058, 51059, 51061, 51062, 51063, 51064, 51065, 51066, 51071, 51072, 51073, 51102, 51103, 51130, 51131, 51160, 51165, 51170, 51171, 52123, 52126, 52129, 52158, 52337, 52342, 52345, 52348, 52351, 52354, 52357, 52360, 52363, 52366, 52369, 52372, 52375, 52379, 52380, 52382, 52430, 52446, 52821, 53209, 53212, 53221, 53224, 53227, 53230, 53233

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