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HEALTH INSURANCE (PATHOLOGY SERVICES TABLE) AMENDMENT REGULATIONS 2007 (NO. 2) (SLI NO 101 OF 2007) - SCHEDULE 1

Amendments

(regulation 3)

   

[1]           Schedule 1, Part 2, subrule 1 (1), after definition of patient episode

insert

receiving APP , in relation to a patient episode, means an approved pathology practitioner in an approved pathology authority who:

                (a)    receives a request from a referring APP to render a designated test or tests; and

               (b)    renders each test included in the designated test that the referring APP has not performed.

[2]           Schedule 1, Part 2, subrule 1 (1), after definition of recognised pathologist

insert

referring APP , in relation to a patient episode, means an approved pathology practitioner in an approved pathology authority who:

                (a)    has been requested to render one or more designated tests; and

               (b)    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 of the tests included in the designated test; and

                (c)    requests a receiving APP in another approved pathology authority to render:

                          (i)    the test or tests that the approved pathology practitioner is unable to render; or

                         (ii)    all of the tests that are included in the designated test; and

               (d)    renders each test included in the designated test, other than the test or tests in respect of which the request mentioned in paragraph (c) is made.

[3]           Schedule 1, Part 2, rule 6

substitute

6               Referral of designated tests by 1 pathology practitioner to another

         (1)   In this rule:

"designated test" means a pathology test relating to a patient episode that is a test of a kind described in item 65150, 65175, 66650, 66695, 66711, 66722, 66785, 66800, 66812, 66819, 66825, 69384, 69494, 71089, 71153 or 77165.

         (2)   This rule applies where 1 or more designated tests are referred by a referring APP to a receiving APP in another approved pathology authority.

         (3)   If a referring APP has rendered 1 or more designated tests:

                (a)    the amount specified in item 65150, 65153, 65175, 65176, 65177, 65178, 66650, 66695, 66698, 66701, 66704, 66707, 66711, 66722, 66725, 66728, 66731, 66785, 66800, 66803, 66812, 66819, 66825, 69384, 69387, 69390, 69393, 69396, 69494, 69495, 71089, 71091, 71153, 71155, 71157, 77165, 71166 or 71167 (as the case may be) is payable for each designated test rendered by the referring APP; and

               (b)    subject to subrule (5), the amount specified in item 65158, 65181, 66652, 66697, 66715, 66724, 66790, 66805, 66817, 66821, 66827, 69401, 69498, 71092, 71156 or 71170 (as the case may be) is payable for each designated test rendered by the receiving APP.

         (4)   If a referring APP has not rendered a designated test:

                (a)    for the first designated test that is rendered by the receiving APP -- the amount specified in item 65157 65180 66651 66696, 66714, 66723, 66789, 66804, 66816, 66820, 66826, 69400, 69497, 71090, 71154 or 71169 (as the case may be) is payable; and

               (b)    for each subsequent designated test (if any) that is rendered by the receiving APP -- subject to subrule (6), the amount specified in item 65158, 65181, 66652, 66697, 66715, 66724, 66790, 66805, 66817, 66821, 66827, 69401, 69498, 71092, 71156 or 71170 (as the case may be) is payable for each test rendered.

         (5)    For paragraph (3) (b), the maximum number of designated tests for which the fee mentioned in the relevant item is payable is as follows:

                (a)    for item 66652, 66715, 66790, 66817, 66821 or 66827 --

               (b)    for item 65158, 66805, 69498 or 71092 --

                (c)    for item 71156 or 71170 --

               (d)    for item 65181 or 66724 --

                (e)    for item 66697 or 69401 --

where:

"X" is the number of designated tests rendered by a referring APP.

         (6)   For paragraph (4) (b), the maximum number of designated tests for which the fee mentioned in the relevant item is payable is as follows:

                (a)    for item 66652, 66715, 66790, 66817, 66821 or 66827 -- 1;

               (b)    for item 65158, 66805, 69498 or 71092 -- 2;

                (c)    for item 71156 or 71170 -- 3;

               (d)    for item 65181 or 66724 -- 4;

                (e)    for item 66697 or 69401 -- 5.

         (7)   Items in Group P10 (Patient episode initiation) do not apply to a receiving APP in subrule (2).

[4]           Schedule 1, Part 2, paragraphs 14 (2) (b), (c) and (d)

substitute

               (b)    the service is rendered to a public patient at a recognised hospital.

[5]           Schedule 1, Part 2, subrule 14 (9)

omit

item 73921

insert

item 73940

[6]           Schedule 1, Part 2, rule 15

omit each mention of

item 73921

insert

item 73940

[7]           Schedule 1, Part 2, paragraph 16 (2) (c)

substitute

                (c)    both approved pathology authorities are corporations and are connected entities within the meaning of the Corporations Act 2001 ; or

[8]           Schedule 1, Part 2, subrule 18 (1)

substitute

         (1)   In this rule:

"general practitioner" has the meaning given by subrule 18A (1).

"set of pathology services" has the meaning given by subrule 18A (2).

[9]           Schedule 1, Part 2, after rule 18

insert

18A          Meaning of general practitioner and set of pathology services

         (1)   In rule 18:

general practitioner means a medical practitioner who:

                (a)    is not a consultant physician in any specialty; and

               (b)    is not a specialist in any specialty.

         (2)   In rule 18 and subject to subrule (3):

set of pathology services means a group of pathology services:

                (a)    that consists of services that are described in at least 4 different items; and

               (b)    all of which are requested in a single patient episode; and

                (c)    each of which relates to a patient who is not an admitted patient of a hospital.

         (3)   In rule 18, an item mentioned in this subrule is to be excluded from a set of pathology services:

                (a)    if a service is requested by an approved pathology practitioner of an approved pathology authority and rendered by another approved pathology practitioner of an approved pathology authority that is not related to the approved pathology authority of the first mentioned approved pathology practitioner -- item 65079, 65082, 65157, 65158, 65166, 65180, 65181, 66606, 66609, 66639, 66642, 66651, 66652, 66663, 66666, 66696, 66697, 66714, 66715, 66723, 66724, 66780, 66783, 66789, 66790, 66792, 66804, 66805, 66816, 66817, 66820, 66821, 66826, 66827, 69325, 69328, 69331, 69379, 69383, 69400, 69401, 69419, 69451, 69489, 69492, 69497, 69498, 69500, 71076, 71090, 71092, 71096, 71148, 71154, 71156, 71169, 71170, 73309, 73312, 73315, 73318 or 73321; or

               (b)    an item in Group P10 (Patient episode initiation), Group P11 (Specimen referred) or Group P12 (Management of bulk‑billed services).

         (4)   An approved pathology authority is related to another approved pathology authority for paragraph (3) (a) if:

                (a)    both approved pathology authorities are employed (including employed under contract) by the same person, whether or not the person is also an approved pathology authority; or

               (b)    either of the approved pathology authorities is employed (including employed under contract) by the other; or

                (c)    both approved pathology authorities are corporations and are connected entities within the meaning of the Corporations Act 2001 ; or

               (d)    the approved pathology authorities are partners (whether or not either or both of the approved pathology authorities are individuals and whether or not other persons are in partnership with either or both of the approved pathology authorities); or

                (e)    both approved pathology authorities are operated by the Commonwealth or an authority of the Commonwealth; or

                (f)    both approved pathology authorities are operated by the same State or internal Territory or an authority of the same State or internal Territory.

[10]         Schedule 1, Part 2, rule 19

omit

For item 69444:

insert

For items 69499 and 69500:

[11]         Schedule 1, Part 2, rule 20

omit

For item 73317:

insert

For items 73317 and 73318:

[12]         Schedule 1, Part 2, subrule 22 (1)

substitute

         (1)   For this rule:

"metal toxicity testing group" means items 66825, 66826, 66827 and 66828.

"nutritional metals testing group" means items 66819, 66820, 66821 and 66822.

[13]         Schedule 1, Part 2, rule 25

substitute

25             Limitation on certain items

         (1)   For any particular patient, item 69336 is applicable not more than once in each period of 7 days.

         (2)   For any particular patient, each of items 66819, 66820, 66821, 66822, 66825, 66826, 66827 and 66828 is applicable not more 3 times in a 6 month period.

         (3)   For any particular patient, the following items are applicable not more than once in a 12 month period:

                (a)    items 66655 and 66659;

               (b)    item 69491 or 69492;

                (c)    item 69499 or 69500.

         (4)   For any particular patient, the following items are applicable not more than twice in a 12 month period:

                (a)    items 66539, 71075, 71127, 71135 and 71137;

               (b)    item 66605 or 66606;

                (c)    item 69488 or 69489.

         (5)   For any particular patient, each of items 66551, 69445, 69451, 71079, 73314, 73315 and 73523 is applicable not more than 4 times in a 12 month period.

         (6)   For any particular patient, each of items 66554 and 71077 is applicable not more than 6 times in a 12 month period.

         (7)   For any particular patient, item 66626 is applicable not more than 36 times in a 12 month period.

         (8)   For any particular patient, item 69418 or 69419 is applicable not more than twice in a 24 month period.

         (9)   For any particular patient, item 66750 or 66751 is applicable not more than once in a pregnancy.

[14]         Schedule 1, Part 2, rule 26

omit

item 69364, 69365 or 69367

insert

item 69316, 69317, 69319, 69494, 69495, 69496, 69497 or 69498

[15]         Schedule 1, Part 2, rule 27

omit

item 73320

insert

item 71148, 73320 or 73321

[16]         Schedule 1, Part 3, after item 65078

insert

65079

A test described in item 65078 if rendered by a receiving APP -- 1 or more tests

(Item is subject to rules 18 and 18A)

91.75

[17]         Schedule 1, Part 3, after item 65081

insert

65082

A test described in item 65081 if rendered by a receiving APP -- 1 or more tests

(Item is subject to rules 18 and 18A)

98.25

[18]         Schedule 1, Part 3, items 65096 to 65111

substitute

65096

Blood grouping (including back‑grouping if performed), and examination of serum for Rh and other blood group antibodies, including:

   (a)  identification and quantitation of any antibodies detected; and

   (b)  (if performed) any test described in item 65060 or 65070

41.65

65099

Compatibility tests by crossmatch -- all tests performed on any 1 day for up to 6 units, including:

   (a)  all grouping checks of the patient and donor; and

   (b)  examination for antibodies and, if necessary, identification of any antibodies detected; and

   (c)  (if performed) any tests described in item 65060, 65070, 65090 or 65096

(Item is subject to rule 5)

110.80

65102

Compatibility tests by crossmatch -- all tests performed on any 1 day in excess of 6 units, including:

   (a)  all grouping checks of the patient and donor; and

   (b)  examination for antibodies and, if necessary, identification of any antibodies detected; and

   (c)  (if performed) any tests described in item 65060, 65070, 65090, 65096, 65099 or 65105

(Item is subject to rule 5)

167.50

65105

Compatibility testing using at least a 3 cell panel and issue of red cells for transfusion -- all tests performed on any 1 day for up to 6 units, including:

   (a)  all grouping checks of the patient and donor; and

   (b)  examination for antibodies and, if necessary, identification of any antibodies detected; and

   (c)  (if performed) any tests described in item 65060, 65070, 65090 or 65096

(Item is subject to rule 5)

110.80

65108

Compatibility testing using at least a 3 cell panel and issue of red cells for transfusion -- all tests performed on any 1 day in excess of 6 units, including:

   (a)  all grouping checks of the patient and donor; and

   (b)  examination for antibodies and, if necessary, identification of any antibodies detected; and

   (c)  (if performed) any tests described in item 65060, 65070, 65090, 65096, 65099 or 65105

(Item is subject to rule 5)

167.50

65109

Release of fresh frozen plasma or cryoprecipitate for the use in a patient for the correction of a coagulopathy -- 1 release

13.10

65110

Release of compatible fresh platelets for the use in a patient for platelet support as prophylaxis to minimize bleeding or during active bleeding -- 1 release

13.10

65111

Examination of serum for blood group antibodies (including identification and, if necessary, quantitation of any antibodies detected)

23.60

[19]         Schedule 1, Part 3, items 65129 to 65171

substitute

65129

4 or more tests described in item 65120

36.10

65137

A test for the presence of lupus anticoagulant, not being a service connected with a service to which item 65175, 65176, 65177, 65178 or 65179 applies

25.75

65142

Confirmation or clarification of an abnormal or indeterminate result of a test mentioned in item 65175, by testing a specimen collected on a different day -- 1 or more tests

25.75

65144

Platelet aggregation in response to ADP, collagen, 5HT, ristocetin or other substances; or heparin, low molecular weight heparins, heparinoid or other drugs -- 1 or more tests

57.55

65147

Quantitation of anti‑Xa activity when monitoring is required for a patient receiving a low molecular weight heparin or heparinoid -- 1 test

38.55

65150

Quantitation of von Willebrand factor antigen, von Willebrand factor activity (ristocetin cofactor assay), von Willebrand factor collagen binding activity, factor II, factor V, factor VII, factor VIII, factor IX, factor X, factor XI, factor XII, factor XIII, Fletcher factor, Fitzgerald factor, circulating coagulation factor inhibitors other than by Bethesda assay -- 1 test

(Item is subject to rule 6)

72.15

65153

2 tests described in item 65150

(Item is subject to rule 6)

144.35

65156

3 or more tests described in item 65150

(Item is subject to rule 6)

216.50

65157

A test described in item 65150, if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP -- 1 test

(Item is subject to rules 6, 18 and 18A)

72.15

65158

A test described in item 65150, if rendered by a receiving APP, where 1 or more tests in the item have been rendered by the referring APP -- 1 test

(Item is subject to rules 6, 18 and 18A)

72.15

65159

Quantitation of circulating coagulation factor inhibitors by Bethesda assay -- 1 test

72.15

65162

Examination of a maternal blood film for the presence of fetal red blood cells (Kleihauer test)

10.55

65165

Detection and quantitation of fetal red blood cells in the maternal circulation by detection of red cell antigens using flow cytometric methods including (if performed) any test described in item 65070 or 65162

35.05

65166

A test described in item 65165 if rendered by a receiving APP -- 1 or more tests

(Item is subject to rules 18 and 18A)

35.05

65171

A test for the presence of antithrombin III deficiency, protein C deficiency, protein S deficiency or activated protein C resistance in a first degree relative of a person who has a proven deficiency mentioned in this item -- 1 or more tests

25.75

65175

A test for the presence of antithrombin III deficiency, protein C deficiency, protein S deficiency, lupus anticoagulant, activated protein C resistance, if the request for the test specifically identifies that the patient has a history of venous thromboembolism -- quantitation by 1 or more techniques -- 1 test

(Item is subject to rule 6)

25.75

65176

2 tests described in item 65175

(Item is subject to rule 6)

49.45

65177

3 tests described in item 65175

(Item is subject to rule 6)

73.20

65178

4 tests described in item 65175

(Item is subject to rule 6)

96.85

65179

5 tests described in item 65175

(Item is subject to rule 6)

120.55

65180

A test described in item 65175, if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP -- 1 test

(Item is subject to rules 6, 18 and 18A)

25.75

65181

A test described in item 65175, if rendered by a receiving APP, where 1 or more tests in the item have been rendered by the referring APP -- 1 test

(Item is subject to rules 6, 18 and 18A)

23.70

[20]         Schedule 1, Part 3, items 66551 and 66554

substitute

66551

Quantitation of glycosylated haemoglobin performed in the management of established diabetes 

(Item is subject to rule 25)

17.10

66554

Quantitation of glycosylated haemoglobin performed in the management of pre‑existing diabetes where the patient is pregnant -- including a service in item 66551 (if performed)

(Item is subject to rule 25)

17.10

[21]         Schedule 1, Part 3, items 66605 to 66623

substitute

66605

Vitamins -- quantitation of vitamins A, B1, B2, B3, B6, C and E in blood, urine or other body fluid 

(Item is subject to rule 25)

31.15

66606

A test described in item 66605 if rendered by a receiving APP -- 1 or more tests

(Item is subject to rules 18, 18A and 25)

31.15

66608

Vitamin D or D fractions -- 1 or more tests

43.00

66609

A test described in item 66608 if rendered by a receiving APP -- 1 or more tests

(Item is subject to rules 18 and 18A)

43.00

66623

All qualitative and quantitative tests on blood, urine or other body fluid for:

   (a)  a drug or drugs of abuse (including illegal drugs and legally available drugs taken other than in appropriate dosage); or

   (b)  ingested or absorbed toxic chemicals;

including a service described in item 66800, 66803, 66806, 66812 or 66815 (if performed), but excluding:

   (c)  the surveillance of sports people and athletes for performance improving substances; and

   (d)  the monitoring of patients participating in a drug abuse treatment program

42.25

[22]         Schedule 1, Part 3, items 66638 to 66655

substitute

66638

Isoelectric focussing or similar methods for determination of alpha‑1‑antitrypsin phenotype in serum -- 1 or more tests

29.70

66639

A test described in item 66638 if rendered by a receiving APP -- 1 or more tests

(Item is subject to rules 18 and 18A)

29.70

66641

Electrophoresis of serum or other body fluid to demonstrate:

   (a)  the isoenzymes of lactate dehydrogenase; or

   (b)  the isoenzymes of alkaline phosphatase;

including the preliminary quantitation of total relevant enzyme activity -- 1 or more tests

29.70

66642

A test described in item 66641 if rendered by a receiving APP -- 1 or more tests

(Item is subject to rules 18 and 18A)

29.70

66644

C‑1 esterase inhibitor -- quantitation

20.50

66647

C‑1 esterase inhibitor -- functional assay

45.90

66650

Alpha‑fetoprotein, CA‑15.3 antigen (CA15.3), CA‑19.9 antigen (CA19.9), CA‑125 antigen (C125), cancer associated serum antigen (CASA), carcinoembryonic antigen (CEA), human chorionic gonadotrophin (HCG), mammary serum antigen (MSA), thyroglobulin in serum or other body fluid, in the monitoring of malignancy or in the detection or monitoring of gestational trophoblastic disease or a hepatic or germ cell tumour -- quantitation -- 1 test

(Item is subject to rule 6)

24.75

66651

A test described in item 66650, if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP -- 1 test

(Item is subject to rules 6, 18 and 18A)

24.75

66652

A test described in item 66650, if rendered by a receiving APP, where 1 or more tests in the item have been rendered by the referring APP -- 1 test

(Item is subject to rules 6, 18 and 18A)

20.65

66653

2 or more tests described in item 66650

(Item is subject to rule 6)

45.40

66655

Prostate specific antigen -- quantitation

(Item is subject to rule 25)

20.50

[23]         Schedule 1, Part 3, items 66662 to 66667

substitute

66662

Quantitation of hormone receptors on proven primary breast or ovarian carcinoma or a metastasis from a breast or ovarian carcinoma or a subsequent lesion in the breast -- 1 or more tests

81.35

66663

A test described in item 66662 if rendered by a receiving APP -- 1 or more tests

(Item is subject to rules 18 and 18A)

81.35

66665

Lead quantitation in blood or urine (other than for occupational health screening purposes) to a maximum of 3 tests in a 6 month period -- each test

31.15

66666

A test described in item 66665 if rendered by a receiving APP -- 1 or more tests

(Item is subject to rules 18 and 18A)

31.15

66667

Quantitation of serum zinc in a patient receiving intravenous alimentation -- each test

31.15

[24]         Schedule 1, Part 3, items 66669, 66670, 66672 and 66673

omit

[25]         Schedule 1, Part 3, items 66686 to 66716

substitute

66686

Performance of 1 or more of the following procedures:

   (a)  growth hormone suppression by glucose loading;

   (b)  growth hormone stimulation by exercise;

   (c)  dexamethasone suppression test;

   (d)  sweat collection by iontophoresis for chloride analysis;

   (e)  pharmacological stimulation of growth hormone

51.55

66695

Quantitation in blood or urine of hormones and hormone binding proteins -- ACTH, aldosterone, androstenedione, C‑peptide, calcitonin, cortisol, cyclic AMP, DHEAS, 11‑deoxycortisol, dihydrotestosterone, FSH, gastrin, glucagon, growth hormone, hydroxyprogesterone, insulin, LH, oestradiol, oestrone, progesterone, prolactin, PTH, renin, sex hormone binding globulin, somatomedin C(IGF --1), free or total testosterone, urine steroid fraction or fractions, vasoactive intestinal peptide, vasopressin (antidiuretic hormone) -- 1 test

(Item is subject to rule 6)

30.70

66696

A test described in item 66695, if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP

(Item is subject to rules 6, 18 and 18A)

30.70

66697

A test described in item 66695, if rendered by a receiving APP, where 1 or more tests in the item have been rendered by the referring APP -- 1 test

(Item is subject to rules 6, 18 and 18A)

13.30

66698

2 tests described in item 66695

(Item is subject to rule 6)

44.00

66701

3 tests described in item 66695

(Item is subject to rule 6)

57.30

66704

4 tests described in item 66695

(Item is subject to rule 6)

70.60

66707

5 tests described in item 66695

(Item is subject to rule 6)

83.90

66710

6 or more tests described in item 66695

(Item is subject to rule 6)

97.45

66711

Quantitation in saliva of cortisol in:

   (a)  the investigation of Cushing's syndrome; or

   (b)  the management of children with congenital adrenal hyperplasia;

1 test

(Item is subject to rule 6)

30.70

66712

Two tests described in item 66711

(Item is subject to rule 6)

43.80

66714

A test described in item 66711, if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP

(Item is subject to rules 6, 18 and 18A)

30.70

66715

A test described in item 66711, if rendered by a receiving APP, where 1 test in the item has been rendered by the referring APP -- 1 test

(Item is subject to rules 6, 18 and 18A)

13.10

66716

TSH quantitation

25.45

[26]         Schedule 1, Part 3, after item 66722

insert

66723

A test described in item 66722, if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP -- 1 test

(Item is subject to rules 6, 18 and 18A)

38.55

66724

A test described in item 66722, if rendered by a receiving APP, where 1 or more tests in the item have been rendered by the referring APP -- 1 test

(Item is subject to rules 6, 18 and 18A)

13.40

[27]         Schedule 1, Part 3, item 66737

omit

[28]         Schedule 1, Part 3, items 66750 to 66758

substitute

66750

Quantitation, in pregnancy, of any 2 of the following to detect foetal abnormality:

   (a)  total human chorionic gonadotrophin (total HCG);

   (b)  free alpha human chorionic gonadotrophin (free alpha HCG);

   (c)  free beta human chorionic gonadotrophin (free beta HCG);

   (d)  pregnancy associated plasma protein A (PAPP‑A);

40.45

 

   (e)  unconjugated oestriol (uE 3 );

   (f)  alpha‑fetoprotein (AFP);

including (if performed) a service described in item 73527 or 73529

(Item is subject to rule 25)

 

66751

Quantitation, in pregnancy, of any 3 or more tests described in item 66750

(Item is subject to rule 25)

56.20

66752

Quantitation of citrate, oxalate, total free fatty acids, cysteine, homocysteine, cystine or other amino acids and hydroxyproline (except if performed as part of item 66773 or 66776) -- 1 test

25.10

66755

2 or more tests described in item 66752

39.50

66756

Quantitation of 10 or more amino acids for the diagnosis of inborn errors of metabolism -- up to 4 tests in a 12 month period on specimens of plasma, CSF and urine

100.00

66757

Quantitation of 10 or more amino acids for monitoring of previously diagnosed inborn errors of metabolism in 1 tissue type

100.00

66758

Quantitation of angiotensin converting enzyme, or cholinesterase -- 1 or more tests

25.10

[29]         Schedule 1, Part 3, items 66779 to 66818

substitute

66779

Adrenaline, noradrenaline, dopamine, histamine, hydroxyindoleacetic acid (5HIAA), hydroxymethoxymandelic acid (HMMA), homovanillic acid (HVA), metanephrines, methoxyhydroxyphenylethylene glycol (MHPG) , phenylacetic acid (PAA) or serotonin -- quantitation -- 1 or more tests

40.65

66780

A test described in item 66779 if rendered by a receiving APP -- 1 or more tests

(Item is subject to rules 18 and 18A)

40.65

66782

Porphyrins or porphyrins precursors -- detection in plasma, red cells, urine or faeces -- 1 or more tests

13.40

66783

A test described in item 66782 if rendered by a receiving APP -- 1 or more tests

(Item is subject to rules 18 and 18A)

13.40

66785

Porphyrins or porphyrins precursors -- quantitation in plasma, red cells, urine or faeces -- 1 test

(Item is subject to rule 6)

40.65

66788

Porphyrins or porphyrins precursors -- quantitation in plasma, red cells, urine or faeces -- 2 or more tests

(Item is subject to rule 6)

67.00

66789

A test described in item 66785 if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP -- 1 test

(Item is subject to rules 6, 18 and 18A)

40.65

66790

A test described in item 66785, if rendered by a receiving APP, where 1 or more tests in the item have been rendered by the referring APP -- 1 test

(Item is subject to rules 6, 18 and 18A)

26.35

66791

Porphyrin biosynthetic enzymes -- measurement of activity in blood cells or other tissues -- 1 or more tests

75.75

66792

A test described in item 66791 if rendered by a receiving APP -- 1 or more tests

(Item is subject to rules 18 and 18A)

75.75

66800

Quantitation in blood, urine or other body fluid by any method (except reagent tablet or reagent strip) of any of the following used therapeutically by the patient from whom the specimen was taken: amikacin, carbamazepine, digoxin, disopyramide, ethanol, ethosuximide, gentamicin, lignocaine, lithium, netilmicin, paracetamol, phenobarbitone, phenytoin, primidone, procainamide, quinidine, salicylate, theophylline, tobramycin, valproate or vancomycin -- 1 test

(Item is subject to rule 6)

18.45

66803

2 tests described in item 66800

(Item is subject to rule 6)

31.05

66804

A test described in item 66800 if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP -- 1 test

(Item is subject to rules 6, 18 and 18A)

18.45

66805

A test described in item 66800, if rendered by a receiving APP, where 1 or more tests in the item have been rendered by the referring APP -- 1 test

(Item is subject to rules 6, 18 and 18A)

12.60

66806

3 tests described in item 66800

(Item is subject to rule 6)

43.65

66812

Quantitation, not elsewhere described in this table by any method or methods, in blood, urine or other body fluid, of a drug being used therapeutically by the patient from whom the specimen was taken -- 1 test

(Item is subject to rule 6)

35.45

66815

2 tests described in item 66812

(Item is subject to rule 6)

60.60

66816

A test described in item 66812 if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP -- 1 test

(Item is subject to rules 6, 18 and 18A)

35.45

66817

A test described in item 66812, if rendered by a receiving APP, where 1 or more tests in the item have been rendered by the referring APP -- 1 test

(Item is subject to rules 6, 18 and 18A)

25.15

66819

Quantitation of copper, manganese, selenium or zinc (except if item 66667 applies), in blood, urine or other body fluid or tissue -- 1 test

(Item is subject to rules 6, 22 and 25)

31.15

66820

A test described in item 66819 if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP -- 1 test

(Item is subject to rules 6, 18, 18A, 22 and 25)

31.15

66821

A test described in item 66819, if rendered by a receiving APP , where 1 or more tests in the item have been rendered by the referring APP -- 1 test

(Item is subject to rules 6, 18, 18A, 22 and 25)

22.20

66822

Quantitation of copper, manganese, selenium or zinc (except if item 66667 applies), in blood, urine or other body fluid or tissue -- 2 or more tests

(Item is subject to rules 6, 22 and 25)

53.35

66825

Quantitation of aluminium (except if item 66671 applies), arsenic, beryllium, cadmium, chromium, gold, mercury, nickel or strontium, in blood, urine or other body fluid or tissue -- 1 test

(Item is subject to rules 6, 22 and 25)

31.15

66826

A test described in item 66825 if rendered by a receiving APP where no tests have been rendered by the referring APP -- 1 test

(Item is subject to rules 6, 18, 18A, 22 and 25 )

31.15

66827

A test described in item 66825, if rendered by a receiving APP , where 1 or more tests in the item have been rendered by the referring APP -- 1 test

(Item is subject to rules 6, 18, 18A, 22 and 25)

22.20

66828

Quantitation of aluminium (except if item 66671 applies), arsenic, beryllium, cadmium, chromium, gold, mercury, nickel or strontium, in blood, urine or other body fluid or tissue -- 2 or more tests

(Item is subject to rules 6, 22 and 25)

53.35

[30]         Schedule 1, Part 3, items 69312 to 69333

substitute

69312

Microscopy and culture to detect pathogenic micro‑organisms from urethra, vagina, cervix or rectum (except for faecal pathogens), including (if performed):

   (a)  pathogen identification and antibiotic susceptibility testing; or

   (b)  a service described in items 69300, 69303, 69306 and 69318;

1 or more tests on 1 or more specimens

34.00

69316

Detection of Chlamydia trachomatis by any method -- 1 test

(Item is subject to rule 26)

28.85

69317

This item applies if:

   (a)  1 test described in item 69316 is performed; and

   (b)  1 test described in item 69494 is performed

(Item is subject to rule 26)

36.10

69318

Microscopy and culture to detect pathogenic micro‑organisms from specimens of sputum (except when part of items 69324, 69327 and 69330), including (if performed):

   (a)  pathogen identification and antibiotic susceptibility testing; or

34.00

 

   (b)  a service described in items 69300, 69303, 69306 and 69312;

1 or more tests on 1 or more specimens

 

69319

This item applies if:

   (a)  1 test described in item 69316 is performed; and

   (b)  2 tests described in item 69494 are performed

(Item is subject to rule 26)

43.25

69321

Microscopy and culture of post‑operative wounds, aspirates of body cavities, synovial fluid, CSF or operative or biopsy specimens, for the presence of pathogenic micro‑organisms involving aerobic and anaerobic cultures and the use of different culture media, and including (if performed):

   (a)  pathogen identification and antibiotic susceptibility testing; or

   (b)  a service described in item 69300, 69303, 69306, 69312 or 69318;

specimens from 1 or more sites

48.45

69324

Microscopy (with appropriate stains) and culture for mycobacteria -- 1 specimen of sputum, urine or other body fluid or 1 operative or biopsy specimen, including (if performed):

   (a)  microscopy and culture of other bacterial pathogens isolated as a result of this procedure; or

   (b)  pathogen identification and antibiotic susceptibility testing;

including a service mentioned in item 69300

43.30

69325

A service described in item 69324 if the microscopy and culture is performed by a receiving APP

(Item is subject to rules 18 and 18A)

43.30

69327

Microscopy (with appropriate stains) and culture for mycobacteria -- 2 specimens of sputum, urine or other body fluids or operative or biopsy specimens, including (if performed):

   (a)  microscopy and culture of other bacterial pathogens isolated as a result of this procedure; or

   (b)  pathogen identification and antibiotic susceptibility testing;

including a service described in item 69300

85.55

69328

A service described in item 69327 if the microscopy and culture is performed by a receiving APP

(Item is subject to rules 18 and 18A)

85.55

69330

Microscopy (with appropriate stains) and culture for mycobacteria -- 3 specimens of sputum, urine or other body fluids or operative or biopsy specimens, including (if performed):

   (a)  microscopy and culture of other bacterial pathogens isolated as a result of this procedure; or

   (b)  pathogen identification and antibiotic susceptibility testing;

including a service described in item 69300

128.85

69331

A service described in item 69330 if the microscopy and culture is performed by a receiving APP

(Item is subject to rules 18 and 18A)

128.85

69333

Urine examination (including serial examination) by any means other than simple culture by dip slide, including:

   (a)  cell count; and

   (b)  culture; and

   (c)  colony count; and

   (d)  (if performed) stained preparations; and

   (e)  (if performed) identification of cultured pathogens; and

20.70

 

   (f)  (if performed) antibiotic suseptibility testing; and

   (g)  (if performed) examination for pH, specific gravity, blood, albumin, urobilinogen, sugar, acetone or bile salts

 

[31]         Schedule 1, Part 3, items 69363, 69364, 69365 and 69367

substitute

69363

Detection of Clostridium difficile or Clostridium difficile toxin (except if a service described in item 69345 has been performed) -- 1 or more tests

28.85

[32]         Schedule 1, Part 3, after item 69378

insert

69379

A test described in item 69378 if the quantitation is performed by a receiving APP -- 1 or more tests on 1 or more specimens

(Item is subject to rules 18 and 18A)

181.45

[33]         Schedule 1, Part 3, items 69382 to 69402

substitute

69382

Quantitation of HIV viral RNA load in cerebrospinal fluid in a HIV sero‑positive patient -- 1 or more tests on 1 or more specimens

181.45

69383

A test described in item 69381 if the quantitation is performed by a receiving APP -- 1 or more tests on 1 or more specimens

(Item is subject to rules 18 and 18A)

181.45

69384

Quantitation of 1 antibody to microbial or exogenous antigens not elsewhere described in this table -- 1 test

(Item is subject to rule 6)

15.75

69387

2 tests described in item 69384

(Item is subject to rule 6)

29.75

69390

3 tests described in item 69384

(Item is subject to rule 6)

43.75

69393

4 tests described in item 69384

(Item is subject to rule 6)

57.75

69396

5 tests described in item 69384

(Item is subject to rule 6)

71.75

69399

6 or more tests described in item 69384

(Item is subject to rule 6)

85.75

69400

This item applies to a test described in item 69384 if:

   (a)  a referring APP has not performed a test described in item 69384; and

   (b)  a receiving APP performs a test described in item 69384;

1 test

(Item is subject to rules 6, 18 and 18A)

15.75

69401

A test described in item 69384 if a referring APP has performed a test or tests described in item 69384 -- 1 test

(Item is subject to rules 6, 18 and 18A)

14.00

[34]         Schedule 1, Part 3, items 69415 to 69471

substitute

69415

Microbiological serology during a pregnancy (except in the investigation of a clinically apparent intercurrent microbial illness or close contact with a patient suffering from parvovirus infection or varicella during that pregnancy) including:

   (a)  the determination of all of the following -- rubella immune status, specific syphilis serology, carriage of hepatitis B, hepatitis C antibody, HIV antibody; and

   (b)  (if performed) a service described in 1 or more of items 69384, 69475, 69478 and 69481

61.95

69418

A test for high risk human papillomaviruses (HPV) in a patient who:

   (a)  within the 2 year period before the test, has received excisional or ablative treatment for high grade squamous intraepithelial lesions (HSIL) of the cervix; or

64.00

 

   (b)  within the 2 year period before the test, has had a positive HPV test after excisional or ablative treatment for HSIL of the cervix; or

 

 

   (c)  is undergoing annual cytological review following treatment for HSIL of the cervix;

1 test

(Item is subject to rule 25)

 

69419

A test described in item 69418 if the test is performed by a receiving APP -- 1 test

(Item is subject to rules 18, 18A and 25)

64.00

69445

Detection of hepatitis C viral RNA in a patient undertaking antiviral therapy for chronic HCV hepatitis (including a service described in item 69499) -- 1 test

(Item is subject to rule 25)

92.80

69451

A test described in item 69445 if the test is performed by a receiving APP -- 1 test

(Item is subject to rules 18, 18A and 25)

92.80

69471

Test of cell‑mediated immunity in blood for the detection of active tuberculosis or atypical mycobacterial infection in an immunosuppressed or immunocompromised patient -- 1 test

35.15

[35]         Schedule 1, Part 3, items 69484 and 69486

substitute

69484

Supplementary test for hepatitis B surface antigen or hepatitis C antibody using a different assay on a specimen that yielded a reactive result on initial testing

17.20

69488

Quantitation of HCV RNA load in plasma or serum in:

   (a)  the pre‑treatment evaluation, of a patient with chronic HCV hepatitis, for antiviral therapy; or

   (b)  the assessment of efficacy of antiviral therapy for such a patient;

if the test is requested by, or on the advice of, the specialist or consultant physician who manages the treatment of the patient (including a service described in item 69445 or 69499)

(Item is subject to rule 25)

181.45

69489

A test described in item 69488 if the test is performed by a receiving APP

(Item is subject to rules 18, 18A and 25)

181.45

69491

Nucleic acid amplification and determination of hepatitis C virus (HCV) genotype if:

   (a)  the patient is HCV RNA positive and is being evaluated for antiviral therapy of chronic HCV hepatitis; and

206.20

 

   (b)  the request for the test is made by, or on the advice of, the specialist or consultant physician managing the treatment of the patient

(Item is subject to rule 25)

 

69492

A service described in item 69491 if the test is performed by a receiving APP

(Item is subject to rules 18, 18A and 25)

206.20

69494

Detection of a virus, microbial antigen or microbial nucleic acid (not elsewhere described in this table) -- 1 test

(Item is subject to rules 6 and 26)

28.85

69495

2 tests described in item 69494

(Item is subject to rules 6 and 26)

36.10

69496

3 or more tests described in item 69494

(Item is subject to rules 6 and 26)

43.35

69497

This item applies to a test described in item 69494 if:

   (a)  a referring APP has not performed the test described in item 69494; and

   (b)  a receiving APP performs the test described in item 69494;

1 test

(Item is subject to rules 6, 18, 18A and 26)

28.85

69498

This item applies to a test described in item 69494 if:

   (a)  a referring APP has performed the test or tests described in item 69494; and

   (b)  a receiving APP has performed the test or tests described in item 69494;

1 test

(Item is subject to rules 6, 18, 18A and 26)

7.25

69499

Detection of hepatitis C viral RNA if at least 1 of the following criteria is satisfied:

   (a)  the patient is hepatitis C sero‑positive;

   (b)  the patient's serological status is uncertain after testing;

   (c)  the test is performed for the purpose of:

         (i)   determining the hepatitis C status of an immunosuppressed or immunocompromised patient; or

92.80

 

        (ii)   the detection of acute hepatitis C prior to seroconversion where considered necessary for the clinical management of the patient

(Item is subject to rules 19 and 25)

 

69500

A test described in item 69499 if the test is performed by a receiving APP

(Item is subject to rules 18, 18A, 19 and 25)

92.80

[36]         Schedule 1, Part 3, after item 71075

insert

71076

A test described in item 71073 if the test is performed by a receiving APP -- 1 test

(Item is subject to rules 18 and 18A)

108.00

[37]         Schedule 1, Part 3, items 71089 to 71097

substitute

71089

Quantitation of complement components or breakdown products of complement proteins not elsewhere described in an item in this table -- 1 test

(Item is subject to rule 6)

29.65

71090

This item applies to a test described in item 71089 if:

   (a)  a referring APP has not performed the test described in item 71089; and

   (b)  a receiving APP performs the test described in item 71089;

1 test

(Item is subject to rules 6, 18 and 18A)

29.65

71091

2 tests described in item 71089

(Item is subject to rule 6)

53.75

71092

This item applies to a test described in item 71089 if:

   (a)  a referring APP has performed the test or tests described in item 71089; and

   (b)  a receiving APP performs the test or tests described in item 71089;

1 test

(Item is subject to rules 6, 18 and 18A)

24.10

71093

3 or more tests described in item 71089

(Item is subject to rule 6)

77.75

71095

Quantitation of serum or plasma eosinophil cationic protein, or both, to a maximum of 3 assays in 1 year, for monitoring the response to therapy in corticosteroid treated asthma, in a child aged less than 12 years

41.25

71096

A test described in item 71095 if the quantitation is performed by a receiving APP

(Item is subject to rules 18 and 18A)

41.25

71097

Antinuclear antibodies -- detection in serum or other body fluids, including quantitation if required

24.85

[38]         Schedule 1, Part 3, items 71109, 71113, 71115 and 71117

omit

[39]         Schedule 1, Part 3, items 71147 to 71164

substitute

71147

HLA‑B27 typing

(Item is subject to rule 27)

41.25

71148

A test described in item 71147 if a receiving APP performs the test

(Item is subject to rules 18, 18A and 27)

41.25

71149

Complete tissue typing for 4 HLA‑A and HLA‑B Class I antigens (including any separation of leucocytes), including (if performed) a service described in item 71147

110.15

71151

Tissue typing for HLA‑DR, HLA‑DP and HLA‑DQ Class II antigens (including any separation of leucocytes) -- phenotyping or genotyping of 2 or more antigens

120.95

71153

Testing, for assessment or diagnosis of systemic inflammatory disease or vasculitis, for the presence of an antibody by 1 of the following tests:

   (a)  antineutrophil cytoplasmic antibody (ANCA) immunofluorescence test;

   (b)  antineutrophil proteinase 3 antibody (PR3 ANCA) test;

   (c)  antimyeloperoxidase antibody (MPO ANCA) test;

   (d)  antiglomerular basement membrane antibody (GBM ANCA) test

(Item is subject to rules 6 and 23)

35.15

71154

This item applies to a test described in item 71153 if:

   (a)  a referring APP has performed a test or tests described in item 71153; and

   (b)  a receiving APP performs the test described in item 71153;

1 test

(Item is subject to rules 6, 18, 18A and 23)

35.15

71155

Testing for the presence of 2 antibodies by tests mentioned in item 71153

(Item is subject to rules 6 and 23)

48.25

71156

This item applies to a test described in item 71153 (other than a test described in item 71154) if:

   (a)  a referring APP has performed the test or tests described in item 71153; and

   (b)  a receiving APP performs the test or tests described in item 71153;

1 test

(Item is subject to rules 6, 18, 18A and 23)

13.10

71157

Testing for the presence of 3 antibodies by tests mentioned in item 71153

(Item is subject to rules 6 and 23)

61.35

71159

Testing for the presence of 4 antibodies by tests mentioned in item 71153

(Item is subject to rules 6 and 23)

74.45

71163

Detection of 1 of the following antibodies (of 1 or more class or isotype) in the assessment or diagnosis of coeliac disease or other gluten hypersensitivity syndromes, including a service described in item 71066 (if performed):

   (a)  antibodies to gliadin;

   (b)  antibodies to endomysium;

   (c)  antibodies to tissue transglutaminase;

1 test

25.15

71164

2 or more tests mentioned in item 71163, including a service described in item 71066 (if performed)

40.60

71165

Antibodies to tissue antigens (acetylcholine receptor, adrenal cortex, cardiolipin, heart, histone, insulin, insulin receptor, intrinsic factor, islet cell, lymphocyte, neuron, ovary, parathyroid, platelet, salivary gland, skeletal muscle, skin basement membrane and intercellular substance, thyroglobulin, thyroid microsome or thyroid stimulating hormone receptor) -- detection, including quantitation if required, of 1 antibody

(Item is subject to rule 6)

35.15

71166

Detection of 2 antibodies described in item 71165

(Item is subject to rule 6)

48.25

71167

Detection of 3 antibodies described in item 71165

(Item is subject to rule 6)

61.35

71168

Detection of 4 or more antibodies described in item 71165

(Item is subject to rule 6)

74.45

71169

This item applies to a service described in item 71165 if:

   (a)  a referring APP has not performed the service described in item 71165; and

   (b)  a receiving APP performs the service described in item 71165

(Item is subject to rules 6, 18 and 18A)

35.15

71170

This item applies to a service described in item 71165 if:

   (a)  a referring APP has performed the test or tests described in item 71165; and

   (b)  a receiving APP performs the test or tests described in item 71165;

1 test

(Item is subject to rules 6, 18 and 18A)

13.10

[40]         Schedule 1, Part 3, items 73308 to 73320

substitute

73308

Characterisation of the genotype of a patient for Factor V Leiden gene mutation, or detection of other relevant mutations in the investigation of proven venous thrombosis or pulmonary embolism -- 1 or more tests

37.10

73309

A test described in item 73308 if the test is performed by a receiving APP -- 1 or more tests

(Item is subject to rules 18 and 18A)

37.10

73311

Characterisation of the genotype of a person who is a first degree relative of a person who has been proven to have 1 or more abnormal genotypes under item 73308 -- 1 or more tests

37.10

73312

A test described in item 73311 if the test is performed by a receiving APP -- 1 or more tests

(Item is subject to rules 18 and 18A)

37.10

73314

Characterisation of gene rearrangement by nucleic acid amplification in the diagnosis and monitoring of patients with laboratory evidence of:

   (a)  acute myeloid leukaemia; or

   (b)  acute promyelocytic leukaemia; or

   (c)  acute lymphoid leukaemia; or

   (d)  chronic myeloid leukaemia

(Item is subject to rule 25)

235.00

73315

A service described in item 73314 if the characterisation is performed by a receiving APP -- 1 or more tests

(Item is subject to rules 18, 18A and 25)

235.00

73317

Detection of the C282Y genetic mutation of the HFE gene and, if performed, detection of other mutations for haemochromatosis where:

   (a)  the patient has an elevated transferrin saturation or elevated serum ferritin on testing of repeated specimens; or

   (b)  the patient has a first degree relative with haemochromatosis; or

   (c)  the patient has a first degree relative with homozygosity for the C282Y genetic mutation, or with compound heterozygosity for recognised genetic mutations for haemochromatosis

(Item is subject to rule 20)

37.10

73318

A test described in item 73317 if the detection is performed by a receiving APP -- 1 or more tests

(Item is subject to rules 18, 18A and 20)

37.10

73320

Detection of HLA‑B27 by nucleic acid amplification including a service described in item 71147 unless the service in this item is rendered as a pathologist‑determinable service

(Item is subject to rule 27)

41.25

73321

A test described in item 73320 if the detection is performed by a receiving APP -- 1 or more tests

(Item is subject to rules 18, 18A and 27)

41.25

[41]         Schedule 1, Part 3, Group P10

substitute

Group P10 -- Patient episode initiation

Note    Items 73922 to 73927 in Subgroup 1 apply to the initiation of a patient episode consisting of a service described in a particular item in the table. If the initiation of the patient episode consists of a service described in an item other than those particular services, an item mentioned in Subgroup 2 will apply to the patient episode.

Subgroup 1 -- Initiation of a patient episode involving particular services

73922

Initiation of a patient episode that consists of a service described in item 73053, 73055 or 73057 (in circumstances other than those described in item 73923)

(Item is subject to rule 14)

8.25

73923

Initiation of a patient episode that consists of a service described in item 73053, 73055 or 73057 if:

   (a)  the person is a private patient in a recognised hospital; or

   (b)  the person receives the service from a prescribed laboratory

(Item is subject to rule 14)

2.40

73924

Initiation of a patient episode that consists of 1 or more services described in items 72813, 72816, 72817, 72818, 72823, 72824, 72825, 72826, 72830 and 72836 (in circumstances other than those described in item 73925) from a person who is an in‑patient of a hospital

(Item is subject to rule 14)

14.75

73925

Initiation of a patient episode that consists of 1 or more services described in items 72813, 72816, 72817, 72818, 72823, 72824, 72825, 72826, 72830 and 72836 if the person is:

   (a)  a private patient of a recognised hospital; or

   (b)  a private patient of a hospital who receives the service or services from a prescribed laboratory

(Item is subject to rule 14)

2.40

73926

Initiation of a patient episode that consists only of 1 or more services described in items 72813, 72816, 72817, 72818, 72823, 72824, 72825, 72826, 72830 and 72836 (in circumstances other than those described in item 73927) from a person who not is a patient of a hospital

(Item is subject to rule 14)

8.25

73927

Initiation of a patient episode by a prescribed laboratory that consists of 1 or more services described in items 72813, 72816, 72817, 72818, 72823, 72824, 72825, 72826, 72830 and 72836 from a person who is not a patient of a hospital

(Item is subject to rule 14)

2.40

Subgroup 2 -- Initiation of a patient episode involving other services

73928

Initiation of a patient episode by collection of a specimen for 1 or more services (in circumstances other than those described in item 73922, 73923, 73924, 73925, 73926, 73927 or 73929) if the specimen is collected in an approved collection centre

(Item is subject to rule 14)

17.40

73929

Initiation of a patient episode by collection of a specimen for 1 or more services (in circumstances other than those described in item 73922, 73923, 73924, 73925, 73926 or 73927) if the specimen is collected in an approved collection centre by:

   (a)  an approved pathology practitioner of a prescribed laboratory; or

   (b)  an employee of an approved pathology authority of a prescribed laboratory

(Item is subject to rule 14)

2.40

73930

Initiation of a patient episode by collection of a specimen for 1 or more services (in circumstances other than those described in item 73922, 73923, 73924, 73925, 73926, 73927 or 73931) if the specimen is collected from a person who is an in‑patient of a hospital other than a recognised hospital by an approved pathology practitioner or an employee of an approved pathology authority

(Item is subject to rule 14)

17.70

73931

Initiation of a patient episode by collection of a specimen for 1 or more services (in circumstances other than those described in item 73922, 73923, 73924, 73925, 73926 or 73927) if the specimen is collected:

   (a)  from a person who is a private patient of a hospital by an approved pathology practitioner of a prescribed laboratory; or

   (b)  from a person who is a private patient of a hospital by an employee of an approved pathology authority that operates a prescribed laboratory; or

   (c)  from a person who is a private patient of a recognised hospital by an approved pathology practitioner of an approved pathology authority; or

   (d)  from a person who is a private patient of a recognised hospital by an employee of an approved pathology authority

(Item is subject to rule 14)

2.40

73932

Initiation of a patient episode by collection of a specimen for 1 or more services (in circumstances other than those described in item 73922, 73923, 73924, 73925, 73926, 73927 or 73933) if the specimen is collected from a person in the place where the person resides, and that place is not an institution, by:

   (a)  an approved pathology practitioner of an approved pathology authority; or

   (b)  an employee of an approved pathology authority

(Item is subject to rule 14)

10.30

73933

Initiation of a patient episode by collection of a specimen for 1 or more services (in circumstances other than those described in item 73922, 73923, 73924, 73925, 73926 or 73927) if the specimen is collected from a person in the place where the person resides, and that place is not an institution, by:

   (a)  an approved pathology practitioner of a prescribed laboratory; or

   (b)  an employee of an approved pathology authority that operates a prescribed laboratory

(Item is subject to rule 14)

2.40

73934

Initiation of a patient episode by collection of a specimen for 1 or more services (in circumstances other than those described in item 73922, 73923, 73924, 73925, 73926, 73927 or 73935) if the specimen is collected from a person in an institution by:

   (a)  an approved pathology practitioner; or

   (b)  an employee of an approved pathology authority

(Item is subject to rule 14)

17.70

73935

Initiation of a patient episode by collection of a specimen for 1 or more services (in circumstances other than those described in item 73922, 73923, 73924, 73925, 73926 or 73927) if the specimen is collected from a person in an institution by:

   (a)  an approved pathology practitioner of a prescribed laboratory; or

   (b)  an employee of an approved pathology authority that operates a prescribed laboratory

(Item is subject to rule 14)

2.40

73936

Initiation of a patient episode by collection of a specimen for 1 or more services (in circumstances other than those described in item 73922, 73923, 73924, 73925, 73926, 73927 or 73937) if the specimen is collected from the person by the person

(Item is subject to rule 14)

9.80

73937

Initiation of a patient episode by collection of a specimen for 1 or more services (in circumstances other than those described in item 73922, 73923, 73924, 73925, 73926 or 73927) if the specimen is collected from the person by the person, and:

   (a)  the service is performed in a prescribed laboratory; or

   (b)  the person is a private patient in a recognised hospital

(Item is subject to rule 14)

2.40

73938

Initiation of a patient episode by collection of a specimen for 1 or more services (in circumstances other than those described in items 73922, 73923, 73924, 73925, 73926, 73927 or 73939) if the specimen is collected by, or on behalf of, the treating practitioner

(Item is subject to rule 14)

9.80

73939

Initiation of a patient episode by collection of a specimen for 1 or more services (in circumstances other than those described in item 73922, 73923, 73924, 73925, 73926 or 73927) if the specimen is collected by, or on behalf of, the treating practitioner and:

   (a)  the service is performed in a prescribed laboratory; or

   (b)  the person is a private patient in a recognised hospital

(Item is subject to rule 14)

2.40

[42]         Schedule 1, Part 3, item 73921

substitute

73940

Receipt of a specimen by an approved pathology practitioner of an approved pathology authority from another approved pathology practitioner of another approved pathology authority

(Item is subject to rules 14, 15 and 16)

10.30

[43]         Schedule 1, Part 4

omit

Acetylcholine receptor -- tissue antigens -- antibodies

ARA

71109

insert

Acetylcholine receptor -- tissue antigens -- antibodies

ARA

71165

[44]         Schedule 1, Part 4

omit

Activated Protein C resistance

APC

65132--36, 65142, 65171

insert

Activated Protein C resistance

APC

65142, 65171, 65175--79

[45]         Schedule 1, Part 4

omit

Adrenal cortex -- tissue antigens -- antibodies

ADR

71109

insert

Adrenal cortex -- tissue antigens -- antibodies

ADR

71165

[46]         Schedule 1, Part 4

omit

Aluminium

AL

66672--73

insert

Aluminium

AL

66825, 66828

[47]         Schedule 1, Part 4

omit

Antibodies to tissue antigens -- acetylcholine receptor

ARA

71109

Antibodies to tissue antigens -- adrenal cortex

ADR

71109

insert

Antibodies to tissue antigens -- acetylcholine receptor

ARA

71165

Antibodies to tissue antigens -- adrenal cortex

ADR

71165

[48]         Schedule 1, Part 4

omit

Antibodies to tissue antigens -- cardiolipin

ACL

71109

insert

Antibodies to tissue antigens -- cardiolipin

ACL

71165

[49]         Schedule 1, Part 4

omit

Antibodies to tissue antigens -- heart

AHE

71109

Antibodies to tissue antigens -- histone

AHI

71109

Antibodies to tissue antigens -- insulin receptor antibodies

INSA

71109

Antibodies to tissue antigens -- intercellular cement substance of skin

ICCS

71109

Antibodies to tissue antigens -- intrinsic factor

AIF

71109

Antibodies to tissue antigens -- islet cell

AIC

71109

insert

Antibodies to tissue antigens -- heart

AHE

71165

Antibodies to tissue antigens -- histone

AHI

71165

Antibodies to tissue antigens -- insulin receptor antibodies

INSA

71165

Antibodies to tissue antigens -- intercellular cement substance of skin

ICCS

71165

Antibodies to tissue antigens -- intrinsic factor

AIF

71165

Antibodies to tissue antigens -- islet cell

AIC

71165

[50]         Schedule 1, Part 4

omit

Antibodies to tissue antigens -- lymphocyte

ALY

71109

Antibodies to tissue antigens -- mitochondria

MA

71119

Antibodies to tissue antigens -- neuron

ANE

71109

Antibodies to tissue antigens -- neutrophil cytoplasm

ANCA

71153

Antibodies to tissue antigens -- ovary

AOV

71109

Antibodies to tissue antigens -- parathyroid

PTHA

71109

Antibodies to tissue antigens -- platelet

APA

71109

Antibodies to tissue antigens -- PM‑Sc1

PM1

71119

Antibodies to tissue antigens -- reticulin

RCA

71119

Antibodies to tissue antigens -- salivary gland

ASG

71109

Antibodies to tissue antigens -- Scl‑70

SCL

71119

Antibodies to tissue antigens -- skeletal muscle

SLA

71109

Antibodies to tissue antigens -- skin basement membrane

SKA

71109

Antibodies to tissue antigens -- smooth muscle

SMA

71119

Antibodies to tissue antigens -- thyroglobulin

ATG

71109

Antibodies to tissue antigens -- thyroid microsome

TMA

71109

Antibodies to tissue antigens -- tissue transglutaminase

TTG

71163

Antibodies to tissue antigens -- TSH receptor antibody test

TSHA

71109

insert

Antibodies to tissue antigens -- lymphocyte

ALY

71165

Antibodies to tissue antigens -- mitochondria

MA

71119

Antibodies to tissue antigens -- neuron

ANE

71165

Antibodies to tissue antigens -- neutrophil cytoplasm

ANCA

71153

Antibodies to tissue antigens -- ovary

AOV

71165

Antibodies to tissue antigens -- parathyroid

PTHA

71165

Antibodies to tissue antigens -- platelet

APA

71165

Antibodies to tissue antigens -- PM‑Sc1

PM1

71119

Antibodies to tissue antigens -- reticulin

RCA

71119

Antibodies to tissue antigens -- salivary gland

ASG

71165

Antibodies to tissue antigens -- Scl‑70

SCL

71119

Antibodies to tissue antigens -- skeletal muscle

SLA

71165

Antibodies to tissue antigens -- skin basement membrane

SKA

71165

Antibodies to tissue antigens -- smooth muscle

SMA

71119

Antibodies to tissue antigens -- thyroglobulin

ATG

71165

Antibodies to tissue antigens -- thyroid microsome

TMA

71165

Antibodies to tissue antigens -- tissue transglutaminase

TTG

71163

Antibodies to tissue antigens -- TSH receptor antibody test

TSHA

71165

[51]         Schedule 1, Part 4

omit

Antithrombin III

ATH

65132--36, 65142, 65171

insert

Antithrombin III

ATH

65142, 65171, 65175--79

[52]         Schedule 1, Part 4

omit

Arsenic

AS

66672--73

insert

Arsenic

AS

66825, 66828

[53]         Schedule 1, Part 4

omit

Beryllium

BE

66672--73

insert

Beryllium

BE

66825, 66828

[54]         Schedule 1, Part 4

omit

Cadmium

CD

66672--73

insert

Cadmium

CD

66825, 66828

[55]         Schedule 1, Part 4

omit

Cardiolipin -- tissue antigens -- antibodies

ACL

71109

insert

Cardiolipin -- tissue antigens -- antibodies

ACL

71165

[56]         Schedule 1, Part 4

omit

Chlamydia -- investigation by any method

CHLM

69364

Chlamydia -- investigation by any method and N gonorrhoea by NAA methods

CHGO

69364

Chlamydia -- microbial antibody testing

CHL

69384

Chlamydia -- microbial antigen testing

MCCH

69364

insert

Chlamydia -- investigation by any method

CHLM

69494

Chlamydia -- investigation by any method and N gonorrhoea by NAA methods

CHGO

69494

Chlamydia -- microbial antibody testing

CHL

69384

Chlamydia -- microbial antigen testing

MCCH

69494

[57]         Schedule 1, Part 4

omit

Chromium

CR

66672--73

insert

Chromium

CR

66825, 66828

[58]         Schedule 1, Part 4

omit

Copper

CU

66669--70

insert

Copper

CU

66819, 66822

[59]         Schedule 1, Part 4

omit

Cryptococcal antigen -- microbial antigen testing

CRYN

69364

Cryptococcus -- microbial antibody testing

CRY

69384

CSF -- microscopy and culture of material from

MCPO

69321

CSF antigens -- group B streptococcus

STB

69364

CSF antigens -- Haemophilus influenzae

HI

69364

CSF antigens -- Neisseria meningitidis

NMG

69364

CSF antigens -- Streptococcus pneumoniae

SPN

69364

insert

Cryptococcal antigen -- microbial antigen testing

CRYN

69494

Cryptococcus -- microbial antibody testing

CRY

69384

CSF -- microscopy and culture of material from

MCPO

69321

CSF antigens -- group B streptococcus

STB

69494

CSF antigens -- Haemophilus influenzae

HI

69494

CSF antigens -- Neisseria meningitidis

NMG

69494

CSF antigens -- Streptococcus pneumoniae

SPN

69494

[60]         Schedule 1, Part 4

omit

Faecal antigen test for Helicobacter pylori

FAHP

69364

insert

Faecal antigen test for Helicobacter pylori

FAHP

69494

[61]         Schedule 1, Part 4

omit

Glomerular basement membrane -- tissue antigens -- antibodies

GBA

71109

insert

Glomerular basement membrane -- tissue antigens -- antibodies

GBA

71165

[62]         Schedule 1, Part 4

omit

Gold

AU

66672--73

Group B streptococcus -- CSF antigens

STB

69364

Group B streptococcus -- microbial antigen testing

STB

69364

insert

Gold

AU

66825, 66828

Group B streptococcus -- CSF antigens

STB

69494

Group B streptococcus -- microbial antigen testing

STB

69494

[63]         Schedule 1, Part 4

omit

Haemophilus influenzae -- CSF antigens

HI

69364

Haemophilus influenzae -- microbial antibody testing

HUS

69384

Haemophilus influenzae -- microbial antigen testing

HI

69364

insert

Haemophilus influenzae -- CSF antigens

HI

69494

Haemophilus influenzae -- microbial antibody testing

HUS

69384

Haemophilus influenzae -- microbial antigen testing

HI

69494

[64]         Schedule 1, Part 4

omit

Heart -- tissue antigens -- antibodies

AHE

71109

insert

Heart -- tissue antigens -- antibodies

AHE

71165

[65]         Schedule 1, Part 4

omit

Hepatitis C -- detection

RNAC

69444

Hepatitis C -- genotype

GHCV

69443

Hepatitis C -- quantitation

THCV

69442

insert

Hepatitis C -- detection

RNAC

69499

Hepatitis C -- genotype

GHCV

69491

Hepatitis C -- quantitation

THCV

69488

[66]         Schedule 1, Part 4

omit

Herpes simplex virus -- direct detection from clinical material

HSV

69364

Herpes simplex virus -- investigation by culture

HSVC

69364

Herpes simplex virus -- microbial antibody testing

HPA

69384

Herpes simplex virus -- microbial antigen testing

HSV

69364

insert

Herpes simplex virus -- direct detection from clinical material

HSV

69494

Herpes simplex virus -- investigation by culture

HSVC

69494

Herpes simplex virus -- microbial antibody testing

HPA

69384

Herpes simplex virus -- microbial antigen testing

HSV

69494

[67]         Schedule 1, Part 4

omit

Histone -- tissue antigens -- antibodies

AHI

71109

insert

Histone -- tissue antigens -- antibodies

AHI

71165

[68]         Schedule 1, Part 4

omit

Human papillomaviruses

HPV

69486

insert

Human papillomaviruses

HPV

69418

[69]         Schedule 1, Part 4

omit

Insulin -- tissue antigens -- antibodies

AINS

71109

Insulin receptor antibodies -- tissue antigens -- antibodies

INSA

71109

Intercellular cement substance of skin -- tissue antigens -- antibodies

ICCS

71109

Intestinal disaccharidases

INTD

66680

Intrinsic factor -- tissue antigens -- antibodies

AIF

71109

Iron studies (iron, transferrin and ferritin)

IS

66596

Islet cell -- tissue antigens -- antibodies

AIC

71109

insert

Insulin -- tissue antigens -- antibodies

AINS

71165

Insulin receptor antibodies -- tissue antigens -- antibodies

INSA

71165

Intercellular cement substance of skin -- tissue antigens -- antibodies

ICCS

71165

Intestinal disaccharidases

INTD

66680

Intrinsic factor -- tissue antigens -- antibodies

AIF

71165

Iron studies (iron, transferrin and ferritin)

IS

66596

Islet cell -- tissue antigens -- antibodies

AIC

71165

[70]         Schedule 1, Part 4

omit

Lupus anticoagulant

LUPA

65132--37, 65142

insert

Lupus anticoagulant

LUPA

65137, 65142, 65175--79

[71]         Schedule 1, Part 4

omit

Lymphocyte -- tissue antigens -- antibodies

ALY

71109

insert

Lymphocyte -- tissue antigens -- antibodies

ALY

71165

[72]         Schedule 1, Part 4

omit

Manganese

MN

66669--70

insert

Manganese

MN

66819, 66822

[73]         Schedule 1, Part 4

omit

Mercury

HG

66672--73

insert

Mercury

HG

66825, 66828

[74]         Schedule 1, Part 4

omit

Microbial antigen testing -- Chlamydia

MCCH

69364

Microbial antigen testing -- Clostridium difficile

CLDT

69363

Microbial antigen testing -- group B streptococcus

STB

69364

Microbial antigen testing -- Haemophilus influenzae

HI

69364

Microbial antigen testing -- herpes simplex virus

HSV

69364

Microbial antigen testing -- Neisseria gonorrhoeae

GON

69364

Microbial antigen testing -- Neisseria meningitidis

NMG

69364

Microbial antigen testing -- respiratory syncytial virus

RSVN

69364

Microbial antigen testing -- Streptococcus pneumoniae

SPN

69364

Microbial antigen testing -- Varicella zoster

VCZN

69364

insert

Microbial antigen testing -- Chlamydia

MCCH

69494

Microbial antigen testing -- Clostridium difficile

CLDT

69363

Microbial antigen testing -- group B streptococcus

STB

69494

Microbial antigen testing -- Haemophilus influenzae

HI

69494

Microbial antigen testing -- herpes simplex virus

HSV

69494

Microbial antigen testing -- Neisseria gonorrhoeae

GON

69494

Microbial antigen testing -- Neisseria meningitidis

NMG

69494

Microbial antigen testing -- respiratory syncytial virus

RSVN

69494

Microbial antigen testing -- Streptococcus pneumoniae

SPN

69494

Microbial antigen testing -- Varicella zoster

VCZN

69494

[75]         Schedule 1, Part 4

omit

Microscopy and culture to detect pathogenic micro‑organisms including Chlamydia

MCCH

69364

insert

Microscopy and culture to detect pathogenic micro‑organisms including Chlamydia

MCCH

69494

[76]         Schedule 1, Part 4

omit

Neisseria gonorrhoeae by NAA techniques and chlamydia by any method

CHGO

69364

Neisseria gonorrhoeae -- microbial antigen testing

GON

69364

Neisseria meningitidis -- antigens

NMG

69364

Neisseria meningitidis -- microbial antibody testing

MEN

69384

Neisseria meningitidis -- microbial antigen testing

NMG

69364

insert

Neisseria gonorrhoeae by NAA techniques and chlamydia by any method

CHGO

69494

Neisseria gonorrhoeae -- microbial antigen testing

GON

69494

Neisseria meningitidis -- antigens

NMG

69494

Neisseria meningitidis -- microbial antibody testing

MEN

69384

Neisseria meningitidis -- microbial antigen testing

NMG

69494

[77]         Schedule 1, Part 4

omit

Neuron -- tissue antigens -- antibodies

ANE

71109

Neutrophil cytoplasm -- tissue antigens -- antibodies

ANCA

71109

insert

Neuron -- tissue antigens -- antibodies

ANE

71165

Neutrophil cytoplasm -- tissue antigens -- antibodies

ANCA

71165

[78]         Schedule 1, Part 4

omit

Nickel

NI

66672--73

insert

Nickel

NI

66825, 66828

[79]         Schedule 1, Part 4

omit

Ovary -- tissue antigens -- antibodies

AOV

71109

insert

Ovary -- tissue antigens -- antibodies

AOV

71165

[80]         Schedule 1, Part 4

omit

Parathyroid -- tissue antigens -- antibodies

PTHA

71109

insert

Parathyroid -- tissue antigens -- antibodies

PTHA

71165

[81]         Schedule 1, Part 4

omit

Patient episode initiation fees

PEI

73901--15

insert

Patient episode initiation fees

PEI

73922--39

[82]         Schedule 1, Part 4

omit

Platelet -- tissue antigens -- antibodies

APA

71109

insert

Platelet -- tissue antigens -- antibodies

APA

71165

[83]         Schedule 1, Part 4

omit

Protein -- C

PROC

65132--36, 65142, 65171

Protein -- S

PROS

65132--36, 65142, 65171

insert

Protein -- C

PROC

65142, 65171, 65175--79

Protein -- S

PROS

65142, 65171, 65175--79

[84]         Schedule 1, Part 4

omit

Referred specimen fee

 

73921

insert

Referred specimen fee

 

73940

[85]         Schedule 1, Part 4

omit

Respiratory syncytial virus -- microbial antigen testing

RSVN

69364

insert

Respiratory syncytial virus -- microbial antigen testing

RSVN

69494

[86]         Schedule 1, Part 4

omit

RSV (respiratory syncytial virus) -- microbial antigen testing

RSVN

69364

insert

RSV (respiratory syncytial virus) -- microbial antigen testing

RSVN

69494

[87]         Schedule 1, Part 4

omit

Salivary gland -- tissue antigens -- antibodies

ASG

71109

insert

Salivary gland -- tissue antigens -- antibodies

ASG

71165

[88]         Schedule 1, Part 4

omit

Selenium

SE

66669--70

insert

Selenium

SE

66819, 66822

[89]         Schedule 1, Part 4

omit

Skeletal muscle -- tissue antigens -- antibodies

SLA

71109

insert

Skeletal muscle -- tissue antigens -- antibodies

SLA

71165

[90]         Schedule 1, Part 4

omit

Skin basement membrane -- tissue antigens -- antibodies

SKA

71109

insert

Skin basement membrane -- tissue antigens -- antibodies

SKA

71165

[91]         Schedule 1, Part 4

omit

Specimen referred fee

 

73921

insert

Specimen referred fee

 

73940

[92]         Schedule 1, Part 4

omit

Streptococcus -- Group B

STB

69364

Streptococcus pneumoniae -- CSF antigens

SPN

69364

Streptococcus pneumoniae -- microbial antibody testing

PCC

69384

Streptococcus pneumoniae -- microbial antigen testing

SPN

69364

Strontium

SR

66672--73

insert

Streptococcus -- Group B

STB

69494

Streptococcus pneumoniae -- CSF antigens

SPN

69494

Streptococcus pneumoniae -- microbial antibody testing

PCC

69384

Streptococcus pneumoniae -- microbial antigen testing

SPN

69494

Strontium

SR

66825, 66828

[93]         Schedule 1, Part 4

omit

Thyroglobulin -- tissue antigens -- antibodies

ATG

71109

Thyroid function tests (including TSH)

TFT

66719

Thyroid microsome -- tissue antigens -- antibodies

TMA

71109

insert

Thyroglobulin -- tissue antigens -- antibodies

ATG

71165

Thyroid function tests (including TSH)

TFT

66719

Thyroid microsome -- tissue antigens -- antibodies

TMA

71165

[94]         Schedule 1, Part 4

omit

TSH receptor antibody test -- tissue antigens -- antibodies

TSHA

71109

insert

TSH receptor antibody test -- tissue antigens -- antibodies

TSHA

71165

[95]         Schedule 1, Part 4

omit

Varicella zoster -- microbial antigen testing

VCZN

69364

insert

Varicella zoster -- microbial antigen testing

VCZN

69494

[96]         Schedule 1, Part 5

omit

Anus, neoplasm, radical resection

6

insert

Anus, neoplasm, radical resection

6

Anus, submucosal resection -- neoplasm

5

[97]         Schedule 1, Part 5

omit

Large bowel (including rectum), segmental resection, neoplasm

6

insert

Large bowel (including rectum), segmental resection -- neoplasm

6

Large bowel (including rectum), submucosal resection -- neoplasm

5

[98]         Schedule 1, Part 5

omit

Oesophagus, partial or total resection

6

insert

Oesophagus, partial or total resection

6

Oesophagus, submucosal resection -- neoplasm

5

[99]         Schedule 1, Part 5

omit

Small bowel, resection -- neoplasm

6

insert

Small bowel, resection -- neoplasm

6

Small bowel, submucosal resection -- neoplasm

5

[100]       Schedule 1, Part 5

omit

Stomach, resection, neoplasm -- all specimens

6

insert

Stomach, resection, neoplasm -- all specimens

6

Stomach, submucosal resection -- neoplasm

5




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