Commonwealth Numbered Regulations Commonwealth Numbered Regulations
Select Legislative Instrument No. 249, 2013
I, Quentin Bryce AC CVO, Governor-General of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following regulation under the Health Insurance Act 1973.
Quentin Bryce
Governor-General
By Her Excellency's Command
Peter Dutton
Minister for Health
Contents
1............ Name of regulation.............................................................................. 1
2............ Commencement................................................................................... 1
3............ Authority............................................................................................. 1
4............ Schedule(s)......................................................................................... 1
5............ Pathology services table...................................................................... 1
6............ Dictionary........................................................................................... 1
Schedule 1--Pathology services table 2
Part 1--Preliminary 2
Division 1.1--Interpretation 2
1.1.1...... Abbreviations...................................................................................... 2
Division 1.2--General application provisions 3
1.2.1...... Precedence of items............................................................................. 3
1.2.2...... Circumstances in which services rendered following 2 requests to be taken to have been rendered following one request............................................................................................................ 3
1.2.3...... Services to which clause 1.2.2 does not apply.................................... 4
1.2.4...... Referral of designated tests by one pathology practitioner to another.. 5
1.2.5...... Items not to be split............................................................................. 7
1.2.6...... Certain pathology services to be treated as one service....................... 7
1.2.7...... Meaning of set of pathology services.................................................. 8
1.2.8...... Satisfying requirements described in pathology service.................... 10
Part 2--Services and fees 11
Division 2.1--Group P1: haematology 11
2.1.1...... Services to which clause 1.2.2 does not apply.................................. 11
2.1.2...... Item taken to refer only to the first service of a particular kind.......... 11
Division 2.2--Group P2: chemical 19
2.2.1...... Creatinine ratios................................................................................ 19
2.2.2...... Services to which clause 1.2.2 does not apply.................................. 19
2.2.3...... Limitation on certain items................................................................ 19
2.2.4...... Serum B12 and red cell folate testing................................................ 20
2.2.5...... Thyroid function testing.................................................................... 20
2.2.6...... Limitation on certain items................................................................ 21
2.2.7...... Nutritional and toxicity metals testing............................................... 21
Division 2.3--Group P3: microbiology 35
2.3.1...... Meaning of serial examinations or cultures..................................... 35
2.3.2...... Antigen detection.............................................................................. 35
2.3.3...... Investigation for hepatitis serology................................................... 35
2.3.4...... Limitation on certain items................................................................ 36
2.3.5...... Hepatitis C viral RNA testing........................................................... 36
Division 2.4--Group P4: immunology 47
2.4.1...... Limitation on certain items................................................................ 47
2.4.2...... Tests in Group P4 relating to antibodies........................................... 47
2.4.3...... HLA-B27 typing............................................................................... 47
2.4.4...... Antineutrophil cytoplasmic antibody tests......................................... 47
Division 2.5--Group P5: tissue pathology 55
2.5.1...... Tests on biopsy material.................................................................... 55
Division 2.6--Group P6: cytology 60
2.6.1...... Tests on biopsy material.................................................................... 60
Division 2.7--Group P7: genetics 64
2.7.1...... Haemochromatosis testing................................................................ 64
2.7.2...... HLA-B27 typing............................................................................... 64
Division 2.8--Group P8: infertility and pregnancy tests 70
2.8.1...... Limitation on item 73523.................................................................. 70
Division 2.9--Group P9: simple basic pathology tests 71
Division 2.10--Group P10: patient episode initiation 72
2.10.1.... Items in Group P10 not to apply in certain circumstances................. 72
Division 2.11--Group P11: specimen referred 78
2.11.1.... Items in Group P11 not to apply in certain circumstances................. 78
2.11.2.... Application of an item in Group P11 to a service excludes certain other items 78
2.11.3.... Circumstances in which an item in Group P11 does not apply......... 78
Division 2.12--Group P12: management of bulk-billed services 80
2.12.1.... Application of items 74990 and 74991............................................. 80
Division 2.13--Group P13: bulk billing incentive for episodes consisting of a P10 service 84
Part 3--Abbreviations 86
Part 4--Complexity levels for histopathology items 120
Part 5--Dictionary 127
Schedule 2--Repeals 132
Health Insurance (Pathology Services Table) Regulation 2012 132