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HEALTH INSURANCE (PATHOLOGY SERVICES TABLE) REGULATION 2014 (SLI NO 150 OF 2014) - NOTES

 

Select Legislative Instrument No. 150, 2014

I, General the Honourable Sir Peter Cosgrove AK MC (Ret'd), Governor-General of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following regulation.

Dated 16 October 2014

Peter Cosgrove

Governor-General

By His Excellency's Command

Peter Dutton

Minister for Health

 

  

  

  


Contents

1............ Name................................................................................................... 1

2............ Commencement................................................................................... 1

3............ Authority............................................................................................. 1

4............ Schedules............................................................................................ 1

5............ Pathology services table...................................................................... 2

6............ Dictionary........................................................................................... 2

Schedule 1--Pathology services table                                                       3

Part 1--Preliminary                                                                                                             3

Division 1.1--Interpretation                                                                                     3

1.1.1...... Abbreviations...................................................................................... 3

Division 1.2--General application provisions                                                 4

1.2.1...... Precedence of items............................................................................. 4

1.2.2...... Circumstances in which services rendered following 2 requests to be taken to have been rendered following one request............................................................................................................ 4

1.2.3...... Services to which clause 1.2.2 does not apply.................................... 5

1.2.4...... Referral of designated tests by one pathology practitioner to another.. 6

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.................................................. 9

1.2.8...... Satisfying requirements described in pathology service.................... 10

Part 2--Services and fees                                                                                                12

Division 2.1--Group P1: haematology                                                             12

2.1.1...... Services to which clause 1.2.2 does not apply.................................. 12

2.1.2...... Item taken to refer only to the first service of a particular kind.......... 12

Division 2.2--Group P2: chemical                                                                      20

2.2.1...... Creatinine ratios................................................................................ 20

2.2.2...... Services to which clause 1.2.2 does not apply.................................. 20

2.2.3...... Limitation on certain items................................................................ 20

2.2.5...... Thyroid function testing.................................................................... 21

2.2.6...... Limitation on certain items................................................................ 21

2.2.7...... Nutritional and toxicity metals testing............................................... 22

Division 2.3--Group P3: microbiology                                                             36

2.3.1...... Meaning of serial examinations or cultures..................................... 36

2.3.2...... Antigen detection.............................................................................. 36

2.3.3...... Investigation for hepatitis serology................................................... 36

2.3.4...... Limitation on certain items................................................................ 37

2.3.5...... Hepatitis C viral RNA testing........................................................... 37

Division 2.4--Group P4: immunology                                                               48

2.4.1...... Limitation on certain items................................................................ 48

2.4.2...... Tests in Group P4 relating to antibodies........................................... 48

2.4.3...... HLA-B27 typing............................................................................... 48

2.4.4...... Antineutrophil cytoplasmic antibody tests......................................... 48

Division 2.5--Group P5: tissue pathology                                                      57

2.5.1...... Tests on biopsy material.................................................................... 57

Division 2.6--Group P6: cytology                                                                       62

2.6.1...... Tests on biopsy material.................................................................... 62

Division 2.7--Group P7: genetics                                                                        66

2.7.1...... Haemochromatosis testing................................................................ 66

2.7.2...... HLA-B27 typing............................................................................... 66

Division 2.8--Group P8: infertility and pregnancy tests                        72

2.8.1...... Limitation on item 73523.................................................................. 72

Division 2.9--Group P9: simple basic pathology tests                             73

Division 2.10--Group P10: patient episode initiation                               74

2.10.1.... Items in Group P10 not to apply in certain circumstances................. 74

Division 2.11--Group P11: specimen referred                                             81

2.11.1.... Items in Group P11 not to apply in certain circumstances................. 81

2.11.2.... Application of an item in Group P11 to a service excludes certain other items         81

2.11.3.... Circumstances in which an item in Group P11 does not apply......... 81

Division 2.12--Group P12: management of bulk-billed services        83

2.12.1.... Application of items 74990 and 74991............................................. 83

Division 2.13--Group P13: bulk billing incentive for episodes consisting of a P10 service        87

Part 3--Abbreviations                                                                                                      89

Part 4--Complexity levels for histopathology items                                     122

Part 5--Dictionary                                                                                                            129

Schedule 2--Repeals                                                                                                        134

Health Insurance (Pathology Services Table) Regulation 2013                    134

Schedule 3--Amendments                                                                                            135

Health Insurance (Pathology Services Table) Regulation 2014                    135

 




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