Health Insurance (1992-1993 Pathology Services Table) Regulations (Amendment) (Cth)

Statutory Rules 1993

No. 125 1

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Health Insurance (1992-1993 Pathology Services Table) Regulations 2(Amendment)

I, The Governor-General of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following Regulations under the Health Insurance Act 1973.

Dated 9 June 1993.

 

 BILL HAYDEN

 Governor-General

By His Excellency’s Command,

GRAHAM RICHARDSON

Minister for Health

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1.   Commencement

1.1   These Regulations commence on 1 July 1993.

2.   Amendment

2.1   The Health Insurance (1992-1993 Pathology Services Table) Regulations are amended as set out in these Regulations.

3.   Schedule (Table of pathology services)

3.1   Subrule 1 (1):

Insert the following definition:

“ ‘approved pathology authority’ has the same meaning as in Division 4A of Part IIA of the Act;”.

3.2   Subrule 2 (2):

Omit all the words before paragraph (a), substitute:

“(2)

Subject to subrule (3), if:”.

3.3   Rule 2:

Add at the end:

“(3)

If an item is expressed to include a pathology service that is specified in another item, the other item does not apply to the service in addition to the first-mentioned item.”.

3.4   Paragraph 3A (1) (a):

Omit the paragraph, substitute:

• “(a)

  a pathology service specified in item 66201, other than an estimation of fructosamine or lithium; or”.

3.5   Subrule 3A (2):

Omit all the words before paragraph (a), substitute:

“(2)

Rule 3 does not apply to any of the following pathology services if, under a request for a service, no more than 6 tests are requested and the tests are performed within 6 months of the request:”.

3.6   After subrule 3A (2), insert:

 “(2A) Rule 3 does not apply to a pathology service:

• (a)

  to which item 66217 applies; and

 (b) for which a specimen is collected on each of 3 days for the purpose of making a valid estimation.”.

3.7   Subrule 11 (1) (definition of “approved pathology authority”):

Omit the definition.

3.8   Subrule 11 (4):

Omit “If”, substitute “Subject to subrule (6), if”.

3.9   After subrule 11 (5), insert:

“(6)

If, in respect of the same patient episode:

• (a)

  services referred to in 1 or more items:

  • (i)

    in Group P5; and

  • (ii)

    in one of Groups P1, P2, P3, P4, P6, P7 and P8; or

• (b)

  services referred to in 1 or more items:

  • (i)

    in Group P6; and

  • (ii)

    in one of Groups P1, P2, P3, P4, P5, P7 and P8;

are rendered by an approved pathology practitioner in each of 2 approved pathology authorities, the applicable amount specified in an item in Group P10 is payable to both approved pathology practitioners.

“(7)

If more than one specimen is collected from a person on the same day for the provision of pathology services:

• (a)

  in accordance with more than one request; and

• (b)

  in or by a single approved pathology authority;

only a single amount specified in the applicable item in Group P10 is payable for the services.”.

3.10   Item 66201:

Omit the item, substitute:

“66201 Quantitative estimation in serum, plasma, urine or other body fluid, by any method except by reagent strip with or without reflectance meter or electrophoresis, when not performed as specified in item 66331, of—alanine aminotransferase, albumin, alkaline phosphatase, amylase, aspartate aminotransferase, bicarbonate, bilirubin (total and any fractions), calcium (total, dialysed or ionised), chloride, creatine kinase, creatine kinase isoenzymes (when not performed as specified in item 66245), creatinine, fructosamine, gamma glutamyl transpeptidase, globulin, glucose, lactate dehydrogenase, lipase, lithium, magnesium, phosphate, potassium, total protein, sodium, urate, urea—1 estimation $9.80”.

3.11   Item 66233:

Omit the item.

3.12   After item 66325 insert:

“66331	Quantitative estimation in serum, plasma, urine or other body fluid of cholesterol or triglycerides or both, except by reagent strip with or without reflectance meter or electrophoresis	$11.60
66335	Services specified in item 66331 and 1 estimation specified in item 66201	$13.90
66337	Services specified in item 66331 and 2 estimations specified in item 66201	$15.95
66339	Services specified in item 66331 and 3 estimations specified in item 66201	$18.00
66341	Services specified in item 66331 and 4 or more estimations specified in item 66201	$20.10
66343	Drug assays—including all qualitative and quantitative estimations on blood, urine or other body fluid for a drug, or drugs, of abuse or a therapeutic drug on a sample collected from a patient participating in a drug abuse treatment program, or being treated for drug effects or under a court order or parole board supervision, but excluding the detection of nicotine and metabolites in smoking withdrawal programs—each assay to a maximum of 21 assays in any 12 month period	$20.00”.

3.13   Item 69225:

Omit the item.

3.14   After item 69257 insert:

“69261	Examination for Chlamydia by culture or by the demonstration of chlamydial nucleic acid using a DNA probe in material collected directly from a patient, including a service specified in item 69221, 69223 or 69263	$17.60
69263	Examination for Herpes simplex virus of one or more types in material collected directly from a patient by culture, including a service specified in item 69221, 69223 or 69261	$27.50
69265	Determination of antibodies to Hepatitis C	$13.60”.

3.15   Items 73281, 73283 and 73285:

Omit the items, substitute:

“73287	Chromosome studies, including preparation, count, karyotyping and identification by banding techniques  or by fragile X-site determination of one or more of amniotic fluid, bone marrow, skin and any other tissue or fluid except blood—1 or more estimations	$320.00
73289	Chromosome studies, including preparation, count, karyotyping and identification by banding techniques or by fragile X-site determination of blood—1 or more estimations	$290.00”.

3.16   Items 73802, 73803, 73804 and 73805:

Omit the items, substitute:

“73802	Blood count consisting of leucocyte count, erythrocyte sedimentation rate, examination of blood film (including differential leucocyte count), haemoglobin estimation, haematocrit estimation or erythrocyte count—1 procedure	$4.20
73803	2 procedures specified in item 73802	$5.60
73804	3 or more procedures specified in item 73802	$7.60
73805	Urine—microscopical examination of, or catalase test for, bacteria and cells, whether stained or not	$4.20”.

3.17   Items 73807 and 73808:

Omit the items, substitute:

“73807	Microscopical examination of wet film other than urine, including any relevant stain	$6.30
73808	Microscopical examination of Gram stained film, including any examination specified in items 73805 and 73807	$8.00”.

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NOTES

1. Notified in the Commonwealth of Australia Gazette on 17 June 1993.

2. Statutory Rules 1992 No. 336.