Health Insurance (1994-1995 Pathology Services Table) Regulations (Amendment) (Cth)

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Statutory Rules 1994

No. 361 1

__________________

Health Insurance (1994-1995 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 25 October 1994.

 BILL HAYDEN

 Governor-General

By His Excellency’s Command,

CARMEN LAWRENCE

Minister for Human Services and Health

____________

1.   Commencement

1.1   These Regulations commence on 1 November 1994.

2.   Amendment

2.1   The Health Insurance (1994-1995 Pathology Services Table) Regulations are amended as set out in these Regulations.

3.   Schedule (Table of pathology services)

3.1   Paragraph 4 (1) (a):

Omit “specified”, substitute “described”.

3.2   Paragraph 4 (2) (d):

After “gold”, insert “, sulfasalazine”.

3.3   Paragraph 4 (3) (a):

Omit “66217”, substitute “66221”.

3.4   Rule 6:

Omit subrules 6 (1) and (2), substitute:

“6.

(1) In this rule:

‘designated pathology service’ means a pathology service in respect of tests relating to a single patient episode that are:

  • (a)

    tests of the kind described in item 66235; or

  • (b)

    tests of the kind described in item 66405; or

  • (c)

    tests of the kind described in item 69229.

“6.

(2) This rule applies in respect of a designated pathology service where:

  • (a)

    an approved pathology practitioner (‘practitioner A’) in an approved pathology authority:

    • (i)

      has been requested to render the designated pathology service; and

    • (ii)

      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 (but not all) of the tests included in the service; and

    • (iii)

      requests an approved pathology practitioner (‘practitioner B’) in another approved pathology authority to render the test or tests that practitioner A is unable to render; and

    • (iv)

      renders each test included in the service, other than the test or tests in respect of which the request mentioned in subparagraph (iii) is made; and

  • (b)

    the tests mentioned in subparagraph (a) (iv) that practitioner A renders are not tests constituting a service described in item 66239, 66415 or 69239.

“6.

(2A) Where this rule applies in respect of a designated pathology service:

  • (a)

    item 66235, 66237, 66405, 66407, 66409, 66411, 66413, 69229, 69231, 69233, 69235 or 69237 (as the case requires) applies in respect of the test or tests rendered by practitioner A; and

  • (b)

    where practitioner B renders a service under a request referred to in subparagraph (2) (a) (iii)—subject to subrule (2B), the amount specified in item 66241, 66417 or 69241 (as the case requires) is payable for each test that the service comprises.

“6.

(2B) For the purposes of paragraph (2A) (b), the maximum number of tests to which item 66241, 66417 or 69241 applies is:

  • (a)

    in the case of item 66241:

 3 - X; or

  • (b)

    in the case of item 66417 or 69241:

 6 - X;

where ‘X’ is the number of tests rendered by practitioner A in relation to the designated pathology service in respect of which the request mentioned in that paragraph is made.”.

3.5   After rule 6, insert:

Items not to be split

“6A.

Except as stated in rule 6, the amount specified in an item is payable only to one approved pathology practitioner in respect of a single patient episode.”.

3.6   New rules 7A and 7B:

After rule 7, insert:

Item 66317

“7A.

The amount specified in item 66317 is not payable in respect of a pathology service described in the item unless at least one of the following paragraphs applies:

  • (a)

    if the HDL cholesterol or apolipoprotein B/A1 ratio of the patient is requested to be determined because the patient has a serum cholesterol level >5.5 mmol/1—the determination is performed on the sample that the serum cholesterol level determination for the patient was performed;

  • (b)

    if the HDL cholesterol or apolipoprotein B/A1 ratio of the patient is requested to be determined because the patient has a fasting serum triglyceride level >2.0 mmol/1—the determination is performed on the sample that the serum triglyceride level determination for the patient was performed;

  • (c)

    the pathologist who renders the service has a written statement from the medical practitioner who requested the service that the patient is on a lipid lowering drug.

Thyroid function testing

“7B.

(1) For the purposes of item 66329:

‘abnormal level of TSH’ means a level of TSH that is outside the normal reference range in respect of the particular method of assay used to determine the level.

“7B.

(2) Except where paragraph (a) of item 66329 is satisfied, the amount specified in the item is not payable in respect of a pathology service described in the item unless the pathologist who renders the service has a written statement from the medical practitioner who requested the service that satisfies subrule (3).

“7B.

(3) The written statement from the medical practitioner must indicate:

  • (a)

    that the tests are required for a particular purpose, being a purpose specified in paragraph (b) of item 66329; or

  • (b)

    that the medical practitioner who requested the tests suspects the patient has pituitary dysfunction; or

  • (c)

    that the patient is on drugs that interfere with thyroid hormone metabolism or function.”.

3.7   Subrule 11 (4):

Omit “P9”, substitute “P8”.

3.8   Rule 11:

Add at the end:

“11.

(9) The amount specified in item 73921 is payable only once in respect of a single patient episode.”.

3.9   Part 2 of the Schedule is amended in accordance with the following table:

TABLE

Column 1

Item No.

Column 2

Omit

Column 3

Substitute

65001

5.60

5.65

65003

7.65

7.75

65005

10.10

10.25

65007

17.50

17.70

65009

23.30

23.60

65011

36.30

36.75

65013

111.50

112.90

65015

80.95

82.00

65017

9.80

9.90

65019

19.50

19.75

65021

36.30

36.75

65023

88.60

89.75

65025

16.05

16.25

Column 1

Item No.

Column 2

Omit

Column 3

Substitute

65027

8.85

8.95

65029

12.25

12.40

65031

16.20

16.40

65033

20.15

20.40

65035

24.10

24.40

65037

24.05

24.35

65039

76.40

77.35

65041

48.10

48.70

65043

32.10

32.50

65045

32.05

32.45

65047

46.20

46.75

95049

95049

65049

65049

60.35

61.05

66201

9.90

10.05

66203

11.95

12.10

66205

14.00

14.15

66207

16.05

16.20

66209

18.10

18.25

66211

20.15

20.30

66213

9.60

9.70

66215

14.50

14.70

66223

24.05

24.35

66225

32.85

33.25

66227

8.70

8.80

66229

29.80

30.20

66231

40.50

41.00

66235

20.20

20.45

66237

28.30

28.65

66239

36.40

36.85

66243

32.10

32.50

66247

44.30

44.85

Column 1

Item No.

Column 2

Omit

Column 3

Substitute

66249

29.80

30.20

66250

29.80

30.20

66255

19.65

19.90

66257

19.65

19.90

66258

43.95

44.50

66261

19.65

19.90

66262

36.20

36.65

66263

38.20

38.70

66265

24.05

24.35

66267

43.90

44.45

66269

29.80

30.20

66271

29.80

30.20

66277

34.90

35.35

66279

29.80

30.20

66281

38.95

39.45

66283

38.95

39.45

66285

38.95

39.45

66287

72.55

73.45

66289

96.25

97.45

66293

48.10

48.70

66295

11.45

11.60

66297

38.20

38.70

66299

61.10

61.90

66315

77.90

78.90

66319

16.40

16.60

66321

53.80

54.50

66323

10.85

11.00

66325

34.90

35.35

66331

11.75

11.90

66335

14.00

14.15

66337

16.05

16.20

66339

18.10

18.25

Column 1

Item No.

Column 2

Omit

Column 3

Substitute

66341

20.15

20.30

66343

20.25

20.50

66353

19.65

19.90

66355

19.65

19.90

66357

19.65

19.90

66359

36.20

36.65

66361

19.65

19.90

66363

36.20

36.65

66365

24.05

24.35

66367

24.05

24.35

66369

37.80

38.30

66373

31.15

31.55

66375

42.05

42.60

66405

31.15

31.55

66407

42.05

42.55

66409

52.95

53.55

66411

63.85

64.55

66413

74.75

75.55

66415

85.65

86.55

69201

7.25

7.35

69203

12.20

12.35

69205

19.10

19.35

69207

27.90

28.25

69209

37.80

38.30

69211

45.85

46.45

69213

64.15

64.95

69215

16.80

17.00

69217

20.30

20.55

69219

16.05

16.25

69221

9.60

9.70

69223

9.60

9.70

Column 1

Item No.

Column 2

Omit

Column 3

Substitute

69229

13.75

13.90

69231

21.05

21.30

69233

28.35

28.70

69235

35.65

36.10

69237

42.95

43.50

69239

50.25

50.90

69243

13.60

13.75

69245

18.35

18.60

69247

36.30

36.75

69429

26.35

26.70

69251

24.05

24.35

69253

13.75

13.90

69255

21.00

21.25

69257

27.90

28.25

69261

17.80

18.05

69263

27.80

28.15

69265

13.75

13.90

71061

28.45

28.80

71063

42.90

43.45

71065

42.90

43.45

71067

14.65

14.85

71069

23.15

23.45

71071

31.65

32.05

71073

103.45

104.75

71075

26.35

26.70

71077

26.35

26.70

71079

23.80

24.10

71081

19.65

19.90

71083

19.65

19.90

71085

28.20

28.55

71087

36.80

37.20

Column 1

Item No.

Column 2

Omit

Column 3

Substitute

71089

28.40

28.75

71091

51.45

52.10

71093

74.50

75.45

71097

24.80

25.10

71099

25.85

26.20

71101

16.95

17.15

71103

50.70

51.35

71106

11.00

11.15

71109

33.65

34.10

71113

46.20

46.80

71115

58.75

59.50

71117

71.30

72.20

71119

16.90

17.10

71121

20.25

20.50

71123

23.60

23.90

71125

26.95

27.30

71127

171.85

174.05

71129

212.30

215.00

71131

252.75

255.95

71135

202.70

205.25

71137

29.50

29.85

71139

101.35

102.65

71141

192.35

194.80

71143

253.40

256.60

71145

413.70

418.95

71147

31.60

32.00

71149

105.50

106.85

71151

115.85

117.30

72801

78.05

79.05

72803

126.80

128.40

72805

96.25

97.45

72807

102.35

103.65

Column 1

Item No.

Column 2

Omit

Column 3

Substitute

73043

14.80

15.00

73045

29.00

29.35

73047

60.35

61.10

73049

36.30

36.75

73051

68.00

68.85

73053

12.40

12.55

73055

12.40

12.55

73057

12.40

12.55

73287

323.50

327.60

73289

293.15

296.85

73521

6.70

6.80

73523

27.90

28.25

73525

17.95

18.20

73527

9.80

9.90

73529

73529

(second occurring)

73527

73529

27.90

28.25

73801

6.40

6.50

73802

4.25

4.30

73803

5.60

6.00

73804

7.65

7.70

73805

4.25

4.30

73806

10.45

10.60

73807

6.40

6.50

73808

8.05

8.15

73809

2.15

2.20

73810

6.40

6.50

73811

10.45

10.60

73901

7.75

7.85

73903

13.95

14.15

73905

7.75

7.85

Column 1

Item No.

Column 2

Omit

Column 3

Substitute

73907

16.05

16.25

73909

16.05

16.25

73911

16.05

16.25

73913

9.85

10.00

73915

9.85

10.00

73921

9.85

10.00

3.10   Item 65037:

Omit “and” (first occurring).

3.11   Items 66217, 66219, 66291 and 66371:

Omit the items.

3.12   New item 66221:

After item 66215, insert:

“66221

Test for faecal occult blood (including tests for haemoglobin and its derivatives in the faeces) by:

(a) an immunological method; and

(b) a chemical method (except reagent strip or dip-stick);

each test, to a maximum of 3 tests taken on separate days in a 28 day period

8.80”.

3.13   Items 66235, 66237, 66405, 66407, 66409, 66411, 66413, 69229, 69231, 69233, 69235 and 69237:

Add at the end:

“(Item is subject to rule 6)”.

3.14   Item 66241:

Omit the item, substitute:

“66241

Tests described in item 66235, if rendered under a request referred to in subparagraph (2) (a) (iii) of rule 6

(Item is subject to rule 6)

8.20”.

3.15   Item 66317:

Omit the item, substitute:

“66317

Quantitation of HDL cholesterol or apolipoprotein B/A1 ratio in a patient who:

(a) has a serum cholesterol level >5.5 mmol/1; or

(b) has a fasting serum triglyceride level >2.0 mmol/1; or

(c) is on a lipid lowering drug prescribed by a medical practitioner;

each episode to a maximum of 4 episodes in a 12 month period

(Item is subject to rule 7A)

12.35”.

3.16   New items 66327 and 66329:

After item 66325, insert:

“66327

TSH—quantitation, requested as a preliminary test to thyroid function testing

31.55

66329

Thyroid function tests (comprising the service described in item 66327 and 1 or more of the following tests—estimation of free thyroxine index, free thyroxine, free T3, total T3, thyroxine binding globulin) in respect of a patient, if at least one of the following conditions is satisfied:

(a) the patient has an abnormal level of TSH;

41.00”.

(b) the tests are performed for the purpose of:

  • (i)

    monitoring thyroid disease in the patient; or

  • (ii)

    if the patient is in a hospital—investigating thyroid function in the patient; or

  • (iii)

    investigating dementia or psychiatric illness of the patient; or

  • (iv)

    investigating amenorrhoea or infertility of the patient;

(c) the medical practitioner who requested the tests suspects the patient has pituitary dysfunction;

(d) the patient is on drugs that interfere with thyroid hormone metabolism or function

(Item is subject to rule 7B)

3.17   Item 66417:

Omit the item, substitute:

“66417

Tests described in item 66405, if rendered under a request referred to in subparagraph (2) (a) (iii) of rule 6

(Item is subject to rule 6)

11.05

“66419

Oral glucose test that includes the following:

(a) administration of glucose;

(b) at least 3 estimations of blood glucose;

(c) 1 or more of the tests (other than those described in paragraph (a) or (b)) described in item 66405

17.70”.

3.18   Item 69229:

Omit “Schedule”, substitute “Schedule—1 test”.

3.19   Item 69241:

Omit the item, substitute:

“69241

Tests described in item 69229, if rendered under a request referred to in subparagraph (2) (a) (iii) of rule 6

(Item is subject to rule 6)

7.40”.

3.20   Item 73921:

Add at the end:

“(Item is subject to subrule 11 (9))”.

3.21   Part 3, Division B:

After “Blood—culture”, insert:

“Blood—faecal occult FOB 66221”.

3.22   Part 3, Division B:

After “Electrophoresis, to demonstrate—lactate dehydrogenase isoenzymes”, insert:

“Electrophoresis, to demonstrate—lipoprotein subclasses LEPG 66250”.

3.23   Part 3, Division B (“Electrophoresis, to demonstrate—protein classes, or paraprotein”):

Omit “66249, 66250”, substitute “66249”.

3.24   Part 3, Division B, new entry:

After “Factor XIII deficiency test”, insert:

“Faecal blood FOB 66221”.

3.25   Part 3, Division B (“Glucose—tolerance test”):

Omit “66201”, substitute “66419”.

3.26   Part 3, Division B (“Hormones—thyroid stimulating hormone (where not requested on its own or as part of TFTs)”):

Omit the entry.

3.27   Part 3, Division B (“Thyroid—function tests”):

Omit the entry, substitute:

“Thyroid function tests (including TSH) TFT 66329”.

3.28   Part 3, Division B (“Thyroid-stimulating hormone (where not requested on its own or as part of TFTs)”):

Omit the entry, substitute:

“Thyroid stimulating hormone (if requested on its own, or as a preliminary test to thyroid function testing) TSH 66327

Thyroid stimulating hormone (if requested with other hormones referred to in item 66405)) TSH 66405”.

3.29   Part 3, Division B (“TSH (where not requested on its own or as part of a thyroid function test)”):

Omit the entry.

____________________________________________________________

NOTES

1. Notified in the Commonwealth of Australia Gazette on 31 October 1994.

2. Statutory Rules 1994 No. 233.

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