Health Insurance (1996-97 Diagnostic Imaging Services Table) Regulations (Cth)
made under the
This compilation was prepared on 7 August 2001
taking into account amendments up to SR 1997 No. 12
Prepared by the Office of Legislative Drafting,
Attorney-General’s Department, Canberra
Page
• • •
• • • • • • • • • • • • • • •
These Regulations may be cited as the Health Insurance
(1996-97 Diagnostic Imaging Services Table) Regulations.
These Regulations commence on 1 November 1996.
Statutory Rules 1995 No. 299 and 1996 No. 128 are repealed.
The table of diagnostic imaging services set out in the Schedule is prescribed for the purposes of subsection 4AA (1) of the
Health Insurance Act 1973 .
(regulation 4)
In this table, unless the contrary intention appears:
the Act means theHealth Insurance Act 1973 .
A reference by number to an item in the series 11603 to 11612 (inclusive) is a reference to the item so numbered in the general medical services table.
(1) An item including the symbol
(R) is an R-type diagnostic imaging service.(2) An item including the symbol
(NR) is an NR-type diagnostic imaging service.
An item including the symbol
(S) applies only to a service provided by a specialist in the practice of diagnostic radiology.
A diagnostic imaging service set out in this table is a diagnostic imaging service for the purposes of the Act, whether the service is provided by:
(a) a medical practitioner; or
(b) a person, other than a medical practitioner, who:
(i) is employed by a medical practitioner; or
(ii) provides the service under the supervision of a medical practitioner in accordance with accepted medical practice.
In items 55028 to 61109 (inclusive),
report means a report prepared by a medical practitioner.
If a general anaesthetic is administered in connection with a service specified in an item that includes the formula:
Anaes. n = n1 B + n2 T
in which:
(a)
n is a number; and(b)
n1 andn2 are other numbers;the service that is provided by the medical practitioner who administers the anaesthetic is the service described in item n in the general medical services table.
In this table,
group of practitioners has the same meaning as in subsection 16A (10) of the Act.
(1) In items 55028 to 55033 (inclusive),
medical practitioner in the phrasereferred by a medical practitioner orthe referring medical practitioner includes a dental practitioner who is approved by the Minister under paragraph (b) of the definition ofprofessional service in subsection 3 (1) of theHealth Insurance Act 1973 .(2) In items 55050 to 55053 (inclusive),
medical practitioner in the phrasereferred by a medical practitioner or the referring medical practitioner includes a dental practitioner who is:(a) approved by the Minister under paragraph (b) of the definition of
professional service in subsection 3 (1) of theHealth Insurance Act 1973 ; or(b) a prosthodontist.
In items 59103 and 59739,
Amount under rule 10 means an amount equal to the sum of:
(a) the fee set out in another item for the radiographic examination in conjunction with which a service referred to in item 59103 or 59739 is provided; and
(b) 1 of the following amounts:
(i) in the case of item 59103 — $21.10;
(ii) in the case of item 59739 — $22.40.
Items 60903 to 60981 (inclusive) apply only to the preparation of a patient for a radiological procedure for a service to which an item in Group I3 applies by:
(a) injecting opaque or contrast media; or
(b) removing fluid and replacing it with air, oxygen or other contrast media; or
(c) a similar method.
In item 61109,
angiography suite means a room that contains only equipment designed for angiography that is able to perform digital subtraction or rapid sequence film angiography.
Items 61302 to 61503 (inclusive) apply to a nuclear scanning service only if:
(a) the performance of the scan is undertaken:
(i) by a specialist or consultant physician; or
(ii) by a person acting on behalf of a specialist or consultant physician in the presence of the specialist or consultant physician; and
(b) the compilation of the final report is undertaken by the specialist or consultant physician who undertook the preliminary examination of the patient and the estimation and administration of the dosage.
In item 61462,
Amount under rule 14 means an amount equal to the sum of:
(a) the fee set out in the item in group I4 in conjunction with which a service referred to in item 61462 is provided; and
(b) $110.00.
(1) If a medical practitioner renders 2 or more diagnostic imaging services for the same patient on the same day, the fees set out in the items that apply to the services, other than the item with the highest fee, are reduced by $5.00.
(2) If a medical practitioner renders:
(a) at least 1 R-type diagnostic imaging service; and
(b) at least 1 consultation;
for the same patient on the same day, the highest fee, set out in the items that apply to any diagnostic imaging services rendered by the medical practitioner for the same patient on the same day, is reduced by the least of:
(c) if the fee for the consultation is at least $40.00-$35.00; or
(d) if the fee for the consultation is less than $40.00-$15.00; or
(e) that fee.
(3) Subrule (2) only applies to the consultation for which the highest fee is set out in the items that apply to the consultations.
(4) If a medical practitioner renders:
(a) at least 1 R-type diagnostic imaging service; and
(b) at least 1 non-consultation service;
for the same patient on the same day, the highest fee, set out in the items that apply to any diagnostic imaging services rendered by the medical practitioner for the same patient on the same day, is reduced by $5.00.
(5) If a medical practitioner renders:
(a) an R-type diagnostic imaging service; and
(b) a consultation; and
(c) a non-consultation service;
for the same patient on the same day, the sum of the reductions under subrules (2) and (4) is not to exceed the highest fee set out in the items that apply to any diagnostic imaging services rendered by the medical practitioner for the same patient on the same day.
(6) This rule does not apply to diagnostic imaging services that are rendered in a remote area by a medical practitioner for whom a remote area exemption under section 23DX of the Act is in force for that area.
(7) In this rule:
consultation means a service under an item listed in Groups A1 to A9 of the general medical services table.non-consultation service means a service under an item listed in the general medical service table other than in Groups A1 to A9.(8) A reference in this rule to a
highest fee is a reference to a fee for an item in the first claim processed by the Commission for which subrule (1), (2) or (4) applies.
55028 | Head, ultrasound scan of, performed by, or on behalf of, a medical practitioner where:
| $98.75 |
55029 | Head, ultrasound scan of, where the patient is not referred by a medical practitioner, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies (NR) | $34.25 |
55030 | Orbital contents, ultrasound scan of, performed by, or on behalf of, a medical practitioner where:
| $98.75 |
55031 | Orbital contents, ultrasound scan of, where the patient is not referred by a medical practitioner, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies (NR) | $34.25 |
55032 | Neck, 1 or more structures of, ultrasound scan of, performed by, or on behalf of, a medical practitioner where:
| $98.75 |
55033 | Neck, 1 or more structures of, ultrasound scan of, where the patient is not referred by a medical practitioner, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies (NR) | $34.25 |
55034 | Breast, 1 or both, ultrasound scan of, performed by, or on behalf of, a medical practitioner where:
| $98.75 |
55035 | Breast, 1 or both, ultrasound scan of, where the patient is not referred by a medical practitioner, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies (NR) | $34.25 |
55036 | Abdomen, ultrasound scan of, including scan of urinary tract when undertaken, performed by, or on behalf of, a medical practitioner where:
| $98.75 |
55037 | Abdomen, ultrasound scan of, including scan of urinary tract when undertaken, where the patient is not referred by a medical practitioner, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies (NR) | $34.25 |
55038 | Urinary tract, ultrasound scan of, performed by, or on behalf of, a medical practitioner where:
| $98.75 |
55039 | Urinary tract, ultrasound scan of, where the patient is not referred by a medical practitioner, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies (NR) | $34.25 |
55040 | Pelvis or abdomen, pregnancy related or pregnancy complication, ultrasound scan of, by any or all approaches, performed by, or on behalf of, a medical practitioner where:
| $98.75 |
55041 | Pelvis or abdomen, pregnancy related or pregnancy complication, ultrasound scan of, by any or all approaches, where the patient is not referred by a medical practitioner for ultrasonic examination — each ultrasonic examination, not exceeding 2 examinations in any 1 pregnancy, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies (NR) | $34.25 |
55042 | Pelvis, female, ultrasound scan of, by any or all approaches, performed by, or on behalf of, a medical practitioner where:
| $98.75 |
55043 | Pelvis, female, ultrasound scan of, by any or all approaches, where the patient is not referred by a medical practitioner, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies (NR) | $34.25 |
55044 | Pelvis, male, ultrasound scan of, by any or all approaches, performed by, or on behalf of, a medical practitioner where:
| $98.75 |
55045 | Pelvis, male, ultrasound scan of, by any or all approaches, where the patient is not referred by a medical practitioner, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies (NR) | $34.25 |
55048 | Scrotum, ultrasound scan of, performed by, or on behalf of, a medical practitioner where:
| $99.15 |
55049 | Scrotum, ultrasound scan of, where the patient is not referred by a medical practitioner, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies (NR) | $34.25 |
55050 | Musculo-skeletal, 1 or more regions, ultrasound scan of, performed by, or on behalf of, a medical practitioner where:
| $99.15 |
55051 | Musculo-skeletal, 1 or more regions, ultrasound scan of, where the patient is not referred by a medical practitioner, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies (NR) | $34.25 |
55052 | Joint, 1 or more, ultrasound scan of, performed by, or on behalf of, a medical practitioner where:
| $98.75 |
55053 | Joint, 1 or more, ultrasound scan of, where the patient is not referred by a medical practitioner, not being a service associated with a service to which item 55055, or an item in Subgroup 2 or 3 of this Group, applies (NR) | $34.25 |
55054 | Ultrasonic cross-sectional echography, in conjunction with a surgical procedure using interventional techniques, not being a service associated with a service to which any other item in this Group applies (R) | $98.75 |
55055 | Orbital contents, ultrasonic echography of, unidimensional, not being a service associated with a service to which another item in this Group applies (NR) | $59.80 |
55056 | Ultrasound scan not otherwise specified, not being a service associated with a service to which item 55055 or an item in Subgroup 2 or 3 of this Group applies (R) | $5.20 |
55057 | Ultrasound scan not otherwise specified, not being a service associated with a service to which item 55055 or an item in Subgroup 2 or 3 of this Group applies (NR) | $5.20 |
55058 | Measurement of umbilical blood flow using pulsed wave or continuous wave Doppler techniques after the 26th week of gestation where the patient is referred by a medical practitioner for this procedure and where there is reason to suspect intrauterine growth retardation or a significant risk of foetal death, not being a service associated with a service to which an item in this Group applies — examination and report (R) | $26.95 |
55102 | M-Mode and 2 dimensional real time echocardiographic examination of the heart from at least 2 thoracic windows, performed using a mechanical sector scanner or phased array transducer, with measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave Doppler techniques, with recordings on video tape, not being a service associated with a service to which an item in Subgroup 1 (with the exception of item 55054) or 4 of this Group applies (R) | $162.05 |
55105 | M-Mode and 2 dimensional real time echocardiographic examination of the heart from at least 2 thoracic windows, performed using a mechanical sector scanner or phased array transducer, with measurement of cardiac dimensions, with recordings on video tape, not being a service associated with a service to which an item in Subgroup 1 (with the exception of item 55054) or 4 of this Group applies (R) | $91.70 |
55112 | M-Mode and 2 dimensional real time echocardiographic examination of the heart from at least 2 thoracic windows, performed using a mechanical sector scanner or phased array transducer, with measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave Doppler techniques, and real time colour flow mapping from at least 2 thoracic windows, with recordings on video tape, not being a service associated with a service to which an item in Subgroup 1 (with the exception of item 55054) or 4 of this Group applies (R) | $254.65 |
55118 | Heart, 2 dimensional real time transoesophageal examination of, from at least 2 oesophageal windows performed using a mechanical sector scanner or phased array transducer, with measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous Doppler techniques, and real time colour flow mapping from at least 2 oesophageal windows, with recordings on video tape, not being a service associated with a service to which an item in Subgroup 1 (with the exception of item 55054) or 4 of this Group applies (R) (Anaes. 17708 = 6B + 2T) | $254.10 |
55130 | Intra-operative 2 dimensional real time transoesophageal echocardiography incorporating Doppler techniques with colour flow mapping and recording onto video tape, performed during cardiac surgery, incorporating sequential assessment of cardiac function before and after the surgical procedure (R) (Anaes. 17710 = 6B + 4T) | |
$367.95 | ||
55201 | Duplex scanning (unilateral or bilateral) involving B mode ultrasound imaging and integrated Doppler flow measurement by spectral analysis of:
not being a service associated with a service to which an item in Subgroup 1 (with the exception of item 55054) or 4 of this Group applies — 1 examination and report (R) | $170.60 |
55204 | Two or more examinations of the kind referred to in item 55201 and report, not being a service associated with a service to which an item in Subgroup 1 (with the exception of item 55054) or 4 of this Group applies (R) | $300.70 |
55207 | Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurement by spectral analysis of the cavernosal artery of the penis following intracavernosal administration of a vasoactive agent, performed during the period of pharmacological activity of the injected agent, to confirm a diagnosis of vascular aetiology for impotence, where a specialist in diagnostic radiology, nuclear medicine, urology, general surgery (sub-specialising in vascular surgery) or a consultant physician in nuclear medicine attends the patient in person at the practice location where the service is rendered, immediately prior to or for a period during the rendering of the service, and that specialist interprets the results and prepares a report, not being a service associated with a service to which an item in Subgroup 1 (except item 55054) or 4 of this Group applies — examination and report (R) | $170.60 |
55210 | Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurement by spectral analysis of cavernosal tissue of the penis to confirm a diagnosis and, where indicated, assess the progress and management of:
where a specialist in diagnostic radiology, nuclear medicine, urology, general surgery (sub-specialising in vascular surgery) or a consultant physician in nuclear medicine attends the patient in person at the practice location where the service is rendered, immediately prior to or for a period during the rendering of the service, and that specialist interprets the results and prepares a report, not being a service associated with a service to which an item in Subgroup 1 (with the exception of item 55054) or 4 of this Group applies — examination and report (R). | $170.60 |
55225 | Duplex scanning (unilateral or bilateral) involving B mode ultrasound imaging and integrated Doppler flow measurement by spectral analysis of carotid vessels, with oculoplethysmography, not being a service associated with a service to which an item in Subgroup 1 (with the exception of item 55054) or 4 of this Group applies — examination and report (R) | $205.00 |
55231 | Duplex scanning (unilateral or bilateral) involving B mode ultrasound imaging and integrated Doppler flow measurement by spectral analysis of peripheral vessels (excluding the cavernosal artery and dorsal artery of the penis) and carotid vessels, with oculoplethysmography, not being a service associated with a service to which an item in Subgroup 1 (with the exception of item 55054) or 4 of this Group applies — examination and report (R) | $341.05 |
55234 | Duplex scanning (unilateral or bilateral) involving B mode ultrasound imaging and integrated Doppler flow measurement by spectral analysis of peripheral vessels (excluding the cavernosal artery and dorsal artery of the penis), including a service referred to in item 11603, 11606 or 11609, not being a service associated with a service to which an item in Subgroup 1 (with the exception of item 55054) or 4 of this Group applies — examination and report (R) | $198.30 |
55237 | Duplex scanning (unilateral or bilateral) involving B mode ultrasound imaging and integrated Doppler flow measurement by spectral analysis of peripheral vessels before measured exercise using treadmill or bicycle ergometer, and measurement of pressure:
not being a service associated with a service to which an item in Subgroup 1 (with the exception of item 55054) or 4 of this Group applies — examination and report (R) | $219.95 |
55300 | Prostate, bladder base and urethra, transrectal ultrasound scan of, where performed:
| $98.75 |
56001 | Computerised tomography — scan of brain without intravenous contrast medium, not being a service to which item 57001 applies (R) | $195.15 |
56007 | Computerised tomography — scan of brain with intravenous contrast medium and with any scans prior to intravenous contrast injection when undertaken, not being a service to which item 57007 applies (R) | $249.20 |
56010 | Computerised tomography — scan of pituitary fossa with or without intravenous contrast medium and with or without brain scan when undertaken (R) | $282.35 |
56013 | Computerised tomography — scan of orbits with or without intravenous contrast medium and with or without brain scan when undertaken (R) | $282.35 |
56016 | Computerised tomography — scan of middle ear and temporal bone, unilateral or bilateral, with or without intravenous contrast medium and with or without brain scan when undertaken (R) | $336.25 |
56019 | Computerised tomography — scan of temporal bones with air study (including reconstructions), with intrathecal injection but not including an associated brain scan (R) | $413.10 |
56022 | Computerised tomography — scan of facial bones, para nasal sinuses or both without intravenous contrast medium (R) | $223.70 |
56028 | Computerised tomography — scan of facial bones, para nasal sinuses or both with intravenous contrast medium and with any scans prior to intravenous contrast injection when undertaken (R) | $332.95 |
56101 | Computerised tomography — scan of soft tissues of neck, including larynx, pharynx, upper oesophagus and salivary glands (not associated with cervical spine) without intravenous contrast medium, not being a service to which item 56801 applies (R) | $230.05 |
56107 | Computerised tomography — scan of soft tissues of neck, including larynx, pharynx, upper oesophagus and salivary glands (not associated with cervical spine) with intravenous contrast medium and with any scans prior to intravenous contrast injection when undertaken, not being a service to which item 56807 applies (R) | $339.25 |
56210 | Computerised tomography — scan of spine, 1 or more regions, without intravenous contrast medium, payable once only, whether 1 or more attendances are required to complete the service (R) | $242.15 |
56216 | Computerised tomography — scan of spine, 1 or more regions, with intravenous contrast medium and with any scans prior to intravenous contrast injection when undertaken, payable once only, whether 1 or more attendances are required to complete the service (R) | $350.90 |
56219 | Computerised tomography — scan of spine, 1 or more regions with intrathecal contrast medium, including the preparation for intrathecal injection of contrast medium and any associated plain X-rays, not being a service to which item 59724, 59727 or 59730 applies and not in association with item 60957 (R) | $325.80 |
56301 | Computerised tomography — scan of chest, including lungs, mediastinum, chest wall and pleura, with or without scans of the upper abdomen, without intravenous contrast medium, not being a service to which item 56801 or 57001 applies (R) | $295.55 |
56307 | Computerised tomography — scan of chest, including lungs, mediastinum, chest wall and pleura, with or without scans of the upper abdomen, with intravenous contrast medium and with any scans prior to intravenous contrast injection when undertaken, not being a service to which item 56807 or 57007 applies (R) | $399.80 |
56401 | Computerised tomography — scan of upper abdomen only (diaphragm to iliac crest) without intravenous contrast medium, not being a service to which item 56301, 56501, 56801 or 57001 applies (R) | $250.75 |
56407 | Computerised tomography — scan of upper abdomen only (diaphragm to iliac crest) with intravenous contrast medium, and with any scans prior to intravenous contrast injection, when undertaken, not being a service to which item 56307, 56507, 56807 or 57007 applies (R) | $358.75 |
56409 | Computerised tomography — scan of pelvis only (iliac crest to pubic symphysis) without intravenous contrast medium, not being a service associated with a service to which item 56401 applies (R) | $250.75 |
56412 | Computerised tomography — scan of pelvis only (iliac crest to pubic symphysis) with intravenous contrast medium and with any scans prior to intravenous contrast injection, when undertaken, not being a service associated with a service to which item 56407 applies (R) | $358.75 |
56501 | Computerised tomography — scan of upper abdomen and pelvis without intravenous contrast medium, not being a service to which item 56801 or 57001 applies (R) | $381.80 |
56507 | Computerised tomography — scan of upper abdomen and pelvis with intravenous contrast medium and with any scans prior to intravenous contrast injection, when undertaken, not being a service to which item 56807 or 57007 applies (R) | $481.80 |
56619 | Computerised tomography — scan of extremities, 1 or more regions without intravenous contrast medium, payable once only, whether 1 or more attendances are required to complete the service (R) | $221.60 |
56625 | Computerised tomography — scan of extremities, 1 or more regions with intravenous contrast medium and with any scans prior to intravenous contrast injection, when undertaken, payable once only, whether 1 or more attendances are required to complete the service (R) | $330.85 |
56801 | Computerised tomography — scan of chest, abdomen and pelvis, with or without scans of soft tissues of neck, without intravenous contrast medium (R) | $461.15 |
56807 | Computerised tomography — scan of chest, abdomen and pelvis, with or without scans of soft tissues of neck, with intravenous contrast medium and with any scans prior to intravenous contrast injection, when undertaken (R) | $561.15 |
57001 | Computerised tomography — scan of brain and chest, with or without scans of upper abdomen, without intravenous contrast medium (R) | $461.25 |
57007 | Computerised tomography — scan of brain and chest, with or without scans of upper abdomen, with intravenous contrast medium and with any scans prior to intravenous contrast injection, when undertaken (R) | $561.25 |
57201 | Computerised tomograph-pelvimetry (R) | $153.45 |
57341 | Computerised tomography, in conjunction with a surgical procedure using interventional techniques, not being a service associated with a service to which another item in this table applies (R) | $478.45 |
57350 | Computerised tomography — spiral angiography with intravenous contrast medium and with any scans prior to intravenous contrast injection, when undertaken — or more spiral data acquisitions, including image editing, and maximum intensity projections or 3 dimensional surface shaded display, including multiple projections, not being a service to which another item in this Group applies (R) | $522.20 |
57506 | Hand, wrist, forearm, elbow or humerus (NR) | $30.85 |
57509 | Hand, wrist, forearm, elbow or humerus (R) | $41.15 |
57512 | Hand, wrist and forearm, or forearm and elbow, or elbow and humerus (NR) | $41.90 |
57515 | Hand, wrist and forearm, or forearm and elbow, or elbow and humerus (R) | $55.90 |
57518 | Foot, ankle, leg, knee or femur (NR) | $33.70 |
57521 | Foot, ankle, leg, knee or femur (R) | $44.95 |
57524 | Foot and ankle, or ankle and leg, or leg and knee, or knee and femur (NR) | $51.10 |
57527 | Foot and ankle, or ankle and leg, or leg and knee, or knee and femur (R) | $68.10 |
57700 | Shoulder or scapula (NR) | $41.90 |
57703 | Shoulder or scapula (R) | $55.90 |
57706 | Clavicle (NR) | $33.70 |
57709 | Clavicle (R) | $44.95 |
57712 | Hip joint (R) | $48.80 |
57715 | Pelvic girdle (R) | $63.15 |
57721 | Femur, internal fixation of neck or intertrochanteric (pertrochanteric) fracture (R) | $102.75 |
57900 | Skull or cephalometry (R) | $66.80 |
57903 | Sinuses (R) | $48.80 |
57906 | Mastoids (R) | $66.80 |
57909 | Petrous temporal bones (R) | $66.80 |
57912 | Facial bones — orbit, maxilla or malar, any or all (R) | $48.80 |
57915 | Mandible, not by orthopantomography technique (R) | $48.80 |
57918 | Salivary calculus (R) | $48.80 |
57921 | Nose (R) | $48.80 |
57924 | Eye (R) | $48.80 |
57927 | Temporo-mandibular joints (R) | $51.40 |
57930 | Teeth — single area (R) | $34.05 |
57933 | Teeth — full mouth (R) | $80.95 |
57936 | Teeth — orthopantomography (R) | $49.00 |
57939 | Palato-pharyngeal studies with fluoroscopic screening (R) | $66.80 |
57942 | Palato-pharyngeal studies without fluoroscopic screening (R) | $51.40 |
57945 | Larynx, lateral airways and soft tissues of the neck, not being a service associated with a service to which item 57939 or 57942 applies (R) | $44.95 |
58100 | Spine — cervical (R) | $69.55 |
58103 | Spine — thoracic (R) | $57.15 |
58106 | Spine — lumbo-sacral (R) | $79.70 |
58109 | Spine — sacro-coccygeal (R) | $48.60 |
58112 | Spine — 2 regions (R) | $100.70 |
58115 | Spine — 3 or more regions (R) | $137.65 |
58300 | Bone age study (R) | $41.50 |
58306 | Skeletal survey (R) | $92.55 |
Subgroup 6 — Radiographic Examination of Thoracic Region and Report | ||
58500 | Chest (lung fields) by direct radiography (NR) | $36.60 |
58503 | Chest (lung fields) by direct radiography (R) | $48.80 |
58506 | Chest (lung fields) by direct radiography with fluoroscopic screening (R) | $62.95 |
58509 | Thoracic inlet or trachea (R) | $41.15 |
58521 | Left ribs, right ribs or sternum (R) | $44.95 |
58524 | Left and right ribs, left ribs and sternum, or right ribs and sternum (R) | $58.45 |
58527 | Left ribs, right ribs and sternum (R) | $71.95 |
58700 | Plain renal only (R) | $48.80 |
58706 | Intravenous pyelography, including preliminary plain film (R) | $128.25 |
58709 | Intravenous pyelography, including preliminary plain film and limited tomography, involving up to 3 tomographic cuts (R) | $159.70 |
58715 | Antegrade or retrograde pyelography including preliminary plain film (R) | $102.75 |
58718 | Retrograde cystography or retrograde urethrography (R) (Anaes. 17705 = 3B + 2T) | $68.10 |
58721 | Retrograde micturating cysto-urethrography (R) (Anaes. 17705 = 3B + 2T) | $80.95 |
58900 | Plain abdominal only, not being a service associated with a service to which item 58909, 58912, 58915 or 58924 applies (NR) | $36.60 |
58903 | Plain abdominal only, not being a service associated with a service to which item 58909, 58912, 58915 or 58924 applies (R) | $48.80 |
58906 | Oesophagus, with or without examination for foreign body or barium swallow (R) | $69.40 |
58909 | Barium or other opaque meal of oesophagus, stomach and duodenum, with or without screening of chest and with or without preliminary plain film (R) | $95.10 |
58912 | Barium or other opaque meal of oesophagus, stomach, duodenum and follow through to colon, with or without screening of chest and with or without preliminary plain film (R) | $113.10 |
58915 | Barium or other opaque meal, small bowel series only, with or without preliminary plain film (R) | $80.95 |
58918 | Opaque enema (R) | $95.10 |
58921 | Opaque enema, including air contrast study (R) | $113.10 |
58924 | Graham's test (cholecystography), including preliminary abdominal radiography (R) | $80.95 |
58927 | Cholegraphy direct — operative or post-operative (R) | $78.40 |
58933 | Cholegraphy — percutaneous transhepatic (R) | $92.55 |
58936 | Cholegraphy — drip infusion (R) | $154.20 |
58939 | Defaecogram (R) | $142.90 |
59103 | Foreign body, localisation of and report, not being a service to which another item in this Group applies (R) | Amount under rule 10 |
59300 | Radiographic examination of both breasts, (with or without thermography) and report if:
| $80.95 |
59303 | Radiographic examination of 1 breast, (with or without thermography) and report if:
| $48.80 |
59306 | Mammary ductogram (galactography) — 1 breast (R) | $93.35 |
59309 | Mammary ductogram, (galactography) — 2 breasts (R) | $186.75 |
59503 | Pelvimetry, not being a service associated with a service to which item 57200 applies (R) | $92.55 |
59700 | Discography — 1 disc (R) | $71.95 |
59703 | Dacryocystography — 1 side (R) | $48.80 |
59712 | Hysterosalpingography (R) | $69.40 |
59718 | Phlebography — 1 side (R) | $102.75 |
59724 | Myelography — 1 region, not being a service associated with a service to which item 56219 applies (R) | $123.35 |
59727 | Myelography — 2 regions, not being a service associated with a service to which item 56219 applies (R) | $205.70 |
59730 | Myelography — 3 regions, not being a service associated with a service to which item 56219 applies(R) | $277.95 |
59733 | Sialography — 1 side (R) | $69.40 |
59736 | Vasoepididymography — 1 side (R) | $69.40 |
59739 | Sinuses and fistulae (R) | Amount under rule 10 |
59745 | Pneumoarthrography (R) | $43.70 |
59748 | Arthrography — contrast (R) | $51.40 |
59751 | Arthrography — double contrast (R) | $89.95 |
59754 | Lymphangiography, including initial and delayed radiography (R) | $68.10 |
59760 | Peritoneogram (herniography) with or without contrast medium including preparation — performed on a person over 14 years of age (R) | $119.20 |
59763 | Air insufflation during video-fluoroscopic imaging, including associated consultation (R) | $138.60 |
Subgroup 13 — Angiography and Report | ||
59900 | Serial angiocardiography (rapid cassette changing) — each series (R) (Anaes. 17711 = 7B + 4T) | $86.60 |
59903 | Serial angiocardiography (single plane) — each series (R) (Anaes. 17711 = 7B + 4T) | $119.20 |
59906 | Serial angiocardiography (bi-plane) — each series (R) (Anaes. 17711 = 7B + 4T) | $119.20 |
59912 | Selective coronary arteriography (R) | $317.55 |
59915 | Cerebral angiography — 1 side (R) | |
$80.95 | ||
59918 | Arteriography, peripheral — 1 side (R) | $102.75 |
59921 | Aortography (R) | $102.75 |
59924 | Selective arteriography — per injection and film or data acquisition run (R) | $102.75 |
59970 | Angiography with fluoroscopy and image acquisition using a mobile image intensifier, 1 or more regions including any preliminary plain films, preparation and contrast injection (R) | $156.85 |
60000 | Digital subtraction angiography, examination of head and neck with or without arch aortography — 1 to 3 data acquisition runs (R) | $525.50 |
60003 | Digital subtraction angiography, examination of head and neck with or without arch aortography — 4 to 6 data acquisition runs (R) | $770.65 |
60006 | Digital subtraction angiography, examination of head and neck with or without arch aortography — 7 to 9 data acquisition runs (R) | $1,095.85 |
60009 | Digital subtraction angiography, examination of head and neck with or without arch aortography — 10 or more data acquisition runs (R) | $1,282.45 |
60012 | Digital subtraction angiography, examination of thorax — 1 to 3 data acquisition runs (R) | $525.50 |
60015 | Digital subtraction angiography, examination of thorax — 4 to 6 data acquisition runs (R) | $770.65 |
60018 | Digital subtraction angiography, examination of thorax — 7 to 9 data acquisition runs (R) | $1,095.85 |
60021 | Digital subtraction angiography, examination of thorax — 10 or more data acquisition runs (R) | $1,282.45 |
60024 | Digital subtraction angiography, examination of abdomen — 1 to 3 data acquisition runs (R) | $525.50 |
60027 | Digital subtraction angiography, examination of abdomen — 4 to 6 data acquisition runs (R) | $770.65 |
60030 | Digital subtraction angiography, examination of abdomen — 7 to 9 data acquisition runs (R) | $1,095.85 |
60033 | Digital subtraction angiography, examination of abdomen — 10 or more data acquisition runs (R) | $1,282.45 |
60036 | Digital subtraction angiography, examination of upper limb or limbs — 1 to 3 data acquisition runs (R) | $525.50 |
60039 | Digital subtraction angiography, examination of upper limb or limbs — 4 to 6 data acquisition runs (R) | $770.65 |
60042 | Digital subtraction angiography, examination of upper limb or limbs — 7 to 9 data acquisition runs (R) | $1,095.85 |
60045 | Digital subtraction angiography, examination of upper limb or limbs — 10 or more data acquisition runs (R) | $1,282.45 |
60048 | Digital subtraction angiography, examination of lower limb or limbs — 1 to 3 data acquisition runs (R) | $525.50 |
60051 | Digital subtraction angiography, examination of lower limb or limbs — 4 to 6 data acquisition runs (R) | $770.65 |
60054 | Digital subtraction angiography, examination of lower limb or limbs — 7 to 9 data acquisition runs (R) | $1,095.85 |
60057 | Digital subtraction angiography, examination of lower limb or limbs — 10 or more data acquisition runs (R) | $1,282.45 |
60060 | Digital subtraction angiography, examination of aorta and lower limb or limbs — 1 to 3 data acquisition runs (R) | $525.50 |
60063 | Digital subtraction angiography, examination of aorta and lower limb or limbs — 4 to 6 data acquisition runs (R) | $770.65 |
60066 | Digital subtraction angiography, examination of aorta and lower limb or limbs — 7 to 9 data acquisition runs (R) | $1,095.85 |
60069 | Digital subtraction angiography, examination of aorta and lower limb or limbs — 10 or more data acquisition runs (R) | $1,282,45 |
60072 | Selective arteriography or selective venography by digital subtraction angiography technique — 1 vessel (NR) | $44.80 |
60075 | Selective arteriography or selective venography by digital subtraction angiography technique — 2 vessels (NR) | $89.60 |
60078 | Selective arteriography or selective venography by digital subtraction angiography technique — 3 or more vessels (NR) | $134.35 |
60100 | Tomography of any region and report (R) | $62.95 |
60500 | Fluoroscopy, with general anaesthesia (not being a service associated with a radiographic examination) (R) (Anaes. 17707 = 5B + 2T) | $44.95 |
60503 | Fluoroscopy, without general anaesthesia (not being a service associated with a radiographic examination) (R) | $30.85 |
60506 | Fluoroscopy using a mobile image intensifier, in conjunction with a surgical procedure lasting less than 1 hour, not being a service associated with a service to which another item in this table applies (R) | $66.05 |
60509 | Fluoroscopy using a mobile image intensifier, in conjunction with a surgical procedure lasting 1 hour or more, not being a service associated with a service to which another item in this table applies (R) | $102.35 |
60700 | Radiographic examination of region and report, not being a service to which another item in this Group applies (R) | $5.20 |
60903 | Cerebral angiography — 1 side — percutaneous, catheter or open exposure (NR) (Anaes. 17710 = 5B + 5T) | $132.75 |
60909 | Dacryocystography — 1 side (NR) | $41.15 |
60915 | Aortography (NR) (Anaes. 17709 = 5B + 4T) | $73.10 |
60918 | Arteriography (peripheral) or phlebography — 1 vessel (NR) (Anaes. 17708 = 5B + 3T) | $54.50 |
60927 | Selective arteriogram or phlebogram (NR) (Anaes. 17708 = 5B + 3T) | $45.00 |
60930 | Percutaneous injection of opaque contrast into renal cyst (including aspiration) or renal pelvis for antegrade pyelography (NR) | $62.95 |
60933 | Pneumoarthrography or pneumoperitoneum (NR) | $50.10 |
60936 | Single or double contrast arthrography, excluding arthrography of the joints between articular processes of the vertebrae (NR) | $50.20 |
60939 | Drip-infusion cholegraphy (NR) | $37.65 |
60942 | Retrograde or percutaneous micturating cystourethrography or cystography or urethrography (NR) | $70.65 |
60945 | Hysterosalpingography (NR) (Anaes. 17705 = 3B + 2T) | $62.95 |
60948 | Discography — 1 disc (NR) (Anaes. 17707 = 5B + 2T) | $41.15 |
60957 | Myelography (NR) (Anaes. 17712 = 7B + 5T) | $123.35 |
60966 | Sinus or fistula (NR) | $21.35 |
60969 | Sialography (NR) | $56.10 |
60972 | Lymphangiography — 1 side (NR) | $123.35 |
60981 | Percutaneous transhepatic cholangiogram (NR) (Anaes. 17709 = 4B + 5T) | $123.35 |
61109 | Fluoroscopy in an angiography suite with image intensification, in conjunction with a surgical procedure using interventional techniques, not being a service associated with a service to which another item in this table applies (R) | $268.05 |
61302 | Single stress or rest myocardial perfusion study with thallium or sestamibi — planar imaging (R) | $379.00 |
61303 | Single stress or rest myocardial perfusion study with thallium or sestamibi, with single photon emission tomography and with planar imaging when undertaken (R) | $489.00 |
61306 | Combined stress and rest, stress and re-injection, or rest and redistribution, myocardial perfusion study with thallium or sestamibi, or both, including delayed imaging or re-injection protocol on a subsequent occasion — planar imaging (R) | $599.25 |
61307 | Combined stress and rest, stress and re-injection, or rest and redistribution, myocardial perfusion study with thallium or sestamibi, or both, including delayed imaging or re-injection protocol on a subsequent occasion, with single photon emission tomography and with planar imaging when undertaken (R) | $729.25 |
61310 | Myocardial infarct-avid study, with planar imaging and single photon emission tomography, or planar imaging, or single photon emission tomography (R) | $310.15 |
61313 | Gated cardiac blood pool study (equilibrium), with planar imaging and single photon emission tomography, or planar imaging, or single photon emission tomography (R) | $261.00 |
61314 | Gated cardiac blood pool study, and first pass blood flow or cardiac shunt study, with planar imaging and single photon emission tomography, or planar imaging, or single photon emission tomography (R) | $359.50 |
61316 | Gated cardiac blood pool study, with intervention, with planar imaging and single photon emission tomography, or planar imaging, or single photon emission tomography (R) | $326.65 |
61317 | Gated cardiac blood pool study, with intervention and first pass blood flow study or cardiac shunt study, with planar imaging and single photon emission tomography, or planar imaging, or single photon emission tomography (R) | $420.60 |
61320 | Cardiac first pass blood flow study or cardiac shunt study, not being a service to which another item in this Group applies (R) | $193.30 |
61328 | Lung perfusion study, with planar imaging and single photon emission tomography, or planar imaging, or single photon emission tomography (R) | $183.50 |
61340 | Lung ventilation study using aerosol, technegas or xenon gas, with planar imaging and single photon emission tomography, or planar imaging, or single photon emission tomography (R) | $213.65 |
61348 | Lung perfusion study and lung ventilation study using aerosol, technegas or xenon gas, with planar imaging and single photon emission tomography, or planar imaging, or single photon emission tomography (R) | $376.80 |
61352 | Liver and spleen study (colloid) — planar imaging (R) | $219.00 |
61353 | Liver and spleen study (colloid), with single photon emission tomography and with planar imaging when undertaken (R) | $326.40 |
61356 | Red blood cell spleen or liver study, including single photon emission tomography when undertaken (R) | $331.65 |
61360 | Hepatobiliary study, including morphine administration or pre-treatment with cholecystokinin (CCK) when undertaken (R) | $344.50 |
61361 | Hepatobiliary study with formal quantification following baseline imaging, using an infusion of cholecystokinin (CCK) (R) | $394.50 |
61364 | Bowel haemorrhage study (R) | $419.60 |
61368 | Meckel’s diverticulum study (R) | $188.40 |
61372 | Salivary study (R) | $188.40 |
61373 | Gastro-oesophageal reflux study, including delayed imaging on a separate occasion when undertaken (R) | $413.50 |
61376 | Oesophageal clearance study (R) | $121.10 |
61381 | Gastric emptying study, using single tracer (R) | $509.25 |
61383 | Combined solid and liquid gastric emptying study using dual isotope technique or the same isotope on separate days (R) | $552.00 |
61384 | Radionuclide colonic transit study (R) | $609.80 |
61386 | Renal study, including perfusion and renogram images and computer analysis or cortical study with planar imaging (R) | $280.75 |
61387 | Renal cortical study, with single photon emission tomography and planar quantification (R) | $385.05 |
61389 | Single renal study with pre-procedural administration of a diuretic or angiotensin converting enzyme (ACE) inhibitor (R) | $312.95 |
61390 | Renal study with diuretic administration following a baseline study (R) | $346.20 |
61393 | Combined examination involving a renal study following angiotensin converting enzyme (ACE) inhibitor provocation and a baseline study, in either order and related to a single referral episode (R) | $521.00 |
61397 | Cystoureterogram (R) | $208.45 |
61401 | Testicular study (R) | $137.00 |
61402 | Brain study using TC-exametazine, with single photon emission tomography and with planar imaging when undertaken (R) | $510.90 |
61405 | Brain study with blood brain barrier agent, with planar imaging and single photon emission tomography, or planar imaging, or single photon emission tomography (R) | $292.20 |
61409 | Cerebro-spinal fluid transport study, with imaging on 2 or more separate occasions (R) | $737.60 |
61413 | Cerebro-spinal fluid shunt patency study (R) | $190.80 |
61417 | Dynamic blood flow study or regional blood volume quantitative study, not being a service associated with a service to which another item in this Group applies (R) | $100.30 |
61421 | Bone study — whole body, with, when undertaken, blood flow, blood pool and delayed imaging on a separate occasion (R) | $409.50 |
61425 | Bone study — whole body and single photon emission tomography, with, when undertaken, blood flow, blood pool and delayed imaging on a separate occasion (R) | $513.50 |
61426 | Whole body study using iodine (R) | $468.50 |
61429 | Whole body study using gallium (R) | $458.50 |
61430 | Whole body study using gallium, with single photon emission tomography (R) | $568.50 |
61433 | Whole body study using cells labelled with Technetium (R) | $419.60 |
61434 | Whole body study using cells labelled with Technetium, with single photon emission tomography (R) | $519.60 |
61437 | Whole body study using thallium (R) | $458.30 |
61438 | Whole body study using thallium, with single photon emission tomography (R) | $568.30 |
61441 | Bone marrow study — whole body (R) | $413.50 |
61446 | Localised bone or joint study, including when undertaken, blood flow, blood pool and repeat imaging on a separate occasion (R) | $285.05 |
61449 | Localised bone or joint study and single photon emission tomography, including when undertaken, blood flow, blood pool and imaging on a separate occasion (R) | $391.10 |
61450 | Localised study using gallium (R) | $335.70 |
61453 | Localised study using gallium, with single photon emission tomography (R) | $446.20 |
61454 | Localised study using cells labelled with Technetium (R) | $293.90 |
61457 | Localised study using cells labelled with technetium, with single photon emission tomography (R) | $397.30 |
61458 | Localised study using thallium (R) | $335.15 |
61461 | Localised study using thallium, with single photon emission tomography (R) | $445.70 |
61462 | Repeat planar and single photon emission tomography imaging, or repeat planar or single photon emission tomography imaging on a subsequent occasion where no fee has been paid for the first investigation and there is no additional administration of radiopharmaceutical agent, not being a service associated with items 61373, 61409, 61421, 61425, 61446, 61449, 61484 or 61485 (R) | Amount under rule 14 |
61465 | Venography (R) | $224.25 |
61469 | Lymphoscintigraphy (R) | $293.90 |
61473 | Thyroid study including uptake measurement when undertaken (R) | $150.00 |
61480 | Parathyroid study, including planar imaging and single photon emission tomography when undertaken (R) | $326.65 |
61484 | Adrenal study, with imaging on 2 or more separate occasions (R) | $743.80 |
61485 | Adrenal study, with imaging on 2 or more occasions and renal localisation and single photon emission tomography when undertaken (R) | $843.80 |
61495 | Tear duct study (R) | $188.40 |
61499 | Particle perfusion study (intra-arterial) or Le Veen shunt study (R) | $213.65 |
61503 | Study of region or organ, not being a service to which another item in this Group applies (R) | $5.20 |
The Health Insurance
(1996-97 Diagnostic Imaging Services Table) Regulations (in force under the
1996 No. 233 | 30 Oct 1996 | 1 Nov 1996 | |
1996 No. 337 | 24 Dec 1996 | 20 Jan 1997 | — |
1997 No. 12 | 19 Feb 1997 | 19 Feb 1997 | — |
1997 No. 297 | 31 Oct 1997 | 1 Nov 1997 | — |
am. = amended rep. = repealed rs. = repealed and substituted | |
Schedule................................. | am. 1996 No. 337; 1997 No. 12 |
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