Health Insurance (1998-99 Diagnostic Imaging Services Table) Amendment Regulations 1999 (No. 1) (Cth)

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Health Insurance (1998-99 Diagnostic Imaging Services Table) Amendment Regulations 1999 (No. 1)

Statutory Rules 1999No. 20

I, WILLIAM PATRICK DEANE, 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 23 February 1999.

WILLIAM DEANE

Governor-General

By His Excellency’s Command,

Michael wooldridge

Minister for Health and Aged Care

Health Insurance (1998-99 Diagnostic Imaging Services Table) Amendment Regulations 1999 (No. 1)1

Statutory Rules 1999

No. 202

made under the

Health Insurance Act 1973

   

Contents

Page

1Name of regulations

 These regulations are the Health Insurance (1998-99 Diagnostic Imaging Services Table) Amendment Regulations 1999 (No. 1).

2Commencement

 These regulations commence on 1 March 1999.

3Amendment of Health Insurance (1998-99 Diagnostic Imaging Services Table) Regulations 1998

Schedule 1 amends the Health Insurance (1998-99 Diagnostic Imaging Services Table) Regulations 1998.

Schedule 1Amendments

 (regulation 3)

[1]Schedule 1, Part 1, rule 1

insert

computed tomography means a service rendered (with or without intravenous contrast):

  • (a)

    using a detector coupled to an X-ray tube that emits a finely collimated X-ray beam as it rotates within a gantry around a patient either in incremental or helical manner; and

  • (b)

    registering a resulting variable amount of X-rays and transforming that information into a cross‑sectional image after the application of complex algorithms.

CT means computed tomography.

CT equipment includes the following components:

  • (a)

    a gantry;

  • (b)

    a couch;

  • (c)

    a computer;

  • (d)

    an operator station;

  • (e)

    a generator.

remote location means a place within Australia that is:

  • (a)

    more than 30 kilometres by road from a hospital that provides a radiology or computed tomography service under the direction of a specialist in the specialty of diagnostic radiology; or

  • (b)

    more than 30 kilometres by road from a free standing radiology or computed tomography facility under the direction of a specialist in the specialty of diagnostic radiology.

[2]Schedule 1, Part 1, rule 2

omit

 an item in the series

insert

 any of items 11240,

[3]Schedule 1, Part 1, after subrule 9

insert

9A Computed tomography services — meaning of (K) and (NK)

  • (1)

    In any of items 56001 to 57355, the symbol (K) means:

    • (a)

      for CT equipment that the Commission is satisfied was first installed and used as new equipment at a site in Australia:

      • (i)

        the service was rendered earlier than 10 years after the earliest date on which any component of the equipment was first installed and ready for use; or

      • (ii)

        the service was rendered in a remote location; or

    • (b)

      for CT equipment imported as pre-used equipment:

      • (i)

        the service was rendered earlier than 10 years after the earliest date of manufacture of any component of the equipment; or

      • (ii)

        the service was rendered in a remote location.

  • (2)

    In any of items 56001 to 57355, the symbol (NK) means the service was rendered 10 years or more after:

    • (a)

      for CT equipment that the Commission is satisfied was first installed and used as new equipment in Australia — the earliest date on which any component of the equipment was first installed and ready for use; or

    • (b)

      for CT equipment imported as pre-used equipment — the earliest date of manufacture of any component of the equipment.

  • (3)

    In this rule:

CT equipment imported as pre-used equipment means equipment that has been used to render CT services before being imported into Australia.

installed and ready for use, in relation to a component, means ready for immediate income‑producing purposes whether or not it is so used.

9BCT services — eligible services

 Items 56001 to 57355 apply only to a computed tomography service performed:

  • (a)

    under the professional supervision of a specialist in the specialty of diagnostic radiology who is available:

    • (i)

      to monitor and influence the conduct and diagnostic quality of the examination; and

    • (ii)

      if necessary — to personally attend on the patient; or

  • (b)

    if paragraph (a) cannot be complied with:

    • (i)

      in an emergency; or

    • (ii)

      because of medical necessity — in a remote location.

[4]Schedule 1, Part 1, after rule 10

insert

10AMammography services — eligible services

 Items 59300 to 59318 apply only to a mammography service performed:

  • (a)

    under the professional supervision of a specialist in the specialty of diagnostic radiology who is available:

    • (i)

      to monitor and influence the conduct and diagnostic quality of the examination; and

    • (ii)

      if necessary — to personally attend on the patient; or

  • (b)

    if paragraph (a) cannot be complied with:

    • (i)

      in an emergency; or

    • (ii)

      because of medical necessity — in a remote location.

[5]Schedule 1, Part 1, subparagraph 18 (b) (ii)

omit

 or rural

[6]Schedule 1, Part 1, subrule 20 (5), definition of comprehensive

omit

 computerised

insert

 computed

[7]Schedule 1, Part 2, items 55028 to 55053

omit

 item 55055

insert

 item 11240

[8]Schedule 1, Part 2, item 55055

omit

[9]Schedule 1, Part 2, Group I2, heading

omit

 Computerised

insert

 Computed

[10]Schedule 1, Part 2, items 56001 to 57355

substitute

56001

Computed tomography — scan of brain without intravenous contrast medium, not being a service to which item 57001 applies (R) (K)

201.45

56007

Computed tomography — scan of brain with intravenous contrast medium and with any scans of the brain prior to intravenous contrast injection, when undertaken, not being a service to which item 57007 applies (R) (K)

257.25

56010

Computed tomography — scan of pituitary fossa with or without intravenous contrast medium and with or without brain scan when undertaken (R) (K)

291.45

56013

Computed tomography — scan of orbits with or without intravenous contrast medium and with or without brain scan when undertaken (R) (K)

291.45

56016

Computed 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) (K)

347.10

56019

Computed tomography — scan of temporal bones with air study (including reconstructions), with intrathecal injection but not including an associated brain scan (R) (K)

426.40

56022

Computed tomography — scan of facial bones, para nasal sinuses or both without intravenous contrast medium (R) (K)

230.90

56028

Computed tomography — scan of facial bones, para nasal sinuses or both with intravenous contrast medium and with any scans of the facial bones, para nasal sinuses or both prior to intravenous contrast injection, when undertaken (R) (K)

343.70

56041

Computed tomography — scan of brain without intravenous contrast medium, not being a service to which item 57041 applies (R) (NK)

100.75

56047

Computed tomography — scan of brain with intravenous contrast medium and with any scans of the brain prior to intravenous contrast injection, when undertaken, not being a service to which item 57047 applies (R) (NK)

128.65

56050

Computed tomography — scan of pituitary fossa with or without intravenous contrast medium and with or without brain scan when undertaken (R) (NK)

145.75

56053

Computed tomography — scan of orbits with or without intravenous contrast medium and with or without brain scan when undertaken (R) (NK)

145.75

56056

Computed 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) (NK)

173.55

56059

Computed tomography — scan of temporal bones with air study (including reconstructions), with intrathecal injection but not including an associated brain scan (R) (NK)

213.20

56062

Computed tomography — scan of facial bones, para nasal sinuses or both without intravenous contrast medium (R) (NK)

115.45

56068

Computed tomography — scan of facial bones, para nasal sinuses or both with intravenous contrast medium and with any scans of the facial bones, para nasal sinuses or both prior to intravenous contrast injection, when undertaken (R) (NK)

171.85

56101

Computed 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) (K)

237.45

56107

Computed 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 of soft tissues of neck, including larynx, pharynx, upper oesophagus and salivary glands (not associated with cervical spine) prior to intravenous contrast injection, when undertaken, not being a service associated with a service to which item 56807 applies (R) (K)

350.15

56141

Computed 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 56841 applies (R) (NK)

118.75

56147

Computed 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 of soft tissues of neck, including larynx, pharynx, upper oesophagus and salivary glands (not associated with cervical spine) prior to intravenous contrast injection, when undertaken, not being a service associated with a service to which item 56847 applies (R) (NK)

175.10

56210

Computed 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) (K)

249.95

56216

Computed tomography — scan of spine, 1 or more regions, with intravenous contrast medium and with any scans of the spine prior to intravenous contrast injection when undertaken; only 1 benefit is payable whether 1 or more attendances are required to complete the service (R) (K)

362.20

56219

Computed 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 applies (R) (K)

336.30

56250

Computed 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) (NK)

125.00

56256

Computed tomography — scan of spine, 1 or more regions, with intravenous contrast medium and with any scans of the spine prior to intravenous contrast injection when undertaken; only 1 benefit is payable whether 1 or more attendances are required to complete the service (R) (NK)

181.10

56259

Computed 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 applies (R) (NK)

168.15

56301

Computed 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 and not including a study performed to exclude coronary artery calcification (R) (K)

305.05

56307

Computed 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 of the chest, including lungs, mediastinum, chest wall or pleura and upper abdomen prior to intravenous contrast injection, when undertaken, not being a service to which item 56807 or 57007 applies and not including a study performed to exclude coronary artery calcification (R) (K)

412.70

56341

Computed 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 56841 or 57041 applies and not including a study performed to exclude coronary artery calcification (R) (NK)

152.55

56347

Computed 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 of the chest, including lungs, mediastinum, chest wall or pleura and upper abdomen prior to intravenous contrast injection, when undertaken, not being a service to which item 56847 or 57047 applies and not including a study performed to exclude coronary artery calcification (R) (NK)

206.35

56401

Computed 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) (K)

258.80

56407

Computed tomography — scan of upper abdomen only (diaphragm to iliac crest), with intravenous contrast medium, and with any scans of upper abdomen (diaphragm to iliac crest) prior to intravenous contrast injection, when undertaken, not being a service to which item 56307, 56507, 56807 or 57007 applies (R) (K)

370.30

56409

Computed 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) (K)

258.80

56412

Computed tomography — scan of pelvis only (iliac crest to pubic symphysis), with intravenous contrast medium and with any scans of pelvis (iliac crest to pubic symphysis) prior to intravenous contrast injection, when undertaken, not being a service to which item 56407 applies (R) (K)

370.30

56441

Computed tomography — scan of upper abdomen only (diaphragm to iliac crest) without intravenous contrast medium, not being a service to which item 56341, 56541, 56841 or 57041 applies (R) (NK)

129.40

56447

Computed tomography — scan of upper abdomen only (diaphragm to iliac crest), with intravenous contrast medium, and with any scans of upper abdomen (diaphragm to iliac crest) prior to intravenous contrast injection, when undertaken, not being a service to which item 56347, 56547, 56847 or 57047 applies (R) (NK)

185.15

56449

Computed 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 56441 applies (R) (NK)

129.40

56452

Computed tomography — scan of pelvis only (iliac crest to pubic symphysis), with intravenous contrast medium and with any scans of pelvis (iliac crest to pubic symphysis) prior to intravenous contrast injection, when undertaken, not being a service to which item 56447 applies (R) (NK)

185.15

56501

Computed tomography — scan of upper abdomen and pelvis without intravenous contrast medium, not being a service to which item 56801 or 57001 applies (R) (K)

394.10

56507

Computed tomography — scan of upper abdomen and pelvis with intravenous contrast medium and with any scans of upper abdomen and pelvis prior to intravenous contrast injection, when undertaken, not being a service to which item 56807 or 57007 applies (R) (K)

497.35

56541

Computed tomography — scan of upper abdomen and pelvis without intravenous contrast medium, not being a service to which item 56841 or 57041 applies (R) (NK)

197.05

56547

Computed tomography — scan of upper abdomen and pelvis with intravenous contrast medium and with any scans of upper abdomen and pelvis prior to intravenous contrast injection, when undertaken, not being a service to which item 56847 or 57047 applies (R) (NK)

248.70

56619

Computed 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) (K)

228.75

56625

Computed tomography — scan of extremities, 1 or more regions with intravenous contrast medium and with any scans of extremities prior to intravenous contrast injection, when undertaken; only 1 benefit is payable whether 1 or more attendances are required to complete the service (R) (K)

341.50

56659

Computed 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) (NK)

114.40

56665

Computed tomography — scan of extremities, 1 or more regions with intravenous contrast medium and with any scans of extremities prior to intravenous contrast injection, when undertaken; only 1 benefit is payable whether 1 or more attendances are required to complete the service (R) (NK)

170.75

56801

Computed tomography — scan of chest, abdomen and pelvis with or without scans of soft tissues of neck without intravenous contrast medium, not including a study performed to exclude coronary artery calcification (R) (K)

476.05

56807

Computed tomography — scan of chest, abdomen and pelvis with or without scans of soft tissues of neck with intravenous contrast medium and with any scans of chest, abdomen and pelvis with or without scans of soft tissue of neck prior to intravenous contrast injection, when undertaken, not including a study performed to exclude coronary artery calcification (R) (K)

579.25

56841

Computed tomography — scan of chest, abdomen and pelvis with or without scans of soft tissues of neck without intravenous contrast medium, not including a study performed to exclude coronary artery calcification (R) (NK)

238.05

56847

Computed tomography — scan of chest, abdomen and pelvis with or without scans of soft tissues of neck with intravenous contrast medium and with any scans of chest, abdomen and pelvis with or without scans of soft tissue of neck prior to intravenous contrast injection, when undertaken, not including a study performed to exclude coronary artery calcification (R) (NK)

289.65

57001

Computed tomography — scan of brain and chest with or without scans of upper abdomen without intravenous contrast medium, not including a study performed to exclude coronary artery calcification (R) (K)

476.15

57007

Computed tomography — scan of brain and chest with or without scans of upper abdomen with intravenous contrast medium and with any scans of brain and chest and upper abdomen prior to intravenous contrast injection, when undertaken, not including a study performed to exclude coronary artery calcification (R) (K)

579.35

57041

Computed tomography — scan of brain and chest with or without scans of upper abdomen without intravenous contrast medium, not including a study performed to exclude coronary artery calcification (R) (NK)

238.10

57047

Computed tomography — scan of brain and chest with or without scans of upper abdomen with intravenous contrast medium and with any scans of brain and chest and upper abdomen prior to intravenous contrast injection, when undertaken, not including a study performed to exclude coronary artery calcification (R) (NK)

289.70

57201

Computed tomography — pelvimetry (R) (K)

158.40

57247

Computed tomography — pelvimetry (R) (NK)

79.20

57341

Computed 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) (K)

493.90

57345

Computed 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) (NK)

246.95

57350

Computed tomography — spiral angiography with intravenous contrast medium and with any scans prior to intravenous contrast injection when undertaken — 1 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) (K)

539.05

57355

Computed tomography — spiral angiography with intravenous contrast medium and with any scans prior to intravenous contrast injection when undertaken — 1 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) (NK)

269.55

[11]Schedule 1, Part 2, item 59503

omit

 item 57200

insert

 item 57201

[12]Schedule 1, Part 2, Group I5, Subgroup 26, heading

substitute

Subgroup 26 — Magnetic resonance angiography — scan of cardiovascular system — for monitoring of specified conditions

Notes

1. These regulations amend Statutory Rules 1998 No. 302.

2. Made by the Governor-General on 23 February 1999, and notified in the Commonwealth of Australia Gazette

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