Health Insurance Determination HS/4/1997 (Cth)

Commonwealth of Australia

Health Insurance Act 1973

Health Insurance Determination HS/4/1997

I, MICHAEL RICHARD LEWIS WOOLDRIDGE, Minister for Health and Family Services, make this Determination under subsection 3C(1) of the Health Insurance Act 1973.

Dated 9 September 1997.

M. Wooldridge

Minister for Health and Family Services

Citation

1.       This determination may be cited as the Health Insurance Determination HS/4/1997.

Commencement

2.       This determination will commence on 1 November 1997.

Revocation

3 Determination HS/2/1996 made under subsection 3C(1) of the Act and dated 22 July 1996 is revoked with effect from 1 November 1997.

Health services

4. (1) A health service mentioned in the Schedule to this determination, is treated as if it were a professional service and a medical service for the following provisions:

(a) section 4 of the National Health Act 1953;

(b) subsections 3(1) and 19(6), and sections 8, 9, 10, 14, 17, 18, 20, 20A, 20B and 20BA of the Health Insurance Act 1973;

(c)     regulations 13, 27, 28, 29, 30 and 31 of the Health Insurance Regulations.

(2)   A health service mentioned in the Schedule to this determination, is treated as if it were

related to an item in the diagnostic procedures and investigations table that specifies the fee mentioned in the Schedule for the health service.

3C DETERMINATION FOR BONE DENSITOMETRY

   SCHEDULE TO DETERMINATION HS/4/1997
UNDER SUBSECTION 3C(1) OF THE HEALTH INSURANCE ACT 1973

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Item No   Health Service   Fee

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12306Bone densitometry (performed by a specialist or consultant physician    $77.30
where the patient is referred by another medical practitioner), using
                  duel energy X‑ray absorptiometry, for:
                  •     the confirmation of a presumptive diagnosis of low bone mineral
   density made on the basis of 1 or more fractures occurring after
   minimal trauma; or
                  •     for the monitoring of low bone mineral density proven by bone
   densitometry at least 12 months previously.
                  Measurement of 2 or more sites ‑ 1 service only in a period of 24
                  months ‑ including interpretation and report; not being a service
associated with a service to which item 12309, 12312, 12315,
                  12318, or 12321 applies (Ministerial Determination)

12309Bone densitometry (performed by a specialist or consultant physician    $77.30
where the patient is referred by another medical practitioner), using
                  quantitative computerised tomography, for:
                  •     the confirmation of a presumptive diagnosis of low bone mineral
   density made on the basis of 1 or more fractures occurring after
   minimal trauma; or
                  •     for the monitoring of low bone mineral density proven by bone
   densitometry at least 12 months previously.
                  Measurement of 2 or more sites ‑ 1 service only in a period of 24
                 months - including interpretation and report; not being a service
associated with a service to which item 12306, 12312, 12315, 12318 or
                  12321 applies (Ministerial Determination)

12312Bone densitometry (performed by a specialist or consultant physician    $77.30
where the patient is referred by another medical practitioner), using
                  duel energy X‑ray absorptiometry, for the diagnosis and monitoring
                  of bone loss associated with 1 or more of the following conditions:
                  •     prolonged glucocorticoid therapy;
                  •     conditions associated with excess glucocorticoid secretion;
                  •     male hypogonadism; or
                  •     female hypogonadism lasting more than 6 months before
   the age of 45.
                  Where the bone density measurement will contribute to the
                  management of a patient with any of the above conditions –
                  measurement of 2 or more sites ‑ 1 service only in a period of 12
                  consecutive months – including interpretation and report; not being a
service associated with a service to which item 12306, 12309, 12315,
                  12318, or 12321 applies (Ministerial Determination)

·     male hypogonadism;

·     primary hyperparathyroidism;

·     female hypogonadism lasting more than 6 months before the age of 45;

Where the bone density measurement will contribute to the management of
a patient with any of the above conditions ‑ measurement of 2 or more sites
- 1 service only in a period of 24 consecutive months ‑ including
interpretation and report; not being a service associated with a service to
which item 12306, 12309, 12312, 12315, or 12321 applies (Ministerial
Determination)

·     chronic liver disease;

·     chronic renal disease;

·     proven malabsorptive disorders;

·     rheumatoid arthritis; or

·     conditions associated with thyroxine excess.

·     prolonged glucocorticoid therapy;

·     conditions associated with excess glucocorticoid secretion;

12318          Bone densitometry (performed by a specialist or consultant physician             $77.30
                  where the patient is referred by another medical practitioner), using
                  quantitative computerised tomography, for the diagnosis and monitoring
                  of bone loss associated with 1 or more of the following conditions:

Where the bone density measurement will contribute to the management
of a patient with any of the above conditions ‑ measurement of 2 or more
sites - 1 service only in a period of 24 consecutive months ‑ including
interpretation and report; not being a service associated with a service to
which item 12306, 12309, 12312, 12318 or 12321 applies (Ministerial
Determination)

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Item No   Health Service   Fee

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12315          Bone densitometry (performed by a specialist or consultant physician                $77.30
                  where the patient is referred by another medical practitioner), using
                  dual energy X‑ray absorptiometry, for the diagnosis and monitoring of
                  bone loss associated with 1 or more of the following conditions:

·     primary hyperparathyroidism;

·     chronic liver disease;

·     chronic renal disease;

·     proven malabsorptive disorders;

·     rheumatoid arthritis; or

·     conditions associated with thyroxine excess.

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Item No   Health Service   Fee

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12321Bone densitometry (performed by a specialist or consultant physician   $77.30
where the patient is referred by another medical practitioner), using
                  dual energy X‑ray absorptiometry, for the measurement of bone density
                  12 months following a significant change in therapy for:

•      established low bone mineral density; or

                  •      the confirmation of a presumptive diagnosis of low bone mineral
                         density made on the basis of 1 or more fractures occurring after
   minimal trauma.
                  Measurement of 2 or more sites - 1 service only in a period of 12
                  consecutive months ‑including interpretation and report; not being a
                  service associated with a service to which item 12306, 12309, 12312,
   12315, or 12318 applies (Ministerial Determination).