Health Insurance Determination HS/4/1999 (Cth)

Commonwealth of Australia

Health Insurance Act 1973

Health Insurance Determination HS/4 /1999

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

Dated 7 September 1999.

M. Wooldridge

Minister for Health and Aged Care

Citation

1.       This determination may be cited as the Health Insurance Determination HS/4 /1999.

Commencement

2.       This determination will come into effect on 1 November 1999.

Revocation

3. Determination HS/3/1998 made under subsection 3C(1) of the Act and dated 2 November1998 is revoked with effect from 1 November 1999.

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) Schedule 1 to 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; and

(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 general medical services table that specifies the fee mentioned in the Schedule for the health service.

   SCHEDULE TO DETERMINATION HS/4/99
UNDER SUBSECTION 3C(1) OF THE HEALTH INSURANCE ACT 1973

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Item No   Health Service   Fee

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12306        Bone densitometry (performed by a specialist or consultant physician where                  $81.00
the patient is referred by another medical practitioner), using dual 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).

12309        Bone densitometry (performed by a specialist or consultant physician where                  $81.00
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).

12312        Bone densitometry (performed by a specialist or consultant physician where                  $81.00
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:

·     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).

12315        Bone densitometry (performed by a specialist or consultant physician where                   $81.00
               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.

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).

12318        Bone densitometry (performed by a specialist or consultant physician where                   $81.00
               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:

·     prolonged glucocorticoid therapy;

·     conditions associated with excess glucocorticoid secretion;

·     chronic liver disease;

·     chronic renal disease;

·     proven malabsorptive disorders;

·     rheumatoid arthritis; or

·     conditions associated with thyroxine excess.

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).

·     male hypogonadism;

·     primary hyperparathyroidism;

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

12321        Bone densitometry (performed by a specialist or consultant physician where                   $81.00
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).