Health Insurance (Diagnostic Imaging Capital Sensitivity) Amendment Determination 2012 (No. 2) (Cth)

Case

Health Insurance (Diagnostic Imaging Capital Sensitivity) Amendment Determination 2012 (No.2)

Health Insurance Act 1973

I, Dr Richard Bartlett, First Assistant Secretary, Medical Benefits Division, Department of Health and Ageing, make this Determination under subsection 3C (1) of the Health Insurance Act 1973.

Dated    25 October 2012

DR RICHARD BARTLETT

First Assistant Secretary

Medical Benefits Division


Department of Health and Ageing

1            Name of Determination

This Determination is the Health Insurance (Diagnostic Imaging Capital Sensitivity) Amendment Determination 2012 (No. 2).

2            Commencement

This Determination commences on 1 November 2012.

3            Amendment of Health Insurance (Diagnostic Imaging Capital Sensitivity) Determination 2011

The Schedule amends the Health Insurance (Diagnostic Imaging Capital Sensitivity) Determination 2011.

Schedule  - Amendments

[1] Schedule 1, after Subdivision D      Subgroups 21 and 22 of Group I5

insert

Subdivision E    Subgroup 33 of Group 15

Group I5—Magnetic resonance imaging

Item

Health service

Fee ($)
(for each state)
_____________________________________________________________________________________
Subgroup 33 —Scan of body—for specified conditions

63508

MRI—scan of head for a patient under 16 years if the service is for:
(a) an unexplained seizure (R) (NK) (Anaes.) (Contrast); or
(b) an unexplained headache if significant pathology is suspected (R) (NK) (Anaes.) (Contrast); or
(c) paranasal sinus pathology that has not responded to conservative therapy (R) (NK) (Anaes.) (Contrast)

201.60

63511

MRI—scan of spine following radiographic examination for a patient under 16 years if the service is for:
(a) significant trauma (R) (NK) (Anaes.) (Contrast); or
(b) unexplained neck or back pain with associated neurological signs (R) (NK)  (Anaes.) (Contrast); or
(c) unexplained back pain if significant pathology is suspected (R) (NK)  (Anaes.) (Contrast)

224.00

63514

MRI—scan of knee following radiographic examination for internal joint derangement for a patient under 16 years (NK)

201.60

63517

MRI—scan of hip following radiographic examination for a patient under 16 years if any of the following is suspected:
(a) septic arthritis (R) (NK) (Anaes.) (Contrast);
(b) slipped capital femoral epiphysis (R) (NK) (Anaes.) (Contrast);
(c) Perthes disease (R) (NK) (Anaes.) (Contrast)

201.60

63520

MRI—scan of elbow following radiographic examination for a patient under 16 years if a significant fracture or avulsion injury, which would change the way in which the patient is managed, is suspected (R)(NK) (Anaes.) (Contrast)

201.60

63523

MRI—scan of wrist following radiographic examination for a patient under 16 years if a scaphoid fracture is suspected (R)(NK) (Anaes.) (Contrast)

224.00

[2]         Schedule 2, items 1, 2 and 3

substitute

  1. Diagnostic imaging services table - clauses

Column 1 Column 2 Column 3
Provision of diagnostic imaging services table Existing item reference of diagnostic imaging services table Additional item reference
Preliminary
(a)      Clause 1.1.1 and subclause 1.2.3(1) Item in Part 2 The items in Schedule 1
(b)     Paragraph 1.2.3(2)(a) 55054, 55130, 55135, 55848, 55850, 57341, 57345, 59312, 59314, 60506, 60509 and 61109 55026, 55131, 55136, 55849, 55851, 59313, 59315, 60507, 60510, 61110
(c)      Subclause 1.2.5(4) 61369 61671
(d)     Subclause 1.2.7(10) 59103, 64990 or 64991 59104
Ultrasound
(e)      Clause 2.1.1  and subclause 2.1.2 (1) 55600 and 55603 55601, 55604
(f)      Clause 2.1.3 55028, 55030 and 55032 55005, 55008, 55011
(g)     Subclause 2.1.4(2) 55706, 55707, 55708, 55709, 55718, 55723, 55759, 55762, 55768 and 55770 55713, 55714, 55716, 55717, 55722, 55726, 55760, 55763, 55769, 55771
(h)     Subclause 2.1.5 (1) 55700, 55704, 55707, 55718, 55759 and 55768 55701, 55710, 55714, 55722, 55760, 55769
(i)       Subclause 2.1.5(1) 55712, 55721, 55764 and 55772 55719, 55724, 55765, 55773
(j)       Subclause 2.1.5(2) 55703, 55705, 55708, 55715, 55723, 55725, 55762, 55766, 55770 and 55774 55702, 55711, 55716, 55720, 55726, 55727, 55763, 55767, 55771, 55775
(k)     Clause 2.1.6 55712, 55721, 55764 and 55772 55719, 55724, 55765, 55773
Diagnostic radiology
(l)       Clause 2.3.1(2) 57901 to 57969 57911 to 57968
(m)   Clauses 2.3.6 and 2.3.4 61109 61110
Nuclear medicine imaging
(n)     Clause 2.4.1 61302 to 61505 and item 61650 61651 to 61719, 61729
Magnetic resonance imaging
(o)     Subclause 2.5.1(1) and clause 2.5.7 63001 to 63482  63484, 63486
(p)     Subclause 2.5.1(2) and clause 2.5.7 63464 to 63476 63457 to 63484
(q)     Subclause 2.5.1(4) and clause 2.5.7

63507 to 63522

 63523
(r)       Subclause 2.5.9(2) 63040 to 63073 63074 to 63085
(s)      Subclause 2.5.9(2) 63101 63104
(t)       Subclause 2.5.9(2) 63125 to 63131 63134 to 63136
(u)     Subclause 2.5.9(2) 63161 to 63185 63186 to 63194
(v)     Subclause 2.5.9(2) 63219 to 63243 63257 to 63265
(w)   Subclause 2.5.9(2) 63271 to 63280 63282 to 63285
(x)     Subclause 2.5.9(2) 63322 to 63340 63341 to 63348
(y)     Subclause 2.5.9(2) 63361 63364
(z)      Subclause 2.5.9(2) 63385 to 63391 63392 to 63394
(aa)  Subclause 2.5.9(2) 63401 and 63404 63407, 63408
(bb)   Subclause 2.5.9(2) 63416 63419
(cc)  Subclause 2.5.9(2) 63425 and 63428 63432, 63433
(dd)  Subclause 2.5.9(2) 63461, 63464 and 63467 63455, 63457, 63458
(ee)  Subclause 2.5.9(2) 63482 63486
(ff)   Subclause 2.5.9(2) 63507 to 63522 63508, 63511, 63514, 63517, 63520 and 63523
(gg)   Subclauses 2.5.10(1) and (2) 63470 63479
(hh)   Subclause 2.5.10(1) and (2) 63473 63481

  1. Diagnostic imaging services table - items

Column 1 Column 2 Column 3
Existing   DIST item Existing item reference Additional item reference
Ultrasound
(a)       55036 55038, 55044 or 55731 55017, 55020, 55732
(b)       55038 55036, 55044 or 55731 55014, 55020, 55732
(c)       55044 55036 or 55038 55014, 55017
(d)       55084 11917, 55036, 55038, 55044, 55600, 55603 or 55731 55014, 55017, 55020, 55601, 55604, 55732
(e)       55085 11917, 55037, 55039, 55045, 55600, 55603 or 55733 55016, 55019, 55022, 55601, 55604, 55734
(f)     55113 to 55118 55054 55026
(g)       55113 to 55117 55118 and 55130 55125, 55131
(h)       55130 55135 55136
(i)     55135 55130 55131
(j)     55238 to 55296 55054 55026
(k)       55706 55709 55717
(l)     55707(f) and 55078(d) 55704 55710
(m)     55707 and 55708 55700, 55703, 55704 or 55705 55701, 55702, 55710, 55711
(n)       55709 55706 55713
(o)       55712 and 55715 55706 or 55709 55713, 55717
(p)       55718 55723 55726
(q)       55721 and 55725 55718 or 55723 55722, 55726
(r)     55723 55718 55722
(s)     55731 55036 or 55038 55014, 55017
(t)     55759 55706, 55709, 55712, 55715 or 55762 55713, 55717, 55719, 55720, 55763
(u)       55762 55706, 55709, 55712, 55715 or 55759 55713, 55717, 55719, 55720, 55760
(v)       55764 and 55766 55759 or 55762 55760, 55763
(w)      55764 and 55766 55706, 55709, 55712 or 55715 55713, 55717, 55719, 55720
(x)       55768 55770 55771
(y)       55768, 55770, 55772 and 55774 55718, 55721, 55723 or 55725 55722, 55724, 55726, 55727
(z)       55770 55768 55769
(aa)   55772 and 55774 55768 or 55770 55769, 55771
(bb)   55848 and 55850 55054 55026
(cc)    55850 55800 to 55848 55849
Computed tomography
(dd)   56219 and 56259 59724 59725
Diagnostic radiology
(ee)    57901 57902 57914
(ff)     57902 57901 57911
(gg)    57945 57939 or 57942 57950, 57953
(hh)   58112, 58115 and 58121 58100, 58103, 58106 and 58109 58102, 58105, 58111, 58117
(ii)       58120 and 58121 58120 or 58121 58126, 58127
(jj)      58900 and 58903 58909, 58912, 58915 or 58924 58911, 58914, 58917, 58926
(kk)   58909 57939, 57942 or 57945 57950, 57953, 57956
(ll)       59733 57918 57932
(mm)        59903, 59912, 59925, 59971, 59972, and 59973 61109 61110
Nuclear medicine imaging
(nn)   61462 61364, 61426, 61429, 61430, 61442, 61450, 61453, 61469, 61484 or 61485 61669, 61692, 61693, 61694, 61700, 61704, 61705, 61712, 61715, 61716
(oo)   61505 61302 to 61650 61651 to 61729
Magnetic resonance imaging
(pp)   63467 63464 63457

  1. Dictionary

Column 1 Column 2 Column 3
Definition Existing item reference Additional item reference
(a)       medical practitioner 55028, 55030 and 55032 55005, 55008, 55011
(b)       scan 63001 to 63522 63523

Note

1.         All legislative instruments and compilations are registered on the Federal Register of Legislative Instruments kept under the Legislative Instruments Act 2003. See

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