Health Insurance (Pathology Services Table) Amendment Regulations 2011 (No. 1) (Cth)

Case

Health Insurance (Pathology Services Table) Amendment Regulations 2011 (No. 1)1

Select Legislative Instrument 2011 No. 101

I, QUENTIN BRYCE, 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 16 June 2011

QUENTIN BRYCE

Governor-General

By Her Excellency’s Command

NICOLA ROXON

Minister for Health and Ageing

  1. Name of Regulations

These Regulations are the Health Insurance (Pathology Services Table) Amendment Regulations 2011 (No. 1).

  1. Commencement

These Regulations commence on 1 July 2011.

  1. Amendment of Health Insurance (Pathology Services Table) Regulations 2010

Schedule 1 amends Schedule 1 to the Health Insurance (Pathology Services Table) Regulations 2010.

Schedule 1          Amendments of Schedule 1 to the Health Insurance (Pathology Services Table) Regulations 2010

(regulation 3)

[1]          Paragraph 1.2.7 (3) (a)

after

66609,

insert

66610,

[2]          Paragraph 2.2.3 (1) (b)

substitute

(b)item 66605, 66606 or 66610.

[3]          Items 66605 to 66609

substitute

66605 Vitamins — quantitation of vitamin B1, B2, B3, B6 or C in blood, urine or other body fluid — one or more tests 30.80
66606 A test described in item 66605 if rendered by a receiving APP — one or more tests 30.80
66607 Vitamins — quantitation of vitamin A or E in blood, urine or other body fluid — one or more tests in a 6 month period 76.25
66608 Vitamin D or D fractions — one or more tests 42.55
66609 A test described in item 66608 if rendered by a receiving APP — one or more tests 42.55
66610 A test described in item 66607 if rendered by a receiving APP — one or more tests 76.25

[4]          Item 66659, column 3

omit

37.40

insert

37.55

[5]          Item 66660, column 3

omit

37.80

insert

37.55

[6]          Subclause 2.3.4 (4)

after

item

insert

69380,

[7]          Item 69333, paragraph (g)

omit

albumin,

insert

protein,

[8]          After item 69379

insert

69380

Genotypic testing for HIV antiretroviral resistance in a patient with confirmed HIV infection if the patient’s viral load is greater than 1 000 copies per ml at any of the following times:

   (a)  at presentation; or

  (b)  before antiretroviral therapy; or

   (c)  when treatment with combination antiretroviral agents fails;

 — maximum of two tests in a 12 month period

775.50

[9]          Items 71057 to 71059

substitute

71057

Electrophoresis, quantitative and qualitative, of serum, urine or other body fluid, collected in a 28 day period, to demonstrate:

   (a)  protein classes; or

33.10

  (b)  presence and amount of paraprotein;

including the preliminary quantitation of total protein, albumin and globulin — one specimen type

71058 Examination as described in item 71057 — two or more specimen types 50.85
71059

Immunofixation, immunoelectrophoresis or isoelectric focusing of:

   (a)  urine for detection of Bence Jones proteins; or

35.90

  (b)  serum, plasma, or other body fluid;

and characterisation of a paraprotein or cryoglobulin — examination of one specimen type (eg serum, urine or CSF)

[10]        Item 71200, column 3

omit

35.90

insert

60.00

[11]        After subclause 2.6.1 (3)

insert

(4)If more than one of the services mentioned in items 73049, 73051, 73062, 73063, 73066 and 73067 are performed in a single patient episode, the fee for the combined services is:

(a)if services mentioned in two items are performed — the higher of the two fees specified; or

(b)if services mentioned in more than two items are performed — the highest of the fees specified.

[12]        Item 73051

substitute

73051

Cytology of material obtained directly from a patient at one identified site by fine needle aspiration of solid tissue or tissues if a recognised pathologist:

   (a)  performs the aspiration; or

  (b)  attends the aspiration and performs a cytological examination during the attendance

171.50

[13]        Item 73063

substitute

73063 Cytology of material obtained directly from a patient at one identified site by fine needle aspiration of solid tissue or tissues if an employee of an approved pathology authority attends the aspiration for confirmation of sample adequacy 100.00

[14]        After item 73065

insert

73066

Cytology of material obtained directly from a patient at two or more separately identified sites by fine needle aspiration of solid tissue or tissues if a recognised pathologist:

   (a)  performs the aspiration; or

  (b)  attends the aspiration and performs cytological examination during the attendance

222.95
73067 Cytology of material obtained directly from a patient at two or more separately identified sites by fine needle aspiration of solid tissue or tissues if an employee of an approved pathology authority attends the aspiration for confirmation of sample adequacy 130.00

[15]        After item 73324

insert

73325

Characterisation of mutations in:

   (a)  the JAK2 gene; or

  (b)  the MPL gene; or

   (c)  both genes;

in the diagnostic work-up, by or on behalf of a specialist or consultant physician, of a patient with clinical and laboratory evidence of:

   (a)  polycythaemia vera; or

  (b)  essential thrombocythaemia;

 — one or more tests

75.00
73326

Characterisation of the gene rearrangement FIP1L1‑PDGFRA in the diagnostic work-up and management of a patient with laboratory evidence of:

   (a)  mast cell disease; or

  (b)  idiopathic hypereosinophilic syndrome; or

   (c)  chronic eosinophilic leukaemia;

 — one or more tests

232.50
73327 Detection of genetic polymorphisms in the Thiopurine S‑methyltransferase gene for the prevention of dose-related toxicity during treatment with thiopurine drugs, including (if performed) any service described in item 65075 — one or more tests 52.30

[16]        Item 74991, subparagraph (e) (iii)

omit each mention of

Metropolitan;

insert

Metropolitan Perth;

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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