Health Insurance (Pathology Services Table) Regulation 2013 (Cth)

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Health Insurance (Pathology Services Table) Regulation 2013

Select Legislative Instrument No. 249, 2013 as amended

made under the

Health Insurance Act 1973

Compilation start date:1 January 2014

Includes amendments up to:SLI No. 250, 2013

 

About this compilation

This compilation

This is a compilation of the Health Insurance (Pathology Services Table) Regulation 2013 as in force on 1 January 2014. It includes any commenced amendment affecting the legislation to that date.

This compilation was prepared on 1 January 2014.

The notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of each amended provision.

Uncommenced amendments

The effect of uncommenced amendments is not reflected in the text of the compiled law but the text of the amendments is included in the endnotes.

Application, saving and transitional provisions for provisions and amendments

If the operation of a provision or amendment is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.

Modifications

If a provision of the compiled law is affected by a modification that is in force, details are included in the endnotes.

Provisions ceasing to have effect

If a provision of the compiled law has expired or otherwise ceased to have effect in accordance with a provision of the law, details are included in the endnotes.

      

Contents

1Name of regulation

 This regulation is the Health Insurance (Pathology Services Table) Regulation 2013.

3Authority

 This regulation is made under the Health Insurance Act 1973.

4Schedule(s)

 Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.

5Pathology services table

For subsection 4A(1) of the Act, this regulation prescribes a table of pathology services set out in Schedule 1.

6Dictionary

 The Dictionary in Part 5 of Schedule 1 defines certain words and expressions that are used in this regulation, and includes references to certain words and expressions that are defined elsewhere in this regulation.

Schedule 1Pathology services table

Note: See section 5.

Part 1PreliminaryDivision 1.1Interpretation1.1.1Abbreviations
  • (1)

    The abbreviations in Part 3 may be used to identify particular pathology services or groups of pathology services.

  • (2)

    The names of services or drugs not listed in Part 3 must be written in full.

Division 1.2General application provisions1.2.1Precedence of items
  • (1)

    If a service is described:

    • (a)

      in an item in general terms; and

    • (b)

      in another item in specific terms;

only the item that describes the service in specific terms applies to the service.

  • (2)

    Subject to subclause (3), if:

    • (a)

      subclause (1) does not apply; and

    • (b)

      a service is described in 2 or more items;

only the item that provides the lower or lowest fee for the service applies to the service.

  • (3)

    If an item is expressed to include a pathology service that is described in another item, the other item does not apply to the service in addition to the first‑mentioned item, whether or not the services described in the 2 items are requested separately.

1.2.2Circumstances in which services rendered following 2 requests to be taken to have been rendered following one request

 (1) In subclause (2):

serviceincludes assay, estimation and test.

 (2)Two or more pathology services (other than services to which, under clause 1.2.3, 2.1.1 or 2.2.2, this clause does not apply) rendered for a patient following 2 or more requests are taken to have been rendered following a single request if:

  • (a)

    the services are listed in the same item; and

  • (b)

    that item is not item 74990 or 74991; and

  • (c)

    the patient’s need for the services was determined under subsection 16A(1) of the Act on the same day even if the services are rendered by an approved pathology practitioner on more than 1 day.

1.2.3Services to which clause 1.2.2 does not apply
  • (1)

    Clause 1.2.2 does not apply to a pathology service described in subclause (2) if:

    • (a)

      under a request for a service, other than a request for a service described in paragraph (2)(a), no more than 6 tests are requested; and

    • (b)

      the tests are performed within 6 months of the request; and

    • (c)

      the pathology provider of the service writes on the account for the service that the service has a rule 3 exemption.

  • (2)

    For subclause (1), the pathology services are:

    • (a)

      estimation of prothrombin time (INR) for a patient undergoing anticoagulant therapy; and

    • (b)

      quantitative estimation of lithium for a patient undergoing lithium therapy; and

    • (c)

      a service described in item 65070 in relation to a patient undergoing chemotherapy for neoplastic disease or immunosuppressant therapy; and

    • (d)

      a service described in item 65070 in relation to

      clozaril, ticlopidine hydrochloride, methotrexate, gold, sulphasalazine or penicillamine therapy of a patient; and

    • (e)

      a service described in any of items 66500 to 66512, in relation to methotrexate or leflunomide therapy of a patient; and

    • (f)

      quantitative estimation of urea, creatinine and electrolytes in relation to:

      • (i)

        cis‑platinum or cyclosporin therapy of a patient; or

      • (ii)

        chronic renal failure of a patient being treated

        in a dialysis program conducted by a recognised hospital; and

    • (g)

      quantitative estimation of albumin and calcium in relation to therapy of a patient with vitamin D, its metabolites or analogues; and

    • (h)

      quantitative estimation of calcium, phosphate, magnesium, urea, creatinine and electrolytes for a cancer patient receiving bisphosphonate infusions.

1.2.4Referral of designated tests by one pathology practitioner to another
  • (1)

    In this clause:

designated testmeans a pathology test relating to a patient episode that is a test of a kind mentioned in item 65150, 65175, 66650, 66695, 66711, 66722, 66785, 66800, 66812, 66819, 66825, 69384, 69494, 71089, 71153 or 77165.

  • (2)

    This clause applies if one or more designated tests are referred by a referring APP to a receiving APP in another approved pathology authority.

  • (3)

    If a referring APP has rendered one or more designated tests:

    • (a)

      the amount mentioned in item 65150, 65153, 65175, 65176, 65177, 65178, 66650, 66695, 66698, 66701, 66704, 66707, 66711, 66722, 66725, 66728, 66731, 66785, 66800, 66803, 66812, 66819, 66825, 69384, 69387, 69390, 69393, 69396, 69494, 69495, 71089, 71091, 71153, 71155, 71157, 77165, 71166 or 71167 (as the case may be) is payable for each designated test rendered by the referring APP; and

    • (b)

      subject to subclause (5), the amount mentioned in item 65158, 65181, 66652, 66697, 66715, 66724, 66790, 66805, 66817, 66821, 66827, 69401, 69498, 71092, 71156 or 71170 (as the case may be) is payable for each designated test rendered by the receiving APP.

  • (4)

    If a referring APP has not rendered a designated test:

    • (a)

      for the first designated test that is rendered by the receiving APP—the amount mentioned in item 65157, 65180, 66651, 66696, 66714, 66723, 66789, 66804, 66816, 66820, 66826, 69400, 69497, 71090, 71154 or 71169 (as the case may be) is payable; and

    • (b)

      for each subsequent designated test (if any) that is rendered by the receiving APP—subject to subclause (6), the amount mentioned in item 65158, 65181, 66652, 66697, 66715, 66724, 66790, 66805, 66817, 66821, 66827, 69401, 69498, 71092, 71156 or 71170 (as the case may be) is payable for each test rendered.

 (5)For paragraph (3)(b), the maximum number of designated tests for which the fee mentioned in the relevant item is payable is as follows:

  • (a)

    for item 66652, 66715, 66790, 66817, 66821 or 66827:

     
  • (b)

    for item 65158, 66805, 69498 or 71092:

     
  • (c)

    for item 71156 or 71170:

     
  • (d)

    for item 65181 or 66724:

 

where:

Xis the number of designated tests rendered by a referring APP.

  • (6)

    For paragraph (4)(b), the maximum number of designated tests for which the fee mentioned in the relevant item is payable is as follows:

    • (a)

      for item 66652, 66715, 66790, 66817, 66821 or 66827—1;

    • (b)

      for item 65158, 66805, 69498 or 71092—2;

    • (c)

      for item 71156 or 71170—3;

    • (d)

      for item 65181 or 66724—4.

  • (7)

    Items in Group P10 (Patient episode initiation) do not apply to a receiving APP in subclause (2).

1.2.5Items not to be split

 Except as stated in clause 1.2.4 the amount mentioned in an item is payable only to one approved pathology practitioner for a single patient episode.

1.2.6Certain pathology services to be treated as one service
  • (1)

    In this clause:

general practitionermeans a medical practitioner who:

  • (a)

    is not a consultant physician in any specialty; and

  • (b)

    is not a specialist in any specialty.

set of pathology services has the meaning given by subclause 1.2.7(1).

  • (2)

    If a general practitioner, participating midwife or participating nurse practitioner requests a set of pathology services, the pathology services in the set are to be treated as individual pathology services in accordance with this clause.

  • (3)

    If the fee mentioned in an item that describes any of the services in the set of pathology services is higher than the fees mentioned in the other items that describe the services in the set:

    • (a)

      the pathology service described in the first‑mentioned item is to be treated as one pathology service; and

    • (b)

      either:

      • (i)

        the pathology service in the set that is described in the item that mentions the second‑highest fee is to be treated as one pathology service; or

      • (ii)

        if 2 or more items that describe any of those services mentions the second‑highest fee—the pathology service described in the item that mentions the second‑highest fee, and has the lowest item number, is to be treated as one pathology service; and

    • (c)

      the pathology services in the set, other than the services that are to be treated as one pathology service under paragraphs (a) and (b), are to be treated as one pathology service.

  • (4)

    If the fees mentioned in 2 or more items that describe any of the services in the set of pathology services are the same, and higher than the fees mentioned in the other items that describe the services in the set:

    • (a)

      the pathology service in the set that is described in the item that mentions the highest fee, and has the lowest item number, is to be treated as one pathology service; and

    • (b)

      the pathology service in the set that is described in the item that mentions the highest fee, and has the second‑lowest item number, is to be treated as one pathology service; and

    • (c)

      the pathology services in the set, other than the services that are to be treated as one pathology service under paragraphs (a) and (b), are to be treated as one pathology service.

  • (5)

    If pathology services are to be treated as one pathology service under paragraph (3)(c) or (4)(c), the fee for the one pathology service is the highest fee mentioned in any of the items that describe the pathology services that are to be treated as the one pathology service.

1.2.7Meaning of set of pathology services
  • (1)

    In clause 1.2.6:

set of pathology services means a group of pathology services:

  • (a)

    that consist of services that are described in at least 4 different items; and

  • (b)

    all of which are requested in a single patient episode; and

  • (c)

    each of which relates to a patient who is not an admitted patient of a hospital; and

  • (d)

    none of which is referred to in item 66900, 69484, 73053 or 73055.

  • (2)

    However, a set of pathology services does not include the following items:

    • (a)

      an item in Group P10 (Patient episode initiation), Group P11 (Specimen referred), Group P12 (Management of bulk‑billed services) or Group P13 (Bulk billing incentive for episodes consisting of a P10 service);

    • (b)

      if a service is requested by an approved pathology practitioner of an approved pathology authority and rendered by another approved pathology practitioner of an approved pathology authority that is not related to the approved pathology authority of the first‑mentioned approved pathology practitioner—item 65079, 65082, 65157, 65158, 65166, 65180, 65181, 66606, 66609, 66610, 66639, 66642, 66651, 66652, 66663, 66666, 66696, 66697, 66714, 66715, 66723, 66724, 66780, 66783, 66789, 66790, 66792, 66804, 66805, 66816, 66817, 66820, 66821, 66826, 66827, 66832, 69325, 69328, 69331, 69379, 69383, 69400, 69401, 69419, 69451, 69489, 69492, 69497, 69498, 69500, 71076, 71090, 71092, 71096, 71148, 71154, 71156, 71169, 71170, 73309, 73312, 73315, 73318, 73321 or 73324.

  • (3)

    An approved pathology authority is related to another approved pathology authority for paragraph (2)(b) if:

    • (a)

      both approved pathology authorities are employed (including employed under contract) by the same person, whether or not the person is also an approved pathology authority; or

    • (b)

      either of the approved pathology authorities is employed (including employed under contract) by the other; or

    • (c)

      both approved pathology authorities are corporations and are connected entities within the meaning of the Corporations Act 2001; or

    • (d)

      the approved pathology authorities are partners (whether or not either or both of the approved pathology authorities are individuals and whether or not other persons are in partnership with either or both of the approved pathology authorities); or

    • (e)

      both approved pathology authorities are operated by the Commonwealth or an authority of the Commonwealth; or

    • (f)

      both approved pathology authorities are operated by the same State or internal Territory or an authority of the same State or internal Territory.

1.2.8Satisfying requirements described in pathology service

 Unless the contrary intention appears, a requirement contained in the description of a pathology service in Part 2 is satisfied if:

  • (a)

    for a requirement for information—the information:

    • (i)

      is included in the request for the service; or

    • (ii)

      was supplied in writing on an earlier occasion to

      the approved pathology authority that rendered

      the service, and has been kept by the approved pathology authority; or

  • (b)

    for a requirement for laboratory test results—the results are:

    • (i)

      included in the request for the service; or

    • (ii)

      obtained from another laboratory test performed in the same patient episode; or

    • (iii)

      included in results from an earlier laboratory test that have been kept by the approved pathology authority.

Part 2Services and feesDivision 2.1Group P1: haematology2.1.1Services to which clause 1.2.2 does not apply
  • (1)

    Clause 1.2.2 does not apply to a pathology service described in item 65060, 65070, 65120, 65123, 65126, 65129, 65150, 65153 or 65156 if:

    • (a)

      the service is rendered in relation to one or more specimens taken on any of not more than 6 occasions in a period of 24 hours; and

    • (b)

      the service is rendered to an inpatient of a hospital; and

    • (c)

      the service is rendered in relation to each specimen as soon as possible after the specimen is taken; and

    • (d)

      the pathology provider of the service writes on the account for the service that the service has a rule 3 exemption.

  • (2)

    Clause 1.2.2 does not apply to a pathology service described in item 65109 or 65110 if:

    • (a)

      the service is rendered:

      • (i)

        for a service described in item 65109—on one of not more than 5 occasions in a period of 24 hours; and

      • (ii)

        for a service described in item 65110—on one of not more than 2 occasions in a period of 24 hours; and

    • (b)

      the service was requested on a separate occasion to any other occasions on which the service was requested in the period of 24 hours; and

    • (c)

      the pathology provider of the service writes on the account for the service that the service has a rule 3 exemption.

2.1.2Item taken to refer only to the first service of a particular kind
  • (1)

    For an item in Group P1 (Haematology):

    • (a)

      if pathology services of a kind mentioned in item 65090 or 65093 are rendered for a patient during a period when the patient is in hospital, the item applies only to the first pathology service of that kind rendered for the patient during the period; and

    • (b)

      if:

      • (i)

        tests (except tests mentioned in item 65099, 65102, 65105 or 65108) are carried out in relation to a patient episode; and

      • (ii)

        specimen material from the patient episode is stored; and

      • (iii)

        in response to a request made within 14 days of the patient episode, further tests (except tests mentioned in item 65099, 65102, 65105 or 65108) are carried out on the stored material;

     the later tests and the earlier tests are taken to be part of one patient episode.

  • (2)

    Items 65102 and 65108 apply only if a minimum of 6 units are issued for a patient’s care in any 1 day.

  • (3)

    For items 65099 and 65102:

compatibility tests by crossmatchmeans that, in addition to all the tests mentioned in paragraphs (a) and (b) of the item, donor red cells from each unit must have been tested directly against the serum of the patient by one or more accepted crossmatching techniques.

Group P1—Haematology

Item

Pathology service

Fee ($)

65060

Haemoglobin, erythrocyte sedimentation rate, blood viscosity—one or more tests

7.85

65066

Examination of:

(a) a blood film by special stains to demonstrate Heinz bodies, parasites or iron; or

(b) a blood film by enzyme cytochemistry for neutrophil alkaline phosphatase, alpha‑naphthyl acetate esterase or chloroacetate esterase; or

10.40

(c) a blood film using any other special staining methods including periodic acid Schiff and Sudan Black; or

(d) a urinary sediment for haemosiderin;

including a service described in item 65072

65070

Erythrocyte count, haematocrit, haemoglobin, calculation or measurement of red cell index or indices, platelet count, leucocyte count and manual or instrument generated differential count (not being a service where haemoglobin only is requested)—one or more instrument‑generated set of results from a single sample and (if performed):

(a) a morphological assessment of a blood film; and

(b) any service in item 65060 or 65072

16.95

65072

Examination for reticulocytes including a reticulocyte count by any method—one or more tests

10.20

65075

Haemolysis or metabolic enzymes—assessment by one or more of the following tests:

(a) erythrocyte autohaemolysis test;

(b) erythrocyte osmotic fragility test;

(c) sugar water test;

(d) G–6–PD (qualitative or quantitative) test;

(e) pyruvate kinase (qualitative or quantitative) test;

(f) acid haemolysis test;

(g) quantitation of muramidase in serum or urine;

(h) Donath Landsteiner antibody test;

(i) other erythrocyte metabolic enzyme tests

51.95

65078

Tests for the diagnosis of thalassaemia consisting of haemoglobin electrophoresis or chromatography and at least 2 of:

(a) examination for HbH; or

(b) quantitation of HbA2; or

(c) quantitation of HbF;

including (if performed) any service described in item 65060 or 65070

90.20

65079

A test described in item 65078 if rendered by a receiving APP—one or more tests

90.20

65081

Tests for the investigation of haemoglobinopathy consisting of haemoglobin electrophoresis or chromatography and at least one of:

(a) heat denaturation test; or

(b) isopropanol precipitation test; or

(c) tests for the presence of haemoglobin S; or

(d) quantitation of any haemoglobin fraction (including S, C, D, E);

including (if performed) any service described in item 65060, 65070 or 65078

96.60

65082

A test described in item 65081 if rendered by a receiving APP—one or more tests

96.60

65084

Bone marrow trephine biopsy—histopathological examination of sections of bone marrow and examination of aspirated material (including clot sections where necessary), including (if performed) any test described in item 65060, 65066 or 65070

165.85

65087

Bone marrow—examination of aspirated material (including clot sections where necessary), including (if performed) any test described in item 65060, 65066 or 65070

83.10

65090

Blood grouping (including back‑grouping if performed)—ABO and Rh (D antigen)

11.15

65093

Blood grouping—Rh phenotypes, Kell system, Duffy system, M and N factors or any other blood group system—one or more systems, including item 65090 (if performed)

22.00

65096

Blood grouping (including back‑grouping if performed), and examination of serum for Rh and other blood group antibodies, including:

(a) identification and quantitation of any antibodies detected; and

(b) (if performed) any test described in item 65060 or 65070

41.00

65099

Compatibility tests by crossmatch—all tests performed on any 1 day for up to 6 units, including:

(a) all grouping checks of the patient and donor; and

(b) examination for antibodies and, if necessary, identification of any antibodies detected; and

(c) (if performed) any tests described in item 65060, 65070, 65090 or 65096

108.90

65102

Compatibility tests by crossmatch—all tests performed on any 1 day in excess of 6 units, including:

(a) all grouping checks of the patient and donor; and

(b) examination for antibodies and, if necessary, identification of any antibodies detected; and

(c) (if performed) any tests described in item 65060, 65070, 65090, 65096, 65099 or 65105

164.60

65105

Compatibility testing using at least a 3 cell panel and issue of red cells for transfusion—all tests performed on any 1 day for up to 6 units, including:

(a) all grouping checks of the patient and donor; and

(b) examination for antibodies and, if necessary, identification of any antibodies detected; and

(c) (if performed) any tests described in item 65060, 65070, 65090 or 65096

108.90

65108

Compatibility testing using at least a 3 cell panel and issue of red cells for transfusion—all tests performed on any 1 day in excess of 6 units, including:

(a) all grouping checks of the patient and donor; and

(b) examination for antibodies and, if necessary, identification of any antibodies detected; and

(c) (if performed) any tests described in item 65060, 65070, 65090, 65096, 65099 or 65105

164.60

65109

Release of fresh frozen plasma or cryoprecipitate for the use in a patient for the correction of a coagulopathy—one release

12.90

65110

Release of compatible fresh platelets for the use in a patient for platelet support as prophylaxis to minimise bleeding or during active bleeding—one release

12.90

65111

Examination of serum for blood group antibodies (including identification and, if necessary, quantitation of any antibodies detected)

23.20

65114

One or more of the following tests:

(a) direct Coombs (antiglobulin) test;

(b) qualitative or quantitative test for cold agglutinins or heterophil antibodies

9.10

65117

One or more of the following tests:

(a) spectroscopic examination of blood for chemically altered haemoglobins;

(b) detection of methaemalbumin (Schumm’s test)

20.25

65120

Prothrombin time (including INR where appropriate), activated partial thromboplastin time, thrombin time (including test for the presence of heparin), test for factor XIII deficiency (qualitative), Echis test, Stypven test, reptilase time, fibrinogen, or one of fibrinogen degradation products, fibrin monomer or D‑dimer—one test

13.70

65123

Two tests described in item 65120

20.35

65126

Three tests described in item 65120

27.85

65129

Four or more tests described in item 65120

35.50

65137

A test for the presence of lupus anticoagulant, not being a service connected with a service to which item 65175, 65176, 65177, 65178 or 65179 applies

25.35

65142

Confirmation or clarification of an abnormal or indeterminate result of a test mentioned in item 65175, by testing a specimen collected on a different day—one or more tests

25.35

65144

Platelet aggregation in response to ADP, collagen, 5HT, ristocetin or other substances, or heparin, low molecular weight heparins, heparinoid or other drugs—one or more tests

56.55

65147

Quantitation of anti‑Xa activity when monitoring is required for a patient receiving a low molecular weight heparin or heparinoid—one test

37.90

65150

Quantitation of von Willebrand factor antigen, von Willebrand factor activity (ristocetin cofactor assay), von Willebrand factor collagen binding activity, factor II, factor V, factor VII, factor VIII, factor IX, factor X, factor XI, factor XII, factor XIII, Fletcher factor, Fitzgerald factor, circulating coagulation factor inhibitors other than by Bethesda assay—one test

70.90

65153

Two tests described in item 65150

141.85

65156

Three or more tests described in item 65150

212.75

65157

A test described in item 65150, if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP—one test

70.90

65158

A test described in item 65150, if rendered by a receiving APP, where one or more tests in the item have been rendered by the referring APP—one test

70.90

65159

Quantitation of circulating coagulation factor inhibitors by Bethesda assay—one test

70.90

65162

Examination of a maternal blood film for the presence of fetal red blood cells (Kleihauer test)

10.45

65165

Detection and quantitation of fetal red blood cells in the maternal circulation by detection of red cell antigens using flow cytometric methods including (if performed) any test described in item 65070 or 65162

34.45

65166

A test described in item 65165 if rendered by a receiving APP—one or more tests

34.45

65171

A test for the presence of antithrombin III deficiency, protein C deficiency, protein S deficiency or activated protein C resistance in a first degree relative of a person who has a proven deficiency mentioned in this item—one or more tests

25.35

65175

A test for the presence of antithrombin III deficiency, protein C deficiency, protein S deficiency, lupus anticoagulant, activated protein C resistance, if the request for the test specifically identifies that the patient has a history of venous thromboembolism—quantitation by one or more techniques—one test

25.35

65176

Two tests described in item 65175

48.65

65177

Three tests described in item 65175

71.95

65178

Four tests described in item 65175

95.20

65179

Five tests described in item 65175

118.50

65180

A test described in item 65175, if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP—one test

25.35

65181

A test described in item 65175, if rendered by a receiving APP, where one or more tests in the item have been rendered by the referring APP—one test

23.30

Division 2.2Group P2: chemical2.2.1Creatinine ratios

 A pathology service mentioned in an item in Group P2 (Chemical) (except item 66500) that:

  • (a)

    involves the measurement of a substance in urine; and

  • (b)

    requires calculation of a substance/creatinine ratio;

is taken to include the measurement of creatinine necessary for the calculation.

2.2.2Services to which clause 1.2.2 does not apply

 Clause 1.2.2 does not apply to a pathology service described in item 66500, 66503, 66506, 66509, 66512, 66584 or 66800 if:

  • (a)

    the service is rendered in relation to one or more specimens taken on any of not more than 6 occasions in a period of 24 hours; and

  • (b)

    the service is rendered to an inpatient of a hospital; and

  • (c)

    the service is rendered in relation to each specimen as soon as possible after the specimen is taken; and

  • (d)

    the pathology provider of the service writes on the account for the service that the service has a rule 3 exemption.

2.2.3Limitation on certain items
  • (1)

    For any particular patient, the following items are applicable not more than twice in a 12 month period:

    • (a)

      items 66539 and 66607;

    • (b)

      item 66605, 66606 or 66610.

  • (2)

    For any particular patient, each of items 66551 and 66660 is applicable not more than 4 times in a 12 month period.

  • (3)

    For any particular patient, each of items 66554 and 66830 is applicable not more than 6 times in a 12 month period.

  • (4)

    For any particular patient, item 66626 is applicable not more than 36 times in a 12 month period.

  • (5)

    For any particular patient, item 66750 or 66751 is applicable not more than once in a pregnancy.

  • (6)

    For any particular patient, item 66517 is applicable not more than 3 times in a pregnancy.

2.2.4Serum B12 and red cell folate testing
  • (1)

    Items 66599 and 66602 do not apply to more than 3 patient episodes that include a service mentioned in item 66599 or 66602, or any combination of those items, in a 12 month period.

  • (2)

    Item 66599 does not apply to a service mentioned in that item if the service was provided as part of the same patient episode as a service mentioned in item 66602.

2.2.5Thyroid function testing
  • (1)

    For item 66719:

abnormal level of TSHmeans a level of TSH that is outside the normal reference range for the particular method of assay used to determine the level.

  • (2)

    Unless paragraph (a) of item 66719 is satisfied, the amount mentioned in the item is not payable for a pathology service mentioned in the item unless the pathologist who renders the service has a written statement from the medical practitioner who requested the service that satisfies subclause (3).

  • (3)

    The written statement from the medical practitioner must indicate:

    • (a)

      that the tests are required for a particular purpose, being a purpose mentioned in paragraph (b) of item 66719; or

    • (b)

      that the medical practitioner who requested the tests suspects the patient has pituitary dysfunction; or

    • (c)

      that the patient is on drugs that interfere with thyroid hormone metabolism or function.

2.2.6Limitation on certain items
  • (1)

    For any particular patient, each of items 66655 and 66659 is applicable not more than once in a 12 month period.

  • (2)

    For any particular patient, each of items 66819, 66820, 66821, 66822, 66825, 66826, 66827 and 66828 is applicable not more than 3 times in a 6 month period.

2.2.7Nutritional and toxicity metals testing
  • (1)

    In this clause:

metal toxicity testing groupmeans items 66825, 66826, 66827, 66828, 66831 and 66832.

nutritional metals testing group means items 66819, 66820, 66821 and 66822.

  • (2)

    An item in the nutritional metals testing group or the metal toxicity testing group does not apply to a service performed if medicare benefits are paid or payable for tests that are performed for the same patient in 3 patient episodes requested within 6 months before the request for that service, under any of:

    • (a)

      that item; or

    • (b)

      the other item in the same group; or

    • (c)

      an item in the other group.

Group P2—Chemical

Item

Pathology service

Fee ($)

66500

Quantitation in serum, plasma, urine or other body fluid (except amniotic fluid), by any method, except reagent tablet or reagent strip, (with or without reflectance meter) of acid phosphatase, alanine aminotransferase, albumin, alkaline phosphatase, ammonia, amylase, aspartate aminotransferase, bicarbonate, bilirubin (total), bilirubin (any fractions), C‑reactive protein, calcium (total or corrected for albumin), chloride, creatine kinase, creatinine, gamma glutamyl transferase, globulin, glucose, lactate dehydrogenase, lipase, magnesium, phosphate, potassium, sodium, total cholesterol, total protein, triglycerides, urate or urea—one test

9.70

66503

Two tests described in item 66500

11.65

66506

Three tests described in item 66500

13.65

66509

Four tests described in item 66500

15.65

66512

Five or more tests described in item 66500

17.70

66517

Quantitation of bile acids in blood in pregnancy

19.65

66518

Investigation of cardiac or skeletal muscle damage by quantitative measurement of creatine kinase isoenzymes, troponin or myoglobin in blood—tests performed on only one specimen in a 24 hour period

20.05

66519

Investigation of cardiac or skeletal muscle damage by quantitative measurement of creatine kinase isoenzymes, troponin or myoglobin in blood—tests performed on 2 or more specimens in a 24 hour period

40.15

66536

Quantitation of HDL cholesterol

11.05

66539

Electrophoresis of serum for demonstration of lipoprotein subclasses:

(a) if the cholesterol is >6.5 mmol/L and triglyceride >4.0 mmol/L; or

(b) in the diagnosis of types III and IV hyperlipidaemia

30.60

66542

Oral glucose tolerance test for the diagnosis of diabetes mellitus, that includes:

(a) administration of glucose; and

(b) at least 2 measurements of blood glucose; and

(c) (if performed) any test described in item 66695

18.95

66545

Oral glucose challenge test in pregnancy for the detection of gestational diabetes that includes:

(a) administration of glucose; and

(b) one or 2 measurements of blood glucose; and

(c) (if performed) any test in item 66695

15.80

66548

Oral glucose tolerance test in pregnancy for the diagnosis of gestational diabetes that includes:

(a) administration of glucose; and

(b) at least 3 measurements of blood glucose; and

(c) (if performed) any test in item 66695

19.90

66551

Quantitation of glycosylated haemoglobin performed in the management of established diabetes

16.80

66554

Quantitation of glycosylated haemoglobin performed in the management of pre‑existing diabetes where the patient is pregnant—including a service in item 66551 (if performed)

16.80

66557

Quantitation of fructosamine performed in the management of established diabetes—each test to a maximum of 4 tests in a 12 month period

9.70

66560

Microalbumin—quantitation in urine

20.10

66563

Osmolality, estimation by osmometer, in serum or in urine—one or more tests

24.70

66566

Quantitation of:

(a) blood gases (including pO2, oxygen saturation and pCO2); and

(b) bicarbonate and pH;

including any other measurement (e.g. haemoglobin, lactate, potassium or ionised calcium) or calculation performed on the same specimen—one or more tests on one specimen

33.70

66569

Quantitation of blood gases, bicarbonate and pH as described in item 66566 on 2 specimens performed on any 1 day

42.60

66572

Quantitation of blood gases, bicarbonate and pH as described in item 66566 on 3 specimens performed on any 1 day

51.55

66575

Quantitation of blood gases, bicarbonate and pH as described in item 66566 on 4 specimens performed on any 1 day

60.45

66578

Quantitation of blood gases, bicarbonate and pH as described in item 66566 on 5 specimens performed on any 1 day

69.35

66581

Quantitation of blood gases, bicarbonate and pH as described in item 66566 on 6 or more specimens performed on any 1 day

78.25

66584

Quantitation of ionised calcium (except if performed as part of item 66566)—one test

9.70

66587

Urine acidification test for the diagnosis of renal tubular acidosis including the administration of an acid load, and pH measurements on 4 or more urine specimens and at least one blood specimen

47.55

66590

Calculus, analysis of one or more

30.60

66593

Ferritin—quantitation, except if requested as part of iron studies

18.00

66596

Iron studies, consisting of quantitation of:

(a) serum iron; and

(b) transferrin or iron binding capacity; and

(c) ferritin

32.55

66599

Serum B12 or red cell folate and, if required, serum folate

23.60

66602

Serum B12 and red cell folate and, if required, serum folate

42.95

66605

Vitamins—quantitation of vitamin B1, B2, B3, B6 or C in blood, urine or other body fluid—one or more tests

30.60

66606

A test described in item 66605 if rendered by a receiving APP—one or more tests

30.60

66607

Vitamins—quantitation of vitamin A or E in blood, urine or other body fluid—one or more tests in a 6 month period

75.75

66608

Vitamin D or D fractions—one or more tests

39.05

66609

A test described in item 66608 if rendered by a receiving APP—one or more tests

39.05

66610

A test described in item 66607 if rendered by a receiving APP—one or more tests

75.75

66623

All qualitative and quantitative tests on blood, urine or other body fluid for:

(a) a drug or drugs of abuse (including illegal drugs and legally available drugs taken other than in appropriate dosage); or

(b) ingested or absorbed toxic chemicals;

including a service described in item 66800, 66803, 66806, 66812 or 66815 (if performed), but excluding:

(c) the surveillance of sports people and athletes for performance improving substances; and

(d) the monitoring of patients participating in a drug abuse treatment program

41.50

66626

Detection or quantitation or both of a drug, or drugs, of abuse or a therapeutic drug, on a sample collected from a patient participating in a drug abuse treatment program, including all tests on blood, urine or other body fluid, not including:

(a) the surveillance of sports people and athletes for performance improving substances; and

(b) the detection of nicotine and metabolites in smoking withdrawal programs

24.10

66629

Beta‑2‑microglobulin—quantitation in serum, urine or other body fluids—one or more tests

20.10

66632

Caeruloplasmin, haptoglobins, or prealbumin—quantitation in serum, urine or other body fluids—one or more tests

20.10

66635

Alpha‑1‑antitrypsin—quantitation in serum, urine or other body fluid—one or more tests

20.10

66638

Isoelectric focusing or similar methods for determination of alpha‑1‑antitrypsin phenotype in serum—one or more tests

49.05

66639

A test described in item 66638 if rendered by a receiving APP—one or more tests

29.20

66641

Electrophoresis of serum or other body fluid to demonstrate:

(a) the isoenzymes of lactate dehydrogenase; or

(b) the isoenzymes of alkaline phosphatase;

including the preliminary quantitation of total relevant enzyme activity—one or more tests

29.20

66642

A test described in item 66641 if rendered by a receiving APP—one or more tests

29.20

66644

C‑1 esterase inhibitor—quantitation

20.15

66647

C‑1 esterase inhibitor—functional assay

45.10

66650

Alpha‑fetoprotein, CA‑15.3 antigen (CA15.3), CA‑19.9 antigen (CA19.9), CA‑125 antigen (C125), cancer associated serum antigen (CASA), carcinoembryonic antigen (CEA), human chorionic gonadotrophin (HCG), neuron specific enolase (NSE) thyroglobulin in serum or other body fluid, in the monitoring of malignancy or in the detection or monitoring of gestational trophoblastic disease or a hepatic or germ cell tumour—quantitation—one test

24.35

66651

A test described in item 66650, if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP—one test

24.35

66652

A test described in item 66650, if rendered by a receiving APP, where one or more tests in the item have been rendered by the referring APP—one test

20.30

66653

Two or more tests described in item 66650

44.60

66655

Prostate specific antigen—quantitation

20.15

66656

Prostate specific antigen (PSA) quantitation in the monitoring of previously diagnosed prostatic disease (including a test to which item 66655 applies)

20.15

66659

Prostate specific antigen (PSA), quantitation of 2 or more fractions of PSA and any derived index, including, if performed, a test described in item 66656, in the follow up of a PSA result that lies at or above the age‑related median but below the age‑related, method‑specific 97.5% reference limit

37.30

66660

Prostate specific antigen (PSA), quantitation of 2 or more fractions of PSA and any derived index, including, if performed, a test described in item 66656, in the follow up of a PSA result that lies at or above the age‑related, method‑specific 97.5% reference limit, but below 10 µg/L

37.30

66662

Quantitation of hormone receptors on proven primary breast or ovarian carcinoma or a metastasis from a breast or ovarian carcinoma or a subsequent lesion in the breast—one or more tests

79.95

66663

A test described in item 66662 if rendered by a receiving APP—one or more tests

79.95

66665

Lead quantitation in blood or urine (other than for occupational health screening purposes) to a maximum of 3 tests in a 6 month period—each test

30.60

66666

A test described in item 66665 if rendered by a receiving APP—one or more tests

30.60

66667

Quantitation of serum zinc in a patient receiving intravenous alimentation—each test

30.60

66671

Quantitation of serum aluminium in a patient in a renal dialysis program—each test

36.90

66674

Quantitation of:

(a) faecal fat; or

(b) breath hydrogen in response to loading with disaccharides;

one or more tests within a 28 day period

39.95

66677

Test for tryptic activity in faeces in the investigation of diarrhoea of longer than 4 weeks duration in children under 6 years

11.15

66680

Quantitation of disaccharidases and other enzymes in intestinal tissue—one or more tests

74.45

66683

Enzymes—quantitation in solid tissue or tissues other than blood elements or intestinal tissue—one or more tests

74.45

66686

Performance of one or more of the following procedures:

(a) growth hormone suppression by glucose loading;

(b) growth hormone stimulation by exercise;

(c) dexamethasone suppression test;

(d) sweat collection by iontophoresis for chloride analysis;

(e) pharmacological stimulation of growth hormone

50.65

66695

Quantitation in blood or urine of hormones and hormone binding proteins—ACTH, aldosterone, androstenedione, C‑peptide, calcitonin, cortisol, DHEAS, 11‑deoxycortisol, dihydrotestosterone, FSH, gastrin, glucagon, growth hormone, hydroxyprogesterone, insulin, LH, oestradiol, oestrone, progesterone, prolactin, PTH, renin, sex hormone binding globulin, somatomedin C(IGF –1), free or total testosterone, urine steroid fraction or fractions, vasoactive intestinal peptide—one test

30.50

66696

A test described in item 66695, if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP

30.50

66697

A test described in item 66695, if rendered by a receiving APP, where one or more tests in the item have been rendered by the referring APP—each test to a maximum of 4 tests

13.20

66698

Two tests described in item 66695

43.70

66701

Three tests described in item 66695

56.90

66704

Four tests described in item 66695

70.15

66707

Five or more tests described in item 66695

83.35

66711

Quantitation in saliva of cortisol in:

(a) the investigation of Cushing’s syndrome; or

(b) the management of children with congenital adrenal hyperplasia;

one test

30.15

66712

Two tests described in item 66711

43.05

66714

A test described in item 66711, if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP

30.15

66715

A test described in item 66711, if rendered by a receiving APP, where one test in the item has been rendered by the referring APP—one test

12.85

66716

TSH quantitation

25.05

66719

Thyroid function tests (comprising the service described in item 66716 and one or more of the following tests—free thyroxine, free T3, for a patient, if at least one of the following conditions is satisfied:

(a) the patient has an abnormal level of TSH;

(b) the tests are performed:

(i) for the purpose of monitoring thyroid disease in the patient; or

(ii) to investigate the sick euthyroid syndrome if the patient is an admitted patient; or

(iii) to investigate dementia or psychiatric illness of the patient; or

(iv) to investigate amenorrhoea or infertility of the patient;

(c) the medical practitioner who requested the tests suspects the patient has a pituitary dysfunction;

(d) the patient is on drugs that interfere with thyroid hormone metabolism or function

34.80

66722

TSH quantitation described in item 66716 and one test described in item 66695

37.90

66723

A test described in item 66722, if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP—one test

37.90

66724

A test described in item 66722, if rendered by a receiving APP, where one or more tests in the item have been rendered by the referring APP—one test

13.15

66725

TSH quantitation described in item 66716 and 2 tests described in item 66695

51.05

66728

TSH quantitation described in item 66716 and 3 tests described in item 66695

64.20

66731

TSH quantitation described in item 66716 and 4 tests described in item 66695

77.40

66734

TSH quantitation described in item 66716 and 5 tests described in item 66695

90.55

66743

Quantitation of alpha‑fetoprotein in serum or other body fluids during pregnancy except if requested as part of item 66750 or 66751

20.10

66749

Amniotic fluid, spectrophotometric examination of, and quantitation of:

(a) lecithin/sphingomyelin ratio; or

(b) palmitic acid, phosphatidylglycerol or lamellar body phospholipid; or

(c) bilirubin, including correction for haemoglobin;

one or more tests

32.95

66750

Quantitation, in pregnancy, of any 2 of the following to detect foetal abnormality:

(a) total human chorionic gonadotrophin (total HCG);

(b) free alpha human chorionic gonadotrophin (free alpha HCG);

(c) free beta human chorionic gonadotrophin (free beta HCG);

(d) pregnancy associated plasma protein A (PAPP‑A);

(e) unconjugated oestriol (uE3);

(f) alpha‑fetoprotein (AFP);

including (if performed) a service described in item 73527 or 73529

39.75

66751

Quantitation, in pregnancy, of any 3 or more tests described in item 66750

55.25

66752

Quantitation of acetoacetate, beta‑hydroxybutyrate, citrate, oxalate, total free fatty acids, cysteine, homocysteine, cystine, lactate, pyruvate or other amino acids and hydroxyproline (except if performed as part of item 66773 or 66776)—one test

24.70

66755

Two or more tests described in item 66752

38.85

66756

Quantitation of 10 or more amino acids for the diagnosis of inborn errors of metabolism—up to 4 tests in a 12 month period on specimens of plasma, CSF and urine

98.30

66757

Quantitation of 10 or more amino acids for monitoring of previously diagnosed inborn errors of metabolism in one tissue type

98.30

66758

Quantitation of angiotensin converting enzyme, or cholinesterase—one or more tests

24.70

66761

Test for reducing substances in faeces by any method (except reagent strip or dipstick)

13.15

66764

Examination for faecal occult blood (including tests for haemoglobin and its derivatives in the faeces except by reagent strip or dip stick methods) with a maximum of 3 examinations on specimens collected on separate days in a 28 day period

8.90

66767

Two examinations described in item 66764 performed on separately collected and identified specimens

17.85

66770

Three examinations described in item 66764 performed on separately collected and identified specimens

26.70

66773

Quantitation of products of collagen breakdown or formation for the monitoring of patients with proven low bone mineral density and, if performed, a service described in item 66752—one or more tests

24.65

66776

Quantitation of products of collagen breakdown or formation for the monitoring of patients with metabolic bone disease or Paget’s disease of bone and, if performed, a service described in item 66752—one or more tests

24.65

66779

Adrenaline, noradrenaline, dopamine, histamine, hydroxyindoleacetic acid (5HIAA), hydroxymethoxymandelic acid (HMMA), homovanillic acid (HVA), metanephrines, methoxyhydroxyphenylethylene glycol (MHPG), phenylacetic acid (PAA) or serotonin—quantitation—one or more tests

39.95

66780

A test described in item 66779 if rendered by a receiving APP—one or more tests

39.95

66782

Porphyrins or porphyrins precursors—detection in plasma, red cells, urine or faeces—one or more tests

13.15

66783

A test described in item 66782 if rendered by a receiving APP—one or more tests

13.15

66785

Porphyrins or porphyrins precursors—quantitation in plasma, red cells, urine or faeces—one test

39.95

66788

Porphyrins or porphyrins precursors—quantitation in plasma, red cells, urine or faeces—2 or more tests

65.85

66789

A test described in item 66785 if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP—one test

39.95

66790

A test described in item 66785, if rendered by a receiving APP, where one or more tests in the item have been rendered by the referring APP—one test

25.90

66791

Porphyrin biosynthetic enzymes—measurement of activity in blood cells or other tissues—one or more tests

74.45

66792

A test described in item 66791 if rendered by a receiving APP—one or more tests

74.45

66800

Quantitation in blood, urine or other body fluid by any method (except reagent tablet or reagent strip) of any of the following used therapeutically by the patient from whom the specimen was taken: amikacin, carbamazepine, digoxin, disopyramide, ethanol, ethosuximide, gentamicin, lignocaine, lithium, netilmicin, paracetamol, phenobarbitone, phenytoin, primidone, procainamide, quinidine, salicylate, theophylline, tobramycin, valproate or vancomycin—one test

18.15

66803

Two tests described in item 66800

30.50

66804

A test described in item 66800 if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP—one test

18.15

66805

A test described in item 66800, if rendered by a receiving APP, where one or more tests in the item have been rendered by the referring APP—one test

12.35

66806

Three tests described in item 66800

41.85

66812

Quantitation, not elsewhere described in this table by any method or methods, in blood, urine or other body fluid, of a drug being used therapeutically by the patient from whom the specimen was taken—one test

34.80

66815

Two tests described in item 66812

59.55

66816

A test described in item 66812 if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP—one test

34.80

66817

A test described in item 66812, if rendered by a receiving APP, where one or more tests in the item have been rendered by the referring APP—one test

24.75

66819

Quantitation of copper, manganese, selenium or zinc (except if item 66667 applies), in blood, urine or other body fluid—one test

30.60

66820

A test described in item 66819 if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP—one test

30.60

66821

A test described in item 66819, if rendered by a receiving APP, where one or more tests in the item have been rendered by the referring APP—one test

21.80

66822

Quantitation of copper, manganese, selenium or zinc (except if item 66667 applies), in blood, urine or other body fluid—2 or more tests

52.45

66825

Quantitation of aluminium (except if item 66671 applies), arsenic, beryllium, cadmium, chromium, gold, mercury, nickel or strontium, in blood, urine or other body fluid or tissue—one test

30.60

66826

A test described in item 66825 if rendered by a receiving APP where no tests have been rendered by the referring APP—one test

30.60

66827

A test described in item 66825, if rendered by a receiving APP, where one or more tests in the item have been rendered by the referring APP—one test

21.80

66828

Quantitation of aluminium (except if item 66671 applies), arsenic, beryllium, cadmium, chromium, gold, mercury, nickel or strontium, in blood, urine or other body fluid or tissue—2 or more tests

52.45

66830

Quantitation of BNP or NT‑proBNP for the diagnosis of heart failure in patients presenting with dyspnoea in a hospital emergency department

58.50

66831

Quantitation of copper or iron in liver tissue biopsy

30.95

66832

A test described in item 66831 if rendered by a receiving APP

30.95

66900

Carbon‑labelled urea breath test using oral C‑13 or C‑14 urea, including the measurement of exhaled 13 CO2 or 14 CO2, (except if item 12533 of the general medical services table applies) for:

(a) the confirmation of Helicobactor pylori colonisation; or

(b) the monitoring of the success of eradication of Helicobactor pylori

77.65

Division 2.3Group P3: microbiology2.3.1Meaning of serial examinations or cultures

serial examinations or cultures, for an item in Group P3 (Microbiology), means:

  • (a)

    a series of examinations or cultures requested on one occasion whether or not:

    • (i)

      the materials are received on different days by the approved pathology practitioner; or

    • (ii)

      the examinations or cultures were requested on one or more request forms by the treating practitioner; and

  • (b)

    if:

    • (i)

      tests are carried out in relation to a patient episode; and

    • (ii)

      specimen material from the patient episode is stored; and

    • (iii)

      in response to a request made within 14 days of the patient episode, further tests are carried out on the stored material;

 the later tests and the earlier tests are taken to be part of one patient episode.

2.3.2Antigen detection

 If a pathology service described in item 69316, 69317, 69319, 69494, 69495, 69496, 69497 or 69498 is rendered as a pathologist‑determinable service, the amount mentioned in the item is not payable for the service unless the recognised pathologist who renders the service records, in writing, the reasons for rendering the service.

2.3.3Investigation for hepatitis serology

 The fee applying in a single patient episode that includes any of items 69475, 69478 and 69481 is the fee specified for only one of those items.

2.3.4Limitation on certain items
  • (1)

    For any particular patient, item 69336 is applicable not more than once in each period of 7 days.

  • (2)

    For any particular patient, the following items are applicable not more than once in a 12 month period:

    • (a)

      item 69482;

    • (b)

      item 69491 or 69492;

    • (c)

      item 69499 or 69500.

  • (3)

    For any particular patient, item 69418 or 69419 is applicable not more than twice in a 24 month period.

  • (4)

    For any particular patient, item 69380, 69488 or 69489 is applicable not more than twice in a 12 month period.

  • (5)

    For any particular patient, each of items 69445, 69451 and 69483 is applicable not more than 4 times in a 12 month period.

2.3.5Hepatitis C viral RNA testing

 For items 69499 and 69500:

Hepatitis C sero‑positive, for a patient, means 2 different assays of Hepatitis C antibodies are positive.

serological status is uncertain, for a patient, means any result where 2 different assays of Hepatitis C antibodies are inconclusive.

Group P3—Microbiology

Item

Pathology service

Fee ($)

69300

Microscopy of wet film material other than blood, from one or more sites, obtained directly from a patient (not cultures) including (if performed):

(a) differential cell count; or

(b) examination for dermatophytes; or

(c) dark ground illumination; or

(d) stained preparation or preparations using any relevant stain or stains;

one or more tests

12.50

69303

Culture and (if performed) microscopy to detect pathogenic micro‑organisms from nasal swabs, throat swabs, eye swabs and ear swabs (except swabs taken for epidemiological surveillance), including (if performed):

(a) pathogen identification and antibiotic susceptibility testing; or

(b) a service described in item 69300;

specimens from one or more sites

22.00

69306

Microscopy and culture to detect pathogenic micro‑organisms from skin or other superficial sites, including (if performed):

(a) pathogen identification and antibiotic susceptibility testing; or

(b) a service described in items 69300, 69303, 69312 and 69318;

one or more tests on one or more specimens

33.75

69309

Microscopy and culture to detect dermatophytes and other fungi causing cutaneous disease, from skin scrapings, skin biopsies, hair and nails (excluding swab specimens) and including (if performed):

(a) the detection of antigens not elsewhere specified in this table; or

(b) a service described in items 69300, 69303, 69306, 69312 and 69318;

one or more tests on one or more specimens

48.15

69312

Microscopy and culture to detect pathogenic micro‑organisms from urethra, vagina, cervix or rectum (except for faecal pathogens), including (if performed):

(a) pathogen identification and antibiotic susceptibility testing; or

(b) a service described in items 69300, 69303, 69306 and 69318;

one or more tests on one or more specimens

33.75

69316

Detection of Chlamydia trachomatis by any method—one test

28.65

69317

This item applies if:

(a) one test described in item 69316 is performed; and

(b) one test described in item 69494 is performed

35.85

69318

Microscopy and culture to detect pathogenic micro‑organisms from specimens of sputum (except when part of items 69324, 69327 and 69330), including (if performed):

(a) pathogen identification and antibiotic susceptibility testing; or

(b) a service described in items 69300, 69303, 69306 and 69312;

one or more tests on one or more specimens

33.75

69319

This item applies if:

(a) one test described in item 69316 is performed; and

(b) 2 tests described in item 69494 are performed

42.95

69321

Microscopy and culture of post‑operative wounds, aspirates of body cavities, synovial fluid, CSF or operative or biopsy specimens, for the presence of pathogenic micro‑organisms involving aerobic and anaerobic cultures and the use of different culture media, and including (if performed):

(a) pathogen identification and antibiotic susceptibility testing; or

(b) a service described in item 69300, 69303, 69306, 69312 or 69318;

specimens from one or more sites

48.15

69324

Microscopy (with appropriate stains) and culture for mycobacteria—one specimen of sputum, urine or other body fluid or one operative or biopsy specimen, including (if performed):

(a) microscopy and culture of other bacterial pathogens isolated as a result of this procedure; or

(b) pathogen identification and antibiotic susceptibility testing;

including a service mentioned in item 69300

43.00

69325

A service described in item 69324 if the microscopy and culture is performed by a receiving APP

43.00

69327

Microscopy (with appropriate stains) and culture for mycobacteria—2 specimens of sputum, urine or other body fluids or operative or biopsy specimens, including (if performed):

(a) microscopy and culture of other bacterial pathogens isolated as a result of this procedure; or

(b) pathogen identification and antibiotic susceptibility testing;

including a service described in item 69300

85.00

69328

A service described in item 69327 if the microscopy and culture is performed by a receiving APP

85.00

69330

Microscopy (with appropriate stains) and culture for mycobacteria—3 specimens of sputum, urine or other body fluids or operative or biopsy specimens, including (if performed):

(a) microscopy and culture of other bacterial pathogens isolated as a result of this procedure; or

(b) pathogen identification and antibiotic susceptibility testing;

including a service described in item 69300

128.00

69331

A service described in item 69330 if the microscopy and culture is performed by a receiving APP

128.00

69333

Urine examination (including serial examination) by any means other than simple culture by dip slide, including:

(a) cell count; and

(b) culture; and

(c) colony count; and

(d) (if performed) stained preparations; and

(e) (if performed) identification of cultured pathogens; and

(f) (if performed) antibiotic susceptibility testing; and

(g) (if performed) examination for pH, specific gravity, blood, protein, urobilinogen, sugar, acetone or bile salts

20.55

69336

Microscopy of faeces for ova, cysts and parasites, that includes the use of:

(a) a concentration technique; and

(b) fixed stains or antigen detection for cryptosporidia and giardia;

and includes a service mentioned in item 69300 (if performed)

33.45

69339

Microscopy of faeces for ova, cysts and parasites using concentration techniques examined after examination described in item 69336 performed on a separately collected and identified specimen collected within 7 days of the examination described in item 69336—not more than one examination in a 7 day period

19.10

69345

Culture and (if performed) microscopy without concentration techniques of faeces for faecal pathogens, using at least 2 selective or enrichment media and culture in at least 2 different atmospheres including (if performed):

(a) pathogen identification and antibiotic susceptibility testing; and

(b) the detection of clostridial toxins; and

(c) a service described in item 69300;

not more than one examination in a 7 day period

52.90

69354

Blood culture for pathogenic micro‑organisms (other than viruses), including sub‑cultures and (if performed):

(a) identification of any cultured pathogen; and

(b) necessary antibiotic susceptibility testing;

to a maximum of 3 sets of cultures—one set of cultures

30.75

69357

Two sets of cultures described in item 69354

61.45

69360

Three sets of cultures described in item 69354

92.20

69363

Detection of Clostridium difficile or Clostridium difficile toxin (except if a service described in item 69345 has been performed)—one or more tests

28.65

69378

Quantitation of HIV viral RNA load in plasma or serum in the monitoring of a HIV sero‑positive patient not on antiretroviral therapy—one or more tests

180.25

69379

A test described in item 69378 if the quantitation is performed by a receiving APP—one or more tests on one or more specimens

180.25

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;

(b) before antiretroviral therapy;

(c) when treatment with combination antiretroviral agents fails;

maximum of 2 tests in a 12 month period

770.30

69381

Quantitation of HIV viral RNA load in plasma or serum in the monitoring of a HIV sero‑positive patient on antiretroviral therapy—one or more tests on one or more specimens

180.25

69382

Quantitation of HIV viral RNA load in cerebrospinal fluid in a HIV sero‑positive patient—one or more tests on one or more specimens

180.25

69383

A test described in item 69381 if the quantitation is performed by a receiving APP—one or more tests on one or more specimens

180.25

69384

Quantitation of one antibody to microbial antigens not elsewhere described in this table—one test

15.65

69387

Two tests described in item 69384

29.00

69390

Three tests described in item 69384

42.35

69393

Four tests described in item 69384

55.70

69396

Five or more tests described in item 69384

69.10

69400

A test described in item 69384 if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP—one test

15.65

69401

A test described in item 69384 if a referring APP has performed a test or tests described in item 69384—each test to a maximum of 4 tests

13.35

69405

Microbiological serology during a pregnancy (except in the investigation of a clinically apparent intercurrent microbial illness or close contact with a patient suffering from parvovirus infection or varicella during that pregnancy) including:

(a) the determination of one of the following: rubella immune status, specific syphilis serology, carriage of Hepatitis B, Hepatitis C antibody, HIV antibody; and

(b) (if performed) a service described in one or more of items 69384, 69475, 69478 and 69481

15.65

69408

Microbiological serology during a pregnancy (except in the investigation of a clinically apparent intercurrent microbial illness or close contact with a patient suffering from parvovirus infection or varicella during that pregnancy) including:

(a) the determination of 2 of the following: rubella immune status, specific syphilis serology, carriage of Hepatitis B, Hepatitis C antibody, HIV antibody; and

(b) (if performed) a service described in one or more of items 69384, 69475, 69478 and 69481

29.00

69411

Microbiological serology during a pregnancy (except in the investigation of a clinically apparent intercurrent microbial illness or close contact with a patient suffering from parvovirus infection or varicella during that pregnancy) including:

(a) the determination of 3 of the following: rubella immune status, specific syphilis serology, carriage of Hepatitis B, Hepatitis C antibody, HIV antibody; and

(b) (if performed) a service described in one or more of items 69384, 69475, 69478 and 69481

42.35

69413

Microbiological serology during a pregnancy (except in the investigation of a clinically apparent intercurrent microbial illness or close contact with a patient suffering from parvovirus infection or varicella during that pregnancy) including:

(a) the determination of 4 of the following: rubella immune status, specific syphilis serology, carriage of Hepatitis B, Hepatitis C antibody, HIV antibody; and

(b) (if performed) a service described in one or more of items 69384, 69475, 69478 and 69481

55.70

69415

Microbiological serology during a pregnancy (except in the investigation of a clinically apparent intercurrent microbial illness or close contact with a patient suffering from parvovirus infection or varicella during that pregnancy) including:

(a) the determination of all of the following: rubella immune status, specific syphilis serology, carriage of hepatitis B, hepatitis C antibody, HIV antibody; and

(b) (if performed) a service described in one or more of items 69384, 69475, 69478 and 69481

69.10

69418

A test for high risk human papillomaviruses (HPV) in a patient who:

(a) within the 2 year period before the test, has received excisional or ablative treatment for high grade squamous intraepithelial lesions (HSIL) of the cervix; or

(b) within the 2 year period before the test, has had a positive HPV test after excisional or ablative treatment for HSIL of the cervix; or

(c) is undergoing annual cytological review following treatment for HSIL of the cervix;

one test

63.55

69419

A test described in item 69418 if the test is performed by a receiving APP—one test

63.55

69445

Detection of hepatitis C viral RNA in a patient undertaking antiviral therapy for chronic HCV hepatitis (including a service described in item 69499)—one test

92.20

69451

A test described in item 69445 if the test is performed by a receiving APP—one test

92.20

69471

Test of cell‑mediated immunity in blood for the detection of latent tuberculosis in an immunosuppressed or immunocompromised patient—one test

34.90

69472

Detection of antibodies to Epstein Barr Virus using specific serology—one test

15.65

69474

Detection of antibodies to Epstein Barr Virus using specific serology—2 or more tests

28.65

69475

Detection of hepatitis antigens or antibodies to determine immune status or viral carriage following exposure or vaccination to Hepatitis A, Hepatitis B, Hepatitis C or Hepatitis D—one test

15.65

69478

Two tests described in item 69475

29.25

69481

Investigation of infectious causes of acute or chronic hepatitis—3 tests described in item 69475

40.55

69482

Quantitation of hepatitis B viral DNA in patients who are hepatitis B surface antigen positive and have chronic hepatitis B but are not receiving antiviral therapy—one test

152.10

69483

Quantitation of hepatitis B viral DNA in patients who:

(a) are hepatitis B surface antigen positive; and

(b) have chronic hepatitis B; and

(c) are receiving antiviral therapy;

one test

152.10

69484

Supplementary test for hepatitis B surface antigen or hepatitis C antibody using a different assay on a specimen that yielded a reactive result on initial testing

17.10

69488

Quantitation of HCV RNA load in plasma or serum in:

(a) the pre‑treatment evaluation, of a patient with chronic HCV hepatitis, for antiviral therapy; or

(b) the assessment of efficacy of antiviral therapy for such a patient;

if the test is requested by, or on the advice of, the specialist or consultant physician who manages the treatment of the patient (including a service described in item 69445 or 69499)

180.25

69489

A test described in item 69488 if the test is performed by a receiving APP

180.25

69491

Nucleic acid amplification and determination of hepatitis C virus (HCV) genotype if:

(a) the patient is HCV RNA positive and is being evaluated for antiviral therapy of chronic HCV hepatitis; and

(b) the request for the test is made by, or on the advice of, the specialist or consultant physician managing the treatment of the patient

204.80

69492

A service described in item 69491 if the test is performed by a receiving APP

204.80

69494

Detection of a virus, microbial antigen or microbial nucleic acid (not elsewhere described in this table)—one test

28.65

69495

Two tests described in item 69494

35.85

69496

Three or more tests described in item 69494

43.05

69497

This item applies to a test described in item 69494 if:

(a) a referring APP has not performed the test described in item 69494; and

(b) a receiving APP performs the test described in item 69494;

one test

28.65

69498

This item applies to a test described in item 69494 if:

(a) a referring APP has performed the test or tests described in item 69494; and

(b) a receiving APP has performed the test or tests described in item 69494;

one test

7.20

69499

Detection of hepatitis C viral RNA if at least one of the following criteria is satisfied:

(a) the patient is hepatitis C sero‑positive;

(b) the patient’s serological status is uncertain after testing;

(c) the test is performed for the purpose of:

(i) determining the hepatitis C status of an immunosuppressed or immunocompromised patient; or

(ii) the detection of acute hepatitis C prior to seroconversion where considered necessary for the clinical management of the patient

92.20

69500

A test described in item 69499 if the test is performed by a receiving APP

92.20

Division 2.4Group P4: immunology2.4.1Limitation on certain items
  • (1)

    For any particular patient, items 71075, 71127, 71135 and 71137 are applicable not more than twice in a 12 month period.

  • (2)

    For any particular patient, item 71079 is applicable not more than 4 times in a 12 month period.

  • (3)

    For any particular patient, item 71077 is applicable not more than 6 times in a 12 month period.

2.4.2Tests in Group P4 relating to antibodies

 For items 71119, 71121, 71123 and 71125, if:

  • (a)

    tests are carried out in relation to a patient episode; and

  • (b)

    specimen material from the patient episode is stored; and

  • (c)

    in response to a request made within 14 days of the patient episode, further tests are carried out on the stored material;

the later tests and the earlier tests are taken to be part of one patient episode.

2.4.3HLA‑B27 typing

 If a pathology service mentioned in item 71148 is rendered as a pathologist‑determinable service, the amount mentioned in the item is not payable for a pathology service mentioned in the item unless the recognised pathologist who renders the service records, in writing, the reasons for rendering the service and the result of the pathology service mentioned in item 71147.

2.4.4Antineutrophil cytoplasmic antibody tests

For subsection 16A(3) of the Act, a request for an antineutrophil cytoplasmic antibody immunofluorescence test is taken to include a request for an antineutrophil proteinase 3 antibody test and an antimyeloperoxidase antibody test if:

  • (a)

    the immunofluorescence test performed as a result of the request is abnormal; or

  • (b)

    a previous immunofluorescence test was abnormal; or

  • (c)

    those antibodies have been previously detected.

Group P4—Immunology

Item

Pathology service

Fee ($)

71057

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

(a) protein classes; or

(b) presence and amount of paraprotein;

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

32.90

71058

Examination as described in item 71057—2 or more specimen types

50.50

71059

Immunofixation, immunoelectrophoresis or isoelectric focusing of:

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

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

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

35.65

71060

Examination as described in item 71059 of 2 or more specimen types

44.05

71062

Electrophoresis and immunofixation or immunoelectrophoresis or isoelectric focusing of CSF for the detection of oligoclonal bands and including if required electrophoresis of the patient’s serum for comparison purposes—one or more tests

44.05

71064

Detection and quantitation of cryoglobulins or cryofibrinogen—one or more tests

20.75

71066

Quantitation of total immunoglobulin A (by any method) in serum, urine, or other body fluid—one test

14.55

71068

Quantitation of total immunoglobulin G (by any method) in serum, urine, or other body fluid—one test

14.55

71069

Two tests described in item 71066, 71068, 71072 or 71074

22.75

71071

Three or more tests described in item 71066, 71068, 71072 or 71074

30.95

71072

Quantitation of total immunoglobulin M (by any method) in serum, urine, or other body fluid—one test

14.55

71073

Quantitation of all 4 immunoglobulin G subclasses

106.15

71074

Quantitation of total immunoglobulin D (by any method) in serum, urine, or other body fluid—one test

14.55

71075

Quantitation of immunoglobulin E (total)—one test

23.00

71076

A test described in item 71073 if the test is performed by a receiving APP—one test

106.15

71077

Quantitation of immunoglobulin E (total) in the follow up of a patient with proven immunoglobulin‑E‑secreting myeloma, proven congenital immunodeficiency or proven allergic bronchopulmonary aspergillosis—one test

27.05

71079

Detection of specific immunoglobulin E antibodies to single or multiple potential allergens

26.80

71081

Quantitation of total haemolytic complement

40.55

71083

Quantitation of complement components C3 and C4 or properdin factor B—one test

20.15

71085

Two tests described in item 71083

28.95

71087

Three or more tests described in item 71083

37.70

71089

Quantitation of complement components or breakdown products of complement proteins not elsewhere described in an item in this table—one test

29.15

71090

This item applies to a test described in item 71089 if:

(a) a referring APP has not performed the test described in item 71089; and

(b) a receiving APP performs the test described in item 71089;

one test

29.15

71091

Two tests described in item 71089

52.85

71092

This item applies to a test described in item 71089 if:

(a) a referring APP has performed the test or tests described in item 71089; and

(b) a receiving APP performs the test or tests described in item 71089;

one test

23.70

71093

Three or more tests described in item 71089

76.45

71095

Quantitation of serum or plasma eosinophil cationic protein, or both, to a maximum of 3 assays in a 12 month period, for monitoring the response to therapy in corticosteroid treated asthma, in a child aged less than 12 years

40.55

71096

A test described in item 71095 if the quantitation is performed by a receiving APP

40.55

71097

Antinuclear antibodies—detection in serum or other body fluids, including quantitation if required

24.45

71099

Double‑stranded DNA antibodies—quantitation by one or more methods other than the Crithidia method

26.50

71101

Antibodies to one or more extractable nuclear antigens—detection in serum or other body fluids

17.40

71103

Characterisation of an antibody detected in a service described in item 71101 (including that service)

52.05

71106

Rheumatoid factor—detection by any technique in serum or other body fluids, including quantitation if required

11.30

71119

Antibodies to tissue antigens not elsewhere specified in this table—detection of one antibody, including quantitation if required

17.35

71121

Detection of 2 antibodies specified in item 71119

20.80

71123

Detection of 3 antibodies specified in item 71119

24.25

71125

Detection of 4 or more antibodies specified in item 71119

27.65

71127

Functional tests for lymphocytes—quantitation, other than by microscopy, of:

(a) proliferation induced by one or more mitogens; or

(b) proliferation induced by one or more antigens; or

(c) estimation of one or more mixed lymphocyte reactions;

including a test described in item 65066 or 65070 (if performed)

176.35

71129

Two tests described in item 71127

217.85

71131

Three or more tests described in item 71127

259.35

71133

Investigation of recurrent infection, by qualitative assessment, for the presence of defects in oxidative pathways in neutrophils by the nitroblue tetrazolium (NBT) reduction test

10.40

71134

Investigation of recurrent infection, by quantitative assessment, of oxidative pathways by flow cytometric techniques, including a test described in item 71133 (if performed)

104.05

71135

Quantitation of neutrophil function, comprising at least 2 of the following:

(a) chemotaxis;

(b) phagocytosis;

(c) oxidative metabolism;

(d) bactericidal activity;

including any test described in item 65066, 65070, 71133 or 71134 (if performed)

207.95

71137

Quantitation of cell‑mediated immunity by multiple antigen delayed type hypersensitivity intradermal skin testing using a minimum of 7 antigens

30.25

71139

Characterisation of 3 or more leucocyte surface antigens by immunofluorescence or immunoenzyme techniques to assess lymphoid or myeloid cell populations, including a total lymphocyte count or total leucocyte count by any method, on one or more specimens of blood, CSF or serous fluid

104.05

71141

Characterisation of 3 or more leucocyte surface antigens by immunofluorescence or immunoenzyme techniques to assess lymphoid or myeloid cell populations on one or more disaggregated tissue specimens

197.35

71143

Characterisation of 6 or more leucocyte surface antigens by immunofluorescence or immunoenzyme techniques to assess lymphoid or myeloid cell populations for the diagnosis (but not monitoring) of an immunological or haematological malignancy, including a service described in one or both of items 71139 and 71141 (if performed), on a specimen of blood, CSF, serous fluid or disaggregated tissue

260.00

71145

Characterisation of 6 or more leucocyte surface antigens by immunofluorescence or immunoenzyme techniques to assess lymphoid or myeloid cell populations for the diagnosis (but not monitoring) of an immunological or haematological malignancy, including a service described in one or more of items 71139, 71141 and 71143 (if performed) on 2 or more specimens of disaggregated tissues or one specimen of disaggregated tissue and one or more specimens of blood, CSF or serous fluid

424.50

71146

Enumeration of CD34+ cells, only for the purposes of autologous or directed allogeneic haemopoietic stem cell transplantation, including a total white cell count on the pheresis collection

104.05

71147

HLA‑B27 typing

40.55

71148

A test described in item 71147 if a receiving APP performs the test

40.55

71149

Complete tissue typing for 4 HLA‑A and HLA‑B Class I antigens (including any separation of leucocytes), including (if performed) a service described in item 71147

108.25

71151

Tissue typing for HLA‑DR, HLA‑DP and HLA‑DQ Class II antigens (including any separation of leucocytes)—phenotyping or genotyping of 2 or more antigens

118.85

71153

Testing, for assessment or diagnosis of systemic inflammatory disease or vasculitis, for the presence of an antibody by one of the following tests:

(a) antineutrophil cytoplasmic antibody (ANCA) immunofluorescence test;

(b) antineutrophil proteinase 3 antibody (PR3 ANCA) test;

(c) antimyeloperoxidase antibody (MPO ANCA) test;

(d) antiglomerular basement membrane antibody (GBM ANCA) test

34.55

71154

This item applies to a test described in item 71153 if:

(a) a referring APP has performed a test or tests described in item 71153; and

(b) a receiving APP performs the test described in item 71153;

one test

34.55

71155

Testing for the presence of 2 antibodies by tests mentioned in item 71153

47.45

71156

This item applies to a test described in item 71153 (other than a test described in item 71154) if:

(a) a referring APP has performed the test or tests described in item 71153; and

(b) a receiving APP performs the test or tests described in item 71153;

one test

12.85

71157

Testing for the presence of 3 antibodies by tests mentioned in item 71153

60.30

71159

Testing for the presence of 4 antibodies by tests mentioned in item 71153

73.15

71163

Detection of one of the following antibodies (of one or more class or isotype) in the assessment or diagnosis of coeliac disease or other gluten hypersensitivity syndromes, including a service described in item 71066 (if performed):

(a) antibodies to gliadin;

(b) antibodies to endomysium;

(c) antibodies to tissue transglutaminase;

one test

24.75

71164

Two or more tests mentioned in item 71163, including a service described in item 71066 (if performed)

39.90

71165

Antibodies to tissue antigens (acetylcholine receptor, adrenal cortex, heart, histone, insulin, insulin receptor, intrinsic factor, islet cell, lymphocyte, neuron, ovary, parathyroid, platelet, salivary gland, skeletal muscle, skin basement membrane and intercellular substance, thyroglobulin, thyroid microsome or thyroid stimulating hormone receptor)—detection of one antibody, including quantitation if required

34.55

71166

Detection of 2 antibodies described in item 71165

47.45

71167

Detection of 3 antibodies described in item 71165

60.30

71168

Detection of 4 or more antibodies described in item 71165

73.15

71169

This item applies to a service described in item 71165 if:

(a) a referring APP has not performed the service described in item 71165; and

(b) a receiving APP performs the service described in item 71165

34.55

71170

This item applies to a service described in item 71165 if:

(a) a referring APP has performed the test or tests described in item 71165; and

(b) a receiving APP performs the test or tests described in item 71165;

one test

12.85

71180

Antibody to cardiolipin or beta‑2 glycoprotein I—detection, including quantitation if required; one antibody specificity (IgG or IgM)

34.55

71183

Detection of 2 antibodies described in item 71180

47.45

71186

Detection of 3 or more antibodies described in item 71180

60.30

71189

Detection of specific IgG antibodies to one or more respiratory disease allergens not elsewhere specified

15.50

71192

Two items described in item 71189

28.35

71195

Three or more items described in item 71189

40.05

71198

Estimation of serum tryptase for the evaluation of unexplained acute hypotension or suspected anaphylactic event, assessment of risk in stinging insect anaphylaxis, exclusion of mastocytosis, monitoring of known mastocytosis

DHEA

66695

Hormones—dihydrotestosterone

DHTS

66695

Hormones—follicle stimulating hormone

FSH

66695

Hormones—gastrin

GAST

66695

Hormones—glucagon

GLGO

66695

Hormones—growth hormone

GH

66695

Hormones—growth hormone—stimulation by exercise or L‑dopa

GHSE

66686

Hormones—growth hormone—suppression by dexamethasone or glucose

GHSG

66686

Hormones—hormone receptor assay—breast

HRA

66662

Hormones—hormone receptor assay—ovary

HRO

66662

Hormones—human chorionic gonadotrophin—detection for pregnancy diagnosis

HCGP

73527, 73529

Hormones—human chorionic gonadotrophin—quantitation

HCG

66650–66653, 66750, 66751, 73529

Hormones—hydroxyprogesterone

OHP

66695

Hormones—insulin

INS

66695

Hormones—luteinizing hormone

LH

66695

Hormones—oestradiol

E2

66695

Hormones—oestriol

E3

66750, 66751

Hormones—oestrone

E1

66695

Hormones—parathyroid hormone

PTH

66695

Hormones—progesterone

PROG

66695

Hormones—prolactin

PROL

66695

Hormones—renin

REN

66695

Hormones—sex hormone binding globulin

SHBG

66695

Hormones—somatomedin

SOMA

66695

Hormones—stimulation by exercise or L‑dopa

GHSE

66686

Hormones—suppression by dexamethasone or glucose

GHSG

66686

Hormones—testosterone

TES

66695

Hormones—urine steroid fraction or fractions

USF

66695

Hormones—vasoactive intestinal peptide

VIP

66695

Hormones—vasopressin

ADH

66695

Huhner’s test

HT

73521

Human chorionic gonadotrophin—detection for pregnancy diagnosis

HCGP

73527, 73529

Human chorionic gonadotrophin—quantitation

HCG

66650–66653, 66750, 66751, 73529

Human papillomaviruses

HPV

69418

HVA (homovanillic acid)

HVA

66779

Hydatid—microbial antibody testing

HYD

69384

Hydroxy‑3‑methoxymandelic acid (previously known as VMA)

HMMA

66779

Hydroxychloroquine

HOCQ

66812

Hydroxyindoleacetic acid

HIAA

66779

Hydroxy methoxy phenylethylene glycol

HMPG

66779

Hydroxyprogesterone

OHP

66695

Hydroxyproline

HYDP

66752

Imipramine

IMIP

66812

Immediate frozen section diagnosis of biopsy material

FS

72855–72856

Immunocyto. one‑3 antibodies

ICC

73059, 73061

Immunocyto. 4+ antibodies

ICC1

73060

Immunoelectrophoresis and electrophoresis—characterisation of cryoglobulins

RYO

71059

Immunoelectrophoresis and electrophoresis—characterisation of paraprotein

PPRO

71059

Immunoglobulins—A

IGA

71066

Immunoglobulins—D

IGD

71074

Immunoglobulins—E (total)

IGE

71075–71079

Immunoglobulins—G

IGG

71068

Immunoglobulins—G, 4 subclasses

SIGG

71073

Immunoglobulins—M

IGM

71072

Immunohistochemical investigation of biopsy material

HIS

72846–72848

Infectious mononucleosis

IM

69384

Influenza A—microbial antibody testing

FLA

69384

Influenza B—microbial antibody testing

FLB

69384

Insulin

INS

66695

Insulin receptor antibodies—tissue antigens—antibodies

INSA

71165

Insulin—tissue antigens—antibodies

AINS

71165

Intercellular cement substance of skin—tissue antigens—antibodies

ICCS

71165

Intestinal disaccharidases

INTD

66680

Intrinsic factor—tissue antigens—antibodies

AIF

71165

Iron studies (iron, transferrin and ferritin)

IS

66596

Islet cell—tissue antigens—antibodies

AIC

71165

Isoelectric focusing and electrophoresis—characterisation of cryoglobulins

RYO

71059

Isoelectric focusing and electrophoresis—characterisation of paraprotein

PPRO

71059

Jo—1—tissue antigens—antibodies

JO1

71119

Keratin—tissue antigens—antibodies

KERA

71119

Kleihauer test

KLEI

65162

Lactate

LACT

66500

Lactate—dehydrogenase

LDH

66500

Lactate—dehydrogenase isoenzymes

LDI

66641

Lamellar body phospholipid

LBPH

66749

Lead

PB

66665

Lecithin/sphingomyelin ratio (amniotic fluid)

LS

66749

Legionella pneumophila—serogroup 1—microbial antibody testing

LP1

69384

Legionella pneumophila—serogroup 2—microbial antibody testing

LP2

69384

Leishmaniasis—microbial antibody testing

LEI

69384

Leptospira—microbial antibody testing

LEP

69384

Leucocyte count

WCC

65070

Leucocyte count—3 surface markers—blood, CSF, serous fluid

LMH3

71139

Leucocyte count—3 surface markers—tissue

LMT3

71141

Leucocyte count—6 surface markers—blood, CSF, serous fluid and tissue(s)

LMHT

71145

Leucocyte count—6 surface markers—blood, CSF, serous fluid or tissue

LM6

71143

Leucocyte count—CD34 surface marker only—blood

LMCD34

71146

Lignocaine

LIGN

66800

Lip—cytology on specimens from

SMCY

73043

Lipase

LIP

66500

Lipid studies

FATS

66500

Lipoprotein subclasses—electrophoresis

LEPG

66539

Listeria—microbial antibody testing

LIS

69384

Lithium

LI

66800

Liver function tests

LFT

66515

Liver/kidney microsomes—tissue antigens—antibodies

LKA

71119

Lupus anticoagulant

LUPA

65137, 65142, 65175–65179

Luteinizing hormone

LH

66695

Lymphocyte—tissue antigens—antibodies

ALY

71165

Lymphocytes—functional tests—one test

LF1

71127

Lymphocytes—functional tests—2 tests

LF2

71129

Lymphocytes—functional tests—3 tests

LF3

71131

Magnesium

MG

66500

Mammary serum antigen

MSA

66650

Manganese

MN

66819, 66822

Mantoux test

MANT

73811

Measles—microbial antibody testing

MEA

69384

Mercury

HG

66825, 66828

Metabolic bone disease

CBMB

66776

Metanephrines

MNEP

66779

Methadone

MTDN

66812

Methaemalbumin detection (Schumm’s test)

SCHM

65117

Methotrexate

MTTA

66812

Methsuximide

MSUX

66812

Methylphenobarbitone

MPBT

66812

Metronidazole

MRDZ

66812

Mexiletine (Mexitil)

MEX

66812

Mianserin

MIAS

66812

Microalbumin

MALB

66560

Microbial antibody testing—actinomycetes

ACT

69384

Microbial antibody testing—adenovirus

ADE

69384

Microbial antibody testing—aspergillus

ASP

69384

Microbial antibody testing—avian precipitins (bird fancier’s disease)

APP

69384

Microbial antibody testing—Blastomyces

BLM

69384

Microbial antibody testing—Bordetella pertussis

BOR

69384

Microbial antibody testing—Borrelia burgdorferi

BOB

69384

Microbial antibody testing—Brucella

BRU

69384

Microbial antibody testing—Campylobacter jejuni

CAM

69384

Microbial antibody testing—Candida

CAN

69384

Microbial antibody testing—Chlamydia

CHL

69384

Microbial antibody testing—Coccidioides

CCC

69384

Microbial antibody testing—Coxsackie B1‑6

COX

69384

Microbial antibody testing—Cryptococcus

CRY

69384

Microbial antibody testing—cytomegalovirus

CMV

69384

Microbial antibody testing—cytomegalovirus serology in pregnancy

CMVP

69384

Microbial antibody testing—dengue

DEN

69384

Microbial antibody testing—diphtheria

DIP

69384

Microbial antibody testing—echinococcus

ECC

69384

Microbial antibody testing—echo‑coxsackie group

ECH

69384

Microbial antibody testing—Entamoeba histolytica

AMO

69384

Microbial antibody testing—Epstein Barr virus

EBV

69472–69474

Microbial antibody testing—fluorescent treponemal antibody—absorption test (FTA‑ABS)

FTA

69384

Microbial antibody testing—Haemophilus influenzae

HUS

69384

Microbial antibody testing—herpes simplex virus

HPA

69384

Microbial antibody testing—Histoplasma

HIP

69384

Microbial antibody testing—Human Immunodeficiency Virus

69384

Microbial antibody testing—hydatid

HYD

69384

Microbial antibody testing—infectious mononucleosis

IM

69384

Microbial antibody testing—influenza A

FLA

69384

Microbial antibody testing—influenza B

FLB

69384

Microbial antibody testing—Legionella pneumophila—serogroup 1

LP1

69384

Microbial antibody testing—Legionella pneumophila—serogroup 2

LP2

69384

Microbial antibody testing—leishmaniasis

LEI

69384

Microbial antibody testing—Leptospira

LEP

69384

Microbial antibody testing—Listeria

LIS

69384

Microbial antibody testing—measles

MEA

69384

Microbial antibody testing—Micropolyspora faeni

MIC

69384

Microbial antibody testing—mumps

MUM

69384

Microbial antibody testing—Murray Valley encephalitis

MVE

69384

Microbial antibody testing—Mycoplasma pneumoniae

MYC

69384

Microbial antibody testing—Neisseria meningitidis

MEN

69384

Microbial antibody testing—Newcastle disease

NCD

69384

Microbial antibody testing—parainfluenza 1

PF1

69384

Microbial antibody testing—parainfluenza 2

PF2

69384

Microbial antibody testing—parainfluenza 3

PF3

69384

Microbial antibody testing—paratyphi

PTY

69384

Microbial antibody testing—pertussis

PER

69384

Microbial antibody testing—poliomyelitis

PLO

69384

Microbial antibody testing—Proteus OX 19

POX

69384

Microbial antibody testing—Proteus OXK

POK

69384

Microbial antibody testing—Q fever

QFF

69384

Microbial antibody testing—rapid plasma reagin test

RPR

69384

Microbial antibody testing—respiratory syncytial virus

RSV

69384

Microbial antibody testing—Ross River virus

RRV

69384

Microbial antibody testing—rubella

RUB

69384

Microbial antibody testing—Salmonella typhi (H)

SAH

69384

Microbial antibody testing—Salmonella typhi (O)

SAO

69384

Microbial antibody testing—Schistosoma

STO

69384

Microbial antibody testing—streptococcal serology—anti‑DNASE B titre

ADNB

69384

Microbial antibody testing—streptococcal serology—anti‑streptolysin O titre

ASOT

69384

Microbial antibody testing—Streptococcus pneumoniae

PCC

69384

Microbial antibody testing—tetanus

TET

69384

Microbial antibody testing—Thermoactinomyces vulgaris

THE

69384

Microbial antibody testing—thermopolyspora

TPS

69384

Microbial antibody testing—Toxocara

TOC

69384

Microbial antibody testing—Toxoplasma

TOX

69384

Microbial antibody testing—TPHA (Treponema pallidum haemagglutination test)

TPHA

69384

Microbial antibody testing—Treponema pallidum haemagglutination test

TPHA

69384

Microbial antibody testing—trichinosis

TOS

69384

Microbial antibody testing—typhus, Weil‑Felix

TYP

69384

Microbial antibody testing—Varicella zoster

VCZ

69384

Microbial antibody testing—VDRL (Venereal Disease Research Laboratory)

VDRL

69384

Microbial antibody testing—Yersinia enterocolitica

YER

69384

Microbial antigen testing—Chlamydia

MCCH

69494

Microbial antigen testing—Clostridium difficile

CLDT

69363

Microbial antigen testing—group B streptococcus

STB

69494

Microbial antigen testing—Haemophilus influenzae

HI

69494

Microbial antigen testing—herpes simplex virus

HSV

69494

Microbial antigen testing—Neisseria gonorrhoeae

GON

69494

Microbial antigen testing—Neisseria meningitidis

NMG

69494

Microbial antigen testing—respiratory syncytial virus

RSVN

69494

Microbial antigen testing—Streptococcus pneumonia

SPN

69494

Microbial antigen testing—Varicella zoster

VCZN

69494

Micropolyspora faeni

MIC

69384

Microscopic examination of—faeces for parasites

OCP

69336–36939

Microscopic examination of—wet film material other than blood

MWFM

69300

Microscopy and culture of—material from nose, throat, eye or ear

MCSW

69303

Microscopy and culture of—material from skin

MCSK

69309

Microscopy and culture of—postoperative wounds, aspirates of body cavities

MCPO

69321

Microscopy and culture of—specimens of sputum

MCSP

69318

Microscopy and culture of—specimens of sputum, urine or other body fluids for mycobacteria—one specimen

AFB1

69324

Microscopy and culture of—specimens of sputum, urine or other body fluids for mycobacteria—2 specimens

AFB2

69327

Microscopy and culture of—specimens of sputum, urine or other body fluids for mycobacteria—3 specimens

AFB3

69330

Microscopy and culture of—superficial sites

MCSS

69306

Microscopy and culture of—urethra, vagina, cervix or rectum

MCGR

69312

Microscopy and culture to detect pathogenic micro‑organisms including Chlamydia

MCCH

69494

Microscopy, culture, identification and sensitivity of urine

UMCS

69333

Mitochondria—tissue antigens—antibodies

MA

71119

Mouth—cytology on specimens from

SMCY

73043

Mumps—microbial antibody testing

MUM

69384

Murray Valley encephalitis—microbial antibody testing

MVE

69384

Mycobacteria microscopy and culture of sputum—one specimen

AFB 1

69324

Mycobacteria microscopy and culture of sputum—2 specimens

AFB 2

69327

Mycobacteria microscopy and culture of sputum—3 specimens

AFB 3

69333

Mycoplasma pneumoniae—microbial antibody testing

MYC

69384

Myoglobin

MYOG

66518

N‑acetyl procainamide

NAPC

66812

Neisseria gonorrhoeae by NAA techniques and chlamydia by any method

CHGO

69494

Neisseria gonorrhoeae—microbial antigen testing

GON

69494

Neisseria meningitidis—antigens

NMG

69494

Neisseria meningitidis—microbial antibody testing

MEN

69384

Neisseria meningitidis—microbial antigen testing

NMG

69494

Netilmicin

66800

Neural tube defects and Down’s syndrome

NTDD

66750, 66751

Neuron—tissue antigens—antibodies

ANE

71165

Neutrophil cytoplasm—tissue antigens—antibodies

ANCA

71165

Neutrophil functions

NFT

71135

Newcastle disease—microbial antibody testing

NCD

69384

Nickel

NI

66825, 66828

Nipple discharge—cytology on specimens from

SMCY

73043

Nitrazepam

NITR

66812

Nordothiepin

NDIP

66812

Norfluoxetine

NFLE

66812

Nortriptyline

NORT

66812

Nose—cytology on specimens from

SMCY

73043

Nose—microscopy and culture of material from

MCSW

69303

Nuclear antigens—detection of antibodies to

ANA

71097

Oestradiol

E2

66695

Oestriol

E3

66750, 66751

Oestrone

E1

66695

Oligoclonal proteins

OGP

71062

Op/biopsy specimens—microscopy and culture of material from

MCPO

69321

Oral glucose challenge test—gestational diabetes

OGCT

66545

Oral glucose tolerance test—gestational diabetes

GTTP

66542

Osmolality, serum or urine

OSML

66563

Ovary—tissue antigens—antibodies

AOV

71165

Oxalate

OXAL

66752

Oxazepam

OXAZ

66812

PAA (phenyl acetic acid)

PAA

66779

Palmitic acid in amniotic fluid

PALM

66749

Pap smear

CCR

73053

Papanicolaou test

CCR

73053

Paracetamol

PARA

66800

Parainfluenza 1—microbial antibody testing

PF1

69384

Parainfluenza 2—microbial antibody testing

PF2

69384

Parainfluenza 3—microbial antibody testing

PF3

69384

Paraprotein characterisation—by electrophoresis and immunoelectrophoresis or immunofixation or isoelectric focusing

PPRO

71059

Paraprotein characterisation—on concurrently collected serum or urine

PPSU

71060

Paraprotein quantitation—by electrophoresis

EPPI

71057

Paraquat

PARQ

66812

Parasites—microscopic examination of faeces

OCP

69336–69339

Parathyroid hormone (PTH)

PTH

66695

Parathyroid—tissue antigens—antibodies

PTHA

71165

Paratyphi—microbial antibody testing

PTY

69384

Partial thromboplastin time

PTT

65120

Patient episode initiation fees

PEI

73922–73939

Pentobarbitone

PENT

66812

Perhexiline

PHEX

66812

Pertussis—microbial antibody testing

PER

69384

Phenobarbitone

PHBA

66800

Phensuximide

PHEN

66812

Phenylacetic acid

PAA

66779

Phenytoin

PHEY

66800

Phosphate

PHOS

66500

Phosphatidylglycerol

PTGL

66749

Platelet—aggregation

PLTG

65144

Platelet—count

PLTC

65070

Platelet—tissue antigens—antibodies

APA

71165

PM‑Sc1—tissue antigens—antibodies

PM1

71119

Poliomyelitis—microbial antibody testing

PLO

69384

Porphobilinogen in urine

UPG

66782

Porphyrins in urine—qualitative test

UPR

66782

Porphyrins—quantitative test, one or more fractions

PR

66785

Potassium

K

66500

Prealbumin

PALB

66632

Prednisolone

PRED

66812

Pregnancy serology—one test

MSP1

69405

Pregnancy serology—2 tests

MSP2

69408

Pregnancy serology—3 tests

MSP3

69411

Pregnancy serology—4 tests

MSP4

69413

Pregnancy testing

73806

Pregnancy testing—diagnosis of Down’s syndrome and neural tube defect

NTDD

66750, 66751

Pregnancy testing—HCG detection

HCG

73527, 73529

Pregnancy testing—HCG quantitation

HCG

73529

Primidone

PRIM

66800

Procainamide

PCAM

66800

Progesterone

PROG

66695

Prolactin

PROL

66695

Propranolol

PPNO

66812

Prostate specific antigen

PSA

66655–66659

Protein—C

PROC

65142, 65171, 65175–65179

Protein—S

PROS

65142, 65171, 65175–65179

Protein, quantitation of—alpha fetoprotein

AFP

66650–66653, 66743, 66750, 66751

Protein, quantitation of—alpha‑l‑antitrypsin

AAT

66635

Protein, quantitation of—beta‑2‑microglobulin

BMIC

66629

Protein, quantitation of—C‑l esterase inhibitor

CEI

66644

Protein, quantitation of—caeruloplasmin

CPLS

66632

Protein, quantitation of—classes or presence and amount of paraprotein by electrophoresis

EPPI

71057, 71058

Protein, quantitation of—ferritin (see also Iron studies)

FERR

66593

Protein, quantitation of—for Down’s syndrome and neural tube defect testing

NTDD

66750, 66751

Protein, quantitation of—haptoglobins

HGLB

66632

Protein, quantitation of—microalbumin

MALB

66560

Protein, total—quantitation of

PROT

66500

Proteus OX 19—microbial antibody testing

POX

69384

Proteus OXK—microbial antibody testing

POK

69384

Prothrombin gene mutation

PGM

73308, 73311

Prothrombin time

PT

65120

Pyruvate

PVTE

66500

Q fever—microbial antibody testing

QFF

69384

Quinalbarbitone

QUIB

66812

Quinidine

QUIN

66800

Quinine

QNN

66812

Rapid plasma reagin test—microbial antibody testing

RPR

69384

RAST

RAST

71079

Rectum—microscopy and culture of material from

MCGR

69312

Red blood cells—Kleihauer

KLEI

65162

Red cell folate and serum B12

B12F

66602

Red cell folate and serum B12 and serum folate if required

B12F

66602

Red cell folate and serum folate

RCF

66599

Red cell porphyrins—qualitative test

RCP

66782

Referred specimen fee

73940

Renin

REN

66695

Reptilase test

REPT

65120

Respiratory syncytial virus—microbial antibody testing

RSV

69384

Respiratory syncytial virus—microbial antigen testing

RSVN

69494

Reticulin—tissue antigens—antibodies

RCA

71119

Reticulocyte count

RETC

65072

Rheumatoid factor

RF

71106

Rheumatoid factor—quantitation

RFQ

71106

Ross River virus—microbial antibody testing

RRV

69384

RSV (respiratory syncytial virus)—microbial antibody testing

RSV

69384

RSV (respiratory syncytial virus)—microbial antigen testing

RSVN

69494

Rubella—serology

RUB

69384

Salicylate (aspirin)

SALI

66800

Salivary gland—tissue antigens—antibodies

ASG

71165

Salmonella typhi (H)—microbial antibody testing

SAH

69384

Salmonella typhi (O)—microbial antibody testing

SAO

69384

Schistosoma—microbial antibody testing

STO

69384

Scl‑70—tissue antigens—antibodies

SCL

71119

Selenium

SE

66819, 66822

Semen examination

SEE

73523

Semen examination—for spermatozoa (post vasectomy)

SES

73521

Serology—in pregnancy (see Pregnancy serology)

Serotonin

5HT

66779

Serum—B12

B12

66599

Serum—folate (with B12)

B12

66599

Serum—folate (with B12 red cell folate)

B12F

66602

Sex hormone binding globulin

SHBG

66695

Skeletal muscle—tissue antigens—antibodies

SLA

71165

Skin—cytology

SMCY

73043

Skin—microscopy and culture of material from

MCSS

69306

Skin—microscopy, culture and Chlamydia of material from

MCSK

69309

Skin basement membrane—tissue antigens—antibodies

SKA

71165

Smooth muscle—tissue antigens—antibodies

SMA

71119

Snake venom

HISS

66623

Sodium

NA

66500

Solid tissue or tissues—chemical assays

ENZS

66683

Solid tissue or tissues—cytology of fine needle aspiration

FNCY

73049

Solid tissue or tissues—cytology of fine needle aspiration by, or in presence of pathologist

FNCP

73051

Somatomedin

SOMA

66695

Sotalol

SALL

66812

Specific IgE or IgG antibodies

RAST

71079

Specimen referred fee

73940

Sperm antibodies

SAB

73525

Sperm antibodies—penetrating ability

SPA

73525

Sputum—cytology—one specimen

BFCY

73045

Sputum—cytology—3 specimens

SPCY

73047

Sputum—for mycobacteria—one specimen

AFB1

69324

Sputum—for mycobacteria—2 specimens

AFB2

69327

Sputum—for mycobacteria—3 specimens

AFB3

69330

Sputum—microscopy and culture of specimens

MCSP

69318

Stelazine

STEL

66812

Steroid fraction or fractions in urine

USF

66695

Streptococcal serology—anti‑DNASE B titre—microbial antibody testing

ADNB

69384

Streptococcal serology—anti‑streptolysin O titre—microbial antibody testing

ASOT

69384

Streptococcus—Group B

STB

69494

Streptococcus pneumoniae—CSF antigens

SPN

69494

Streptococcus pneumoniae—microbial antibody testing

PCC

69384

Streptococcus pneumoniae—microbial antigen testing

SPN

69494

Strontium

SR

66825, 66828

Stypven test

STYP

65120

Sugar water test

SWT

65075

Sulthiame (Ospolot)

SUL

66812

Supplementary testing for Hepatitis C antibodies

HCST

69441

Syphilis serology

STS

69387

Testosterone

TES

66695

Tetanus—microbial antibody testing

TET

69384

Thalassaemia studies

TS

65078

Theophylline

THEO

66800

Thermoactinomyces vulgaris—microbial antibody testing

THE

69384

Thermopolyspora—microbial antibody testing

TPS

69384

Thiopentone

TOPO

66812

Thioridazine

THIO

66812

Throat—microscopy and culture of material from

MCSW

69303

Thrombin time

TT

65120

Thrombophilia testing (see individual thrombophilia tests)

Thyroglobulin

TGL

66650

Thyroglobulin—tissue antigens—antibodies

ATG

71165

Thyroid function tests (including TSH)

TFT

66719

Thyroid microsome—tissue antigens—antibodies

TMA

71165

Thyroid stimulating hormone (if requested on its own, or as a preliminary test to thyroid function testing)

TSH

66716

Thyroid stimulating hormone (if requested with other hormones referred to in item 66695)

TSH

66722–66734

Tissue transglutaminase antibodies

TTG

71163

Tobramycin

66800

Total protein

PROT

66500

Toxocara—microbial antibody testing

TOC

69384

Toxoplasma—microbial antibody testing

TOX

69384

Treponema pallidum haemagglutination test—microbial antibody testing

TPHA

69384

Trichinosis—microbial antibody testing

TOS

69384

Triglycerides

TRIG

66500

Trimipramine

TRIM

66812

Troponin

TROP

66518

Tryptic activity in faeces

TAF

66677

TSH receptor antibody test—tissue antigens—antibodies

TSHA

71165

Tuberculosis

MANT

73811

Tumour markers—CA‑15.3 antigen

CA15

66650

Tumour markers—CA‑19.9 antigen

CA19

66650

Tumour markers—CA‑125 antigen

C125

66650

Tumour markers—carcinoembryonic antigen

CEA

66650

Tumour markers—mammary serum antigen

MSA

66650

Tumour markers—prostate specific antigen

PSA

66656

Tumour markers—prostatic acid phosphatase—one or more fractions

ACP

66656

Tumour markers—thyroglobulin

TGL

66650

Typhus, Weil‑Felix—microbial antibody testing

TYP

69384

Urate

URAT

66500

Urea

U

66500

Urea, electrolytes, creatinine

U&E

66515

Urethra—microscopy and culture of material from

MCGR

69312

Urine—acidification test

UAT

66587

Urine—catalase test

UCAT

73805

Urine—cystine (cysteine)

UCYS

66782

Urine—cytology—on one specimen

BFCY

73045

Urine—cytology—on 3 specimens

SPCY

73047

Urine—haemoglobin

UHB

66782

Urine—microscopy, culture, identification and sensitivity

UMCS

69333

Urine—porphobilinogen

UPG

66782

Urine—porphyrins—qualitative test

UPR

66782

Urine—steroid fraction or fractions

USF

66695

Urine—urobilinogen

UUB

66782

Vagina—cytology on specimens from

CVO

73057

Vagina—microscopy and culture of material from

MCGR

69312

Valproate (Epilim)

VALP

66800

Vancomycin

VAN

66800

Varicella zoster—microbial antibody testing

VCZ

69384

Varicella zoster—microbial antigen testing

VCZN

69494

Vasoactive intestinal peptide

VIP

66695

Vasopressin

ADH

66695

VDRL (Venereal Disease Research Laboratory)—microbial antibody testing

VDRL

69384

Viscosity of blood or plasma

VISC

65060

Vitamins—B12

B12

66599

Vitamins—D

VITD

66608

Vitamins—folate

RCF

66599

Vitamins—quantitation of A, B1, B2, B3, B6, C or E

VIT

66605

VMA (see HMMA)

Von Willebrand’s factor

VWF

65150

Von Willebrand’s factor antigen

VWA

65150

Warfarin

WFR

66812

Yersinia enterocolitica—microbial antibody testing

YER

69384

Zinc

ZN

66667–66670

Part 4Complexity levels for histopathology items  

Complexity levels for histopathology items

Specimen type

Complexity level

Adrenal resection, neoplasm

5

Adrenal resection, not neoplasm

4

Anus, all specimens not otherwise specified

3

Anus, neoplasm, biopsy

4

Anus, neoplasm, radical resection

6

Anus, submucosal resection—neoplasm

5

Appendix

3

Artery, all specimens not otherwise specified

3

Artery, biopsy

4

Bartholin’s gland—cyst

3

Bile duct, resection—all specimens

6

Bone—all specimens not otherwise specified

4

Bone, biopsy, curettings or fragments—lesion

5

Bone, biopsy or curettings quantitation—metabolic disease

6

Bone, femoral head

4

Bone marrow, biopsy

4

Bone, resection, neoplasm—all sites and types

6

Brain neoplasm, resection—cerebello‑pontine angle

4

Brain or meninges, biopsy—all lesions

5

Brain or meninges, not neoplasm—temporal lobe

6

Brain or meninges, resection—neoplasm (intracranial)

5

Brain or meninges, resection—not neoplasm

4

Branchial cleft, cyst

4

Breast, excision biopsy, guidewire localisation—non‑palpable lesion

6

Breast, excision biopsy, or radical resection, malignant neoplasm or atypical proliferative disease—all specimen types

6

Breast, incision biopsy or needle biopsy, malignant neoplasm—all specimen types

4

Breast, microdochectomy

6

Breast, orientated wide local excision for carcinoma with margin assessment

7

Breast tissue—all specimens not otherwise specified

4

Bronchus, biopsy

4

Carotid body—neoplasm

5

Cholesteatoma

3

Digits, amputation—not traumatic

4

Digits, amputation—traumatic

2

Ear, middle and inner—not cholesteatoma

4

Endocrine neoplasm—not otherwise specified

5

Extremity, amputation—not otherwise specified

4

Extremity, amputation or disarticulation—neoplasm

6

Eye, conjunctiva—biopsy or pterygium

3

Eye, cornea

4

Eye, enucleation or exenteration—all lesions

6

Eye—not otherwise specified

4

Fallopian tube, biopsy

4

Fallopian tube, ectopic pregnancy

4

Fallopian tube, sterilization

2

Fetus with dissection

6

Foreskin—new born

2

Foreskin—not new born

3

Gallbladder

3

Gallbladder and porta hepatis‑radical resection

6

Ganglion cyst, all sites

3

Gum or oral mucosa, biopsy

4

Heart—not otherwise specified

5

Heart valve

4

Hernia sac

2

Hydrocele sac

2

Jaw, upper or lower, including bone—radical resection for neoplasm

6

Joint and periarticular tissue, without bone—all specimens

3

Joint tissue, including bone—all specimens

4

Kidney, biopsy including transplant

5

Kidney, nephrectomy transplant

5

Kidney, partial or total nephrectomy—not neoplasm

4

Kidney, partial or total nephrectomy or nephroureterectomy—neoplasm

6

Large bowel, colostomy—stoma

3

Large bowel (including rectum), biopsy—all sites

4

Large bowel (including rectum), biopsy, for confirmation or exclusion of Hirschsprung’s Disease

5

Large bowel (including rectum), polyp

4

Large bowel (including rectum), segmental resection—neoplasm

6

Large bowel (including rectum), submucosal resection—neoplasm

5

Large bowel, segmental resection—colon, not neoplasm

5

Larynx, biopsy

4

Larynx, partial or total resection

5

Larynx, resection with nodes or pharynx or both

6

Lip biopsy—all specimens not mentioned

3

Lip wedge resection or local excision with orientation

4

Liver—all specimens not otherwise specified

5

Liver, hydatid cyst or resection for trauma

4

Liver, total or subtotal hepatectomy—neoplasm

6

Lung, needle or transbronchial biopsy

4

Lung, resection—neoplasm

6

Lung segment, lobar or total resection

6

Lung, wedge biopsy

5

Lymph node, biopsy—all sites

4

Lymph node, biopsy, for lymphoma or lymphoproliferative disorder

5

Lymph nodes, regional resection—all sites

5

Mediastinum mass

5

Muscle, biopsy

6

Nasopharynx or oropharynx, biopsy

4

Nerve, biopsy neuropathy

5

Nerve, neurectomy or removal of neoplasm

4

Nerve—not otherwise specified

3

Nose, mucosal biopsy

4

Nose or sinuses, polyps

3

Odontogenic neoplasm

5

Odontogenic or dental cyst

4

Oesophagus, biopsy

4

Oesophagus, diverticulum

3

Oesophagus, partial or total resection

6

Oesophagus, submucosal resection—neoplasm

5

Omentum, biopsy

4

Ovary with or without tube—neoplasm

5

Ovary with or without tube—not neoplasm

4

Pancreas, biopsy

5

Pancreas, cyst

4

Pancreas, subtotal or total with or without splenectomy

6

Parathyroid gland(s)

4

Penisectomy—simple

4

Penisectomy with node dissection

5

Peritoneum, biopsy

4

Pituitary neoplasm

4

Placenta—not third trimester

4

Placenta—third trimester, abnormal pregnancy or delivery

4

Pleura or pericardium, biopsy or tissue

4

Products of conception, spontaneous or missed abortion

4

Products of conception, termination of pregnancy

3

Prostate—all types of specimen not otherwise specified

4

Prostate, radical prostatectomy or cystoprostatectomy for carcinoma

7

Prostate, radical resection

6

Retroperitoneum, neoplasm

5

Salivary gland—all specimens not otherwise specified

4

Salivary gland, Mucocele

3

Salivary gland, neoplasm—all sites

5

Sinus, paranasal, biopsy

4

Sinus, paranasal, resection—neoplasm

6

Skin—all specimens not otherwise specified including all neoplasms and cysts

3

Skin, biopsy—blistering skin diseases

4

Skin, biopsy—inflammatory dermatosis

4

Skin, biopsy—investigation of alopecia where serial horizontal sections are taken, except for male pattern baldness

5

Skin, biopsy—investigation of lymphoproliferative disorder

5

Skin, eyelid, wedge resection

4

Skin, local resection—orientation

4

Skin, resection of malignant melanoma or melanoma in situ

5

Small bowel—all specimens not otherwise specified

5

Small bowel—biopsy, all sites

4

Small bowel, diverticulum

3

Small bowel, resection—neoplasm

6

Small bowel, submucosal resection—neoplasm

5

Soft tissue, infiltrative lesion—extensive resections at least 5 cm in maximal dimension

6

Soft tissue, lipoma and variants

3

Soft tissue, neoplasm, not lipoma—all specimens

5

Soft tissue—not otherwise specified

4

Spleen

5

Stomach—all specimens not otherwise specified

4

Stomach, endoscopic biopsy or endoscopic polypectomy

4

Stomach, resection, neoplasm—all specimens

6

Stomach, submucosal resection—neoplasm

5

Tendon or tendon sheath, giant cell neoplasm

4

Tendon or tendon sheath—not otherwise specified

3

Testis and adjacent structures, castration

2

Testis and adjacent structures, neoplasm with or without nodes

5

Testis and adjacent structures—not otherwise specified

3

Testis and adjacent structures, vas deferens sterilization

2

Testis, biopsy

5

Thymus—not otherwise specified

5

Thyroglossal duct—all lesions

4

Thyroid—all specimens

5

Tissue or organ—all specimens not otherwise specified

3

Tissue or organ not otherwise specified, abscess

3

Tissue or organ not otherwise specified, haematoma

3

Tissue or organ not otherwise specified, malignant neoplasm with regional nodes

6

Tissue or organ not otherwise specified, neoplasm local

4

Tissue or organ not otherwise specified, pilonidal cyst or sinus

3

Tissue or organ not otherwise specified, thrombus or embolus

3

Tissue or organ not otherwise specified, veins varicosity

3

Tongue, biopsy

4

Tongue or tonsil, neoplasm local

5

Tongue or tonsil, neoplasm with nodes

6

Tonsil, biopsy—excluding resection of whole organ

4

Tonsil or adenoids or both

2

Trachea, biopsy

4

Ureter, biopsy

4

Ureter, resection

5

Urethra, biopsy

4

Urethra, resection

5

Urinary bladder—all specimens not otherwise specified

4

Urinary bladder, partial or total with or without prostatectomy

6

Urinary bladder, transurethral resection of neoplasm

5

Uterus and/or cervix—all specimens not otherwise specified

4

Uterus, cervix cone, biopsy (including LEEP or LLETZ biopsy)

5

Uterus, cervix, curettings or biopsy

4

Uterus, endocervix, polyp

3

Uterus, endometrium, polyp

3

Uterus, with or without adnexa, malignant neoplasm—all specimen types not otherwise specified

6

Uterus with or without adnexa, neoplasm, Wertheim’s or pelvic clearance

6

Vagina, biopsy

4

Vaginal mucosa, incidental

3

Vagina, radical resection

6

Vulva or labia, biopsy

4

Vulval, subtotal or total with or without nodes

6

Part 5Dictionary

Note: All references in the Dictionary to a provision are references to a provision in this Schedule, unless otherwise indicated.

  

 In this Schedule:

abnormal level of TSH,for item 66719, has the meaning given by clause 2.2.5.

Act means the Health Insurance Act 1973.

approved collection centre,for Group P10, has the meaning given by clause 2.10.1.

ASGC,for item 74991, has the meaning given by subclause 2.12.1(3).

biopsy material,for Group P5, has the meaning given by clause 2.5.1.

bulk‑billed,for items 74990 and 74991, has the meaning given by subclause 2.12.1(2).

Commonwealth concession card holder,for items 74990 and 74991, has the meaning given by subclause 2.12.1(2).

compatibility tests by crossmatch,for items 65099 and 65102, has the meaning given by clause 2.1.2.

cytology,for Group P5, has the meaning given by clause 2.5.1.

designated test, has the meaning given by clause 1.2.4.

elevated serum ferritin, for items 73317 and 73318, has the meaning given by clause 2.7.1.

general practitioner, has the meaning given by clause 1.2.6.

group, for a group in this table, means every item in the group.

Hepatitis C sero‑positive, for items 69499 and 69500, has the meaning given by clause 2.3.5.

institution,for Group P10, has the meaning given by clause 2.10.1.

item means:

  • (a)

    an item mentioned, by number, in column 1 of a table in:

    • (i)

      this Schedule; or

    • (ii)

      the diagnostic imaging services table; or

    • (iii)

      the general medical services table; or

  • (b)

    in a reference immediately followed by a number—the item so numbered.

metal toxicity testing group, has the meaning given by clause 2.2.7.

nutritional metals testing group, has the meaning given by clause 2.2.7.

patient episode means:

  • (a)

    a pathology service or pathology services (other than a pathology service to which paragraph (b) refers) provided for a single patient whose need for the service or services was determined under section 16A of the Act:

    • (i)

      on the same day; or

    • (ii)

      if more than one test is performed on the one specimen within 14 days—on the same or different days;

 whether the services:

  • (iii)

    are requested by one or more practitioners, participating midwives or participating nurse practitioners; or

  • (iv)

    are described in a single item or in more than one item; or

  • (v)

    are rendered by one approved pathology practitioner or more than one approved pathology practitioner; or

  • (vi)

    are rendered on the same or different days; or

  • (b)

    a pathology service to which clause 1.2.3, 2.1.1 or 2.2.2 refers that is provided in the circumstances, set out in the clause, that relate to the service.

practice location,for item 74991, has the meaning given by subclause 2.12.1(3).

prescribed laboratory,for Group P10, has the meaning given by clause 2.10.1.

receiving APP, for a patient episode, means an approved pathology practitioner in an approved pathology authority who:

  • (a)

    receives a request from a referring APP to render a designated test or tests; and

  • (b)

    renders each test included in the designated test that the referring APP has not performed.

recognised pathologist means:

  • (a)

    a medical practitioner recognised as a specialist in pathology under subsection 3D(1) of the Act; or

  • (b)

    a medical practitioner in relation to whom there is in force a determination under paragraph 3DB(4)(a) or subsection 3E(1) of the Act that the practitioner is recognised as a specialist in pathology.

referring APP, for a patient episode, means an approved pathology practitioner in an approved pathology authority who:

  • (a)

    has received a request to render one or more designated tests; and

  • (b)

    is unable, because of the lack of facilities in, or expertise or experience of the staff of, the laboratory of the authority, to render one or more of the tests included in the designated test; and

  • (c)

    requests a receiving APP in another approved pathology authority to render:

    • (i)

      the test or tests that the approved pathology practitioner is unable to render; or

    • (ii)

      all of the tests that are included in the designated test; and

  • (d)

    renders each test included in the designated test, other than the test or tests for which the request mentioned in paragraph (c) is made.

regional, rural or remote area, for item 74991, has the meaning given by subclause 2.12.1(3).

request, received by an approved pathology practitioner, includes a request for a pathologist‑determinable service to which subsection 16A(6) of the Act applies.

residential care facility,for Group P10, has the meaning given by clause 2.10.1.

rule 3 exemption means the exemption that has effect because of the operation of clause 1.2.2.

separately identified specimen,for Group P5, has the meaning given by clause 2.5.1.

serial examinationsmeans a series of examinations requested on one occasion, whether or not:

  • (a)

    the materials are received on different days by the approved pathology practitioner; or

  • (b)

    the examinations or cultures were requested on one or more request forms by the treating practitioner.

serial examinations or cultures,for Group P3, has the meaning given by clause 2.3.1.

serological status is uncertain,for items 69499 and 69500, has the meaning given by clause 2.3.5.

set of pathology services, has the meaning given by clause 1.2.7.

SLA, for item 74991, has the meaning given by subclause 2.12.1(3).

specimen collection centre,for Group P10, has the meaning given by clause 2.10.1.

SSD for item 74991, has the meaning given by subclause 2.12.1(3).

treating practitioner,for Group P10, has the meaning given by clause 2.10.1.

unreferred service,for items 74990 and 74991, has the meaning given by subclause 2.12.1(3).

Endnotes

Endnote 1About the endnotes

The endnotes provide details of the history of this legislation and its provisions. The following endnotes are included in each compilation:

Endnote 1—About the endnotes

Endnote 2—Abbreviation key

Endnote 3—Legislation history

Endnote 4—Amendment history

Endnote 5—Uncommenced amendments

Endnote 6—Modifications

Endnote 7—Misdescribed amendments

Endnote 8—Miscellaneous

If there is no information under a particular endnote, the word “none” will appear in square brackets after the endnote heading.

Abbreviation key—Endnote 2

The abbreviation key in this endnote sets out abbreviations that may be used in the endnotes.

Legislation history and amendment history—Endnotes 3 and 4

Amending laws are annotated in the legislation history and amendment history.

The legislation history in endnote 3 provides information about each law that has amended the compiled law. The information includes commencement information for amending laws and details of application, saving or transitional provisions that are not included in this compilation.

The amendment history in endnote 4 provides information about amendments at the provision level. It also includes information about any provisions that have expired or otherwise ceased to have effect in accordance with a provision of the compiled law.

Uncommenced amendments—Endnote 5

The effect of uncommenced amendments is not reflected in the text of the compiled law but the text of the amendments is included in endnote 5.

Modifications—Endnote 6

If the compiled law is affected by a modification that is in force, details of the modification are included in endnote 6.

Misdescribed amendments—Endnote 7

An amendment is a misdescribed amendment if the effect of the amendment cannot be incorporated into the text of the compilation. Any misdescribed amendment is included in endnote 7.

Miscellaneous—Endnote 8

Endnote 8 includes any additional information that may be helpful for a reader of the compilation.

Endnote 2Abbreviation key

ad = added or inserted

pres = present

am = amended

prev = previous

c = clause(s)

(prev) = previously

Ch = Chapter(s)

Pt = Part(s)

def = definition(s)

r = regulation(s)/rule(s)

Dict = Dictionary

Reg = Regulation/Regulations

disallowed = disallowed by Parliament

reloc = relocated

Div = Division(s)

renum = renumbered

exp = expired or ceased to have effect

rep = repealed

hdg = heading(s)

rs = repealed and substituted

LI = Legislative Instrument

s = section(s)

LIA = Legislative Instruments Act 2003

Sch = Schedule(s)

mod = modified/modification

Sdiv = Subdivision(s)

No = Number(s)

SLI = Select Legislative Instrument

o = order(s)

SR = Statutory Rules

Ord = Ordinance

Sub-Ch = Sub-Chapter(s)

orig = original

SubPt = Subpart(s)

par = paragraph(s)/subparagraph(s)

/sub-subparagraph(s)

Endnote 3Legislation history

Number and year

FRLI registration

Commencement

Application, saving and transitional provisions

249, 2013

26 Nov 2013 (see F2013L01978)

27 Nov 2013

250, 2013

26 Nov 2013 (see F2013L01982)

Sch 2 (items 29, 30): 1 Jan 2014

Endnote 4Amendment history

Provision affected

How affected

s 2.........................................

rep LIA s 48D

Sch 1

Sch 1.....................................

am No 250, 2013

Sch 2.....................................

rep LIA s 48C

Endnote 5Uncommenced amendments [none]Endnote 6Modifications [none]Endnote 7Misdescribed amendments [none]Endnote 8Miscellaneous [none]
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