Health Insurance (Diagnostic Imaging Capital Sensitivity) Determination 2011

Ultrasound

diagnostic imaging equipment used to perform a service to which an item in Group I1 in Division 2.1 in Schedule 1 applies

10 years

Mammography

diagnostic imaging equipment used to perform a service to which an item in Subgroup 10 of Group I3 in Division 2.3 in Schedule 1 applies

10 years

Rest of diagnostic radiology

diagnostic imaging equipment used to perform a service to which an item in Subgroups 1 to 9, 11, 12, 14, 15 or 17 of Group I3 in Division 2.3 in Schedule 1 applies

15 years

Nuclear medicine (excluding PET)

diagnostic imaging equipment used to perform a service to which an item in Group I4 in Division 2.4 in Schedule 1 applies

10 years

MRI

diagnostic imaging equipment used to perform a service to which an item in Group I5 in Division 2.5 in Schedule 1 applies

10 years

Ultrasound

diagnostic imaging equipment used to perform a service to which an item in Group I1 in Division 2.1 in Schedule 1 applies

15 years

Mammography

diagnostic imaging equipment used to perform a service to which an item in Subgroup 10 of Group I3 in Division 2.3 in Schedule 1 applies

15 years

Rest of diagnostic radiology

diagnostic imaging equipment used to perform a service to which an item in Subgroups 1 to 9, 11, 12, 14, 15 or 17 of Group I3 in Division 2.3 in Schedule 1 applies

20 years

Nuclear medicine (excluding PET)

diagnostic imaging equipment used to perform a service to which an item in Group I4 in Division 2.4 in Schedule 1 applies

15 years

MRI

diagnostic imaging equipment used to perform a service to which an item in Group I5 in Division 2.5 in Schedule 1 applies

15 years

Subgroup 1 — General

55005

Head, ultrasound scan of, if:

 (a) the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R) (NK)

54.55

55007

Head, ultrasound scan of, if the patient is not referred by a medical practitioner, not being a service associated with a service to which an item in Subgroup 2 or 3 applies (NR) (NK)

18.95

55008

Orbital contents, ultrasound scan of, if:

 (a) the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R) (NK)

54.55

55010

Orbital contents, ultrasound scan of, if the patient is not referred by a medical practitioner, not being a service associated with a service to which an item in Subgroup 2 or 3 applies (NR) (NK)

18.95

55011

Neck, 1 or more structures of, ultrasound scan of, if:

 (a) the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R) (NK)

54.55

55013

Neck, 1 or more structures of, ultrasound scan of, if the patient is not referred by a medical practitioner, not being a service associated with a service to which an item in Subgroup 2 or 3 applies (NR) (NK)

18.95

55014

Abdomen, ultrasound scan of (including scan of urinary tract when performed), if:

 (a) the patient is referred by a medical practitioner or participating nurse practitioner for ultrasonic examination; and

55.65

 (b) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 (c) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner; and

 (d) the service is not a service associated with a service to which an item in Subgroup 2 or 3 applies; and

 (e) the service is not solely a transrectal ultrasonic examination of the prostate gland, bladder base and urethra, or any of those organs; and

 (f) within 24 hours of the service, a service described in item 55017, 55020, 55038, 55044, 55731 or 55732 is not performed on the same patient by the providing practitioner (R) (NK)

55016

Abdomen, ultrasound scan of (including scan of urinary tract when performed), if:

 (a) the patient is not referred by a medical practitioner or participating nurse practitioner; and

18.95

 (b) the service is not a service associated with a service to which an item in Subgroup 2 or 3 applies; and

 (c) the service is not solely a transrectal ultrasonic examination of the prostate gland, bladder base and urethra, or any of those organs (NR) (NK)

55017

Urinary tract, ultrasound scan of, if:

 (a) the patient is referred by a medical practitioner for ultrasonic examination; and

 (b) the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

54.55

 (c) the service is not a service associated with a service to which an item in Subgroup 2 or 3 applies; and

 (d) the service is not solely a transrectal ultrasonic examination of the prostate gland, bladder base and urethra, or any of those organs; and

 (e) within 24 hours of the service, a service described in item 55014, 55020, 55036, 55044, 55731 or 55732 is not performed on the same patient by the providing practitioner (R) (NK)

55019

Urinary tract, ultrasound scan of, if:

 (a) the patient is not referred by a medical practitioner; and

 (b) the service is not a service associated with a service to which an item in Subgroup 2 or 3 applies; and

 (c) the service is not solely a transrectal ultrasonic examination of the prostate gland, bladder base and urethra, or any of those organs (NR) (NK)

18.95

55020

Pelvis, male, ultrasound scan of, by any or all approaches, if:

 (a) the patient is referred by a medical practitioner for ultrasonic examination; and

 (b) the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 (c) the service is not a service associated with a service to which an item in Subgroup 2 or 3 applies; and

55.65

 (d) the service is not solely a transrectal ultrasonic examination of the prostate gland, bladder base and urethra, or any of those organs; and

 (e) within 24 hours of the service, a service described in item 55014, 55017, 55036 or 55038 is not performed on the same patient by the providing practitioner (R) (NK)

55022

Pelvis, male, ultrasound scan of, by any or all approaches, if:

 (a) the patient is not referred by a medical practitioner; and

 (b) the service is not a service associated with a service to which an item in Subgroup 2 or 3 applies; and

 (c) the service is not solely a transrectal ultrasonic examination of the prostate gland, bladder base and urethra, or any of those organs (NR) (NK)

18.95

55023

Scrotum, ultrasound scan of, if:

 (a) the patient is referred by a medical practitioner for ultrasonic examination not being a service associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member (R) (NK)

54.75

55025

Scrotum, ultrasound scan of, if the patient is not referred by a medical practitioner, not being a service associated with a service to which an item in Subgroup 2 or 3 applies (NR) (NK)

18.95

55026

Ultrasonic cross‑sectional echography, in conjunction with a surgical procedure using interventional techniques, not being a service associated with a service to which any other item in this group applies (R) (NK)

54.55

55059

Breast, one, ultrasound scan of, if:

 (a) the patient is referred by a medical practitioner or participating nurse practitioner; and

 (b) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK)

49.15

55060

Breast, one, ultrasound scan of, if:

 (a) the patient is not referred by a medical practitioner or participating nurse practitioner; and

 (b) the service is not associated with a service to which an item in Subgroup 2 or 3 applies (NR) (NK)

17.05

55061

Breasts, both, ultrasound scan of, if:

 (a) the patient is referred by a medical practitioner or participating nurse practitioner; and

 (b) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK)

54.55

55062

Breasts, both, ultrasound scan of, if:

 (a) the patient is not referred by a medical practitioner or participating nurse practitioner; and

 (b) the service is not associated with a service to which an item in Subgroup 2 or 3 applies (NR) (NK)

18.95

55063

Urinary bladder, ultrasound scan of, by any or all approaches, if:

 (a) the patient is referred by a medical practitioner for ultrasonic examination; and

 (b) the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

49.15

 (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (d) within 24 hours of the service, a service described in item 11917, 55014, 55017, 55020, 55036, 55038, 55044, 55600, 55601, 55603, 55604, 55731 or 55732 is not performed on the same patient by the providing practitioner (R) (NK)

55064

Urinary bladder, ultrasound scan of, by any or all approaches, if:

 (a) the patient is not referred by a medical practitioner; and

 (b) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

17.05

 (c) within 24 hours of the service, a service described in item 11917, 55016, 55019, 55022, 55037, 55039, 55045, 55600, 55601, 55603, 55604, 55733 or 55734 is not performed on the same patient by the providing practitioner (NR) (NK)

Subgroup 2 — Cardiac

55119

M‑mode and two‑dimensional real time echocardiographic examination of the heart from at least 2 acoustic windows for the investigation of symptoms or signs of cardiac failure, or suspected or known ventricular hypertrophy or dysfunction, or chest pain:

115.35

 (a) with:

 (i) measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave Doppler techniques; and

 (ii) real time colour flow mapping from at least 2 acoustic windows; and

 (iii) recordings on video tape or digital media; and

 (b) not being a service associated with a service to which an item in Subgroup 1 (except items 55026 and 55054) or 3, or another item in this Subgroup (except items 55118, 55125, 55130 and 55131), applies (R) (NK)

55120

M‑mode and two‑dimensional real time echocardiographic examination of the heart from at least 2 acoustic windows for the investigation of suspected or known acquired valvular, aortic, pericardial, thrombotic or embolic disease or heart tumour:

 (a) with:

 (i) measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave Doppler techniques; and

 (ii) real time colour flow mapping from at least 2 acoustic windows; and

 (iii) recordings on video tape or digital media; and

115.35

 (b) not being a service associated with a service to which an item in Subgroup 1 (except items 55026 and 55054) or 3, or another item in this Subgroup (except items 55118,  55125, 55130 and 55131), applies (R) (NK)

55121

M‑mode and two‑dimensional real time echocardiographic examination of the heart from at least 2 acoustic windows for the investigation of symptoms or signs of congenital heart disease:

 (a) with:

 (i) measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave Doppler techniques; and

115.35

 (ii) real time colour flow mapping from at least 2 acoustic windows; and

 (iii) recordings on video tape or digital media; and

 (b) not being a service associated with a service to which an item in Subgroup 1 (except items 55026 and 55054) or 3, or another item in this Subgroup (except items 55118, 55125, 55130 and 55131), applies (R) (NK)

55122

Exercise stress echocardiography performed in conjunction with item 11712:

 (a) with:

 (i) two‑dimensional recordings before exercise (baseline) from at least 3 acoustic windows; and

130.85

 (ii) matching recordings from the same windows at, or immediately after, peak exercise; and

 (iii) recordings on digital media with equipment permitting display of baseline and matching peak images on the same screen; and

 (b) not being a service associated with a service to which an item in Subgroup 1 (except items 55026 and 55054) or 3, or another item in this Subgroup (except items 55118, 55125, 55130 and 55131), applies (R) (NK)

55123

Pharmacological stress echocardiography performed in conjunction with item 11712:

 (a) with:

 (i) two‑dimensional recordings before drug infusion (baseline) from at least 3 acoustic windows; and

 (ii) matching recordings from the same windows at least twice during drug infusion, including a recording at the peak drug dose; and

130.85

 (iii) recordings on digital media with equipment permitting display of baseline and matching peak images on the same screen; and

 (b) not being a service associated with a service to which an item in Subgroup 1 (except items 55026 and 55054) or 3, or another item in this Subgroup (except items 55118, 55125, 55130 and 55131), applies (R) (NK)

55125

Heart, two‑dimensional real time transoesophageal examination of, from at least 2 levels, and in more than 1 plane at each level:

 (a) with:

 (i) real time colour flow mapping and, if indicated, pulsed wave Doppler examination; and

 (ii) recordings on video tape or digital medium; and

137.75

 (b) not being an intra‑operative service or a service associated with a service to which an item in Subgroup 1 (except items 55026 and 55054) or 3 applies (R) (NK) (Anaes.)

55131

Intra‑operative 2 dimensional real time transoesophageal echocardiography incorporating Doppler techniques with colour flow mapping and recording onto video tape or digital medium, performed during cardiac surgery incorporating sequential assessment of cardiac function before and after the surgical procedure, not being a service associated with a service to which item 55135 or 55136 applies (R) (NK) (Anaes.)

85.00

55136

Intra‑operative 2 dimensional real time transoesophageal echocardiography incorporating Doppler techniques with colour flow mapping and recording onto video tape or digital medium, performed during cardiac valve surgery (replacement or repair) incorporating sequential assessment of cardiac function and valve competence before and after the surgical procedure, not being a service associated with a service to which item 55130 or 55131 applies (R) (NK) (Anaes.)

176.80

Subgroup 3 — Vascular

55220

Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of arteries or bypass grafts in the lower limb or of arteries and bypass grafts in the lower limb, below the inguinal ligament, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK)

84.75

55221

Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of veins in the lower limb, below the inguinal ligament, for acute venous thrombosis, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK)

84.75

55222

Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of veins in the lower limb, below the inguinal ligament, for chronic venous disease, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK)

84.75

55223

Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of arteries or bypass grafts in the upper limb or of arteries and bypass grafts in the upper limb, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK)

84.75

55224

Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of veins in the upper limb, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK)

84.75

55226

Duplex scanning, bilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of extra‑cranial bilateral carotid and vertebral vessels, with or without subclavian and innominate vessels, with or without oculoplethysmography or peri‑orbital Doppler examination, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK)

84.75

55227

Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of intra‑abdominal, aorta and iliac arteries or inferior vena cava and iliac veins or of intra‑abdominal, aorta and iliac arteries and inferior vena cava and iliac veins, excluding pregnancy related studies, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK)

84.75

55228

Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of renal or visceral vessels or of renal and visceral vessels, including aorta, inferior vena cava and iliac vessels as required excluding pregnancy related studies, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK)

84.75

55229

Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of intra‑cranial vessels, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK)

84.75

55230

Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements:

 (a) by spectral analysis of cavernosal artery of the penis following intracavernosal administration of a vasoactive agent; and

 (b) performed during the period of pharmacological activity of the injected agent, to confirm a diagnosis of vascular aetiology for impotence; and

84.75

 (c) if a specialist in diagnostic radiology, nuclear medicine, urology, general surgery (sub‑specialising in vascular surgery) or a consultant physician in nuclear medicine attends the patient in person at the practice location where the service is performed, immediately before or for a period during the performance of the service; and

 (d) if the specialist or consultant physician interprets the results and prepares a report, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK)

55232

Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements:

 (a) by spectral analysis of cavernosal tissue of the penis to confirm a diagnosis; and

 (b) if indicated, assess the progress and management of:

 (i) priapism; or

 (ii) fibrosis of any type; or

84.75

 (iii) fracture of the tunica; or

 (iv) arteriovenous malformations; and

 (c) if a specialist in diagnostic radiology, nuclear medicine, urology, general surgery (sub‑specialising in vascular surgery) or a consultant physician in nuclear medicine attends the patient in person at the practice location where the service is performed, immediately before or for a period during the performance of the service; and

 (d) if the specialist or consultant physician interprets the results and prepares a report, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK)

55233

Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of surgically created arteriovenous fistula or surgically created arteriovenous access grafts in the upper or lower limbs, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054) or 4 applies (R) (NK)

84.75

55235

Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of arteries or veins, or both, including any associated skin marking, for mapping of bypass conduit before vascular surgery, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054), 3 or 4 applies (R) (NK)

84.75

55236

Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow spectral analysis and marking of veins in the lower limbs below the inguinal ligament before varicose vein surgery, including any associated skin marking, not being a service associated with a service to which an item in Subgroup 1 (with the exception of items 55026 and 55054), 3 or 4 applies (R) (NK)

55.55

Subgroup 4 — Urological

55601

Prostate, bladder base and urethra, transrectal ultrasound scan of, if performed:

 (a) personally by a medical practitioner (not being the medical practitioner who assessed the patient as specified in paragraph (c)) using a transducer probe that:

 (i) has a nominal frequency of 7 to 7.5 MHz or a nominal frequency range that includes frequencies of 7 to 7.5 MHz; and

 (ii) can obtain both axial and sagittal scans in 2 planes at right angles; and

 (b) following a digital rectal examination of the prostate by that medical practitioner; and

54.55

 (c) on a patient who has been assessed by a specialist in urology, radiation oncology or medical oncology, a consultant physician in medical oncology, or a participating nurse practitioner, who has:

 (i) examined the patient in the 60 days before the scan; and

 (ii) recommended the scan for the management of the patient’s current prostatic disease (R) (NK)

55604

Prostate, bladder base and urethra, transrectal ultrasound scan of, if performed:

 (a) personally by a medical practitioner who made the assessment mentioned in paragraph (c) using a transducer probe that:

 (i) has a nominal frequency of 7 to 7.5 MHz or a nominal frequency range that includes frequencies of 7 to 7.5 MHz; and

 (ii) can obtain both axial and sagittal scans in 2 planes at right angles; and

 (b) following a digital rectal examination of the prostate by that medical practitioner; and

54.55

 (c) on a patient who has been assessed by a specialist in urology, radiation oncology or medical oncology or a consultant physician in medical oncology who has:

 (i) examined the patient in the 60 days before the scan; and

 (ii) recommended the scan for the management of the patient’s current prostatic disease (R) (NK)

Subgroup 5 — Obstetric and gynaecological

55701

Pelvis or abdomen, pregnancy‑related or pregnancy complication, ultrasound scan of, by any or all approaches, if:

 (a) the patient is referred by a medical practitioner or participating midwife; and

 (b) the dating of the pregnancy (as confirmed by ultrasound) is less than 12 weeks of gestation; and

 (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (d) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 (e) if the patient is referred by a participating midwife — the referring midwife does not have a business or financial arrangement with the providing practitioner; and

30.00

 (f) 1 or more of the following conditions are present:

 (i) hyperemesis gravidarum;

 (ii) diabetes mellitus;

 (iii) hypertension;

 (iv) toxaemia of pregnancy;

 (v) liver or renal disease;

 (vi) autoimmune disease;

 (vii) cardiac disease;

 (viii) alloimmunisation;

 (ix) maternal infection;

 (x) inflammatory bowel disease;

 (xi) bowel stoma;

 (xii) abdominal wall scarring;

 (xiii) previous spinal or pelvic trauma or disease;

 (xiv) drug dependency;

 (xv) thrombophilia;

 (xvi) significant maternal obesity;

 (xvii) advanced maternal age;

 (xviii) abdominal pain or mass;

 (xix) uncertain dates;

 (xx) high risk pregnancy;

 (xxi) previous post dates delivery;

 (xxii) previous caesarean section;

 (xxiii) poor obstetric history;

 (xxiv) suspicion of ectopic pregnancy;

 (xxv) risk of miscarriage;

 (xxvi) diminished symptoms of pregnancy;

 (xxvii) suspected or known cervical incompetence;

 (xxviii) suspected or known uterine abnormality;

 (xxix) pregnancy after assisted reproduction;

 (xxx) risk of fetal abnormality (R) (NK)

55702

Pelvis or abdomen, pregnancy‑related or pregnancy complication, ultrasound scan of, by any or all approaches, if:

 (a) the patient is not referred by a medical practitioner or participating midwife; and

 (b) the dating of the pregnancy (as confirmed by ultrasound) is less than 12 weeks of gestation; and

 (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (d) 1 or more of the following conditions are present:

 (i) hyperemesis gravidarum;

 (ii) diabetes mellitus;

 (iii) hypertension;

 (iv) toxaemia of pregnancy;

 (v) liver or renal disease;

 (vi) autoimmune disease;

17.50

 (vii) cardiac disease;

 (viii) alloimmunisation;

 (ix) maternal infection;

 (x) inflammatory bowel disease;

 (xi) bowel stoma;

 (xii) abdominal wall scarring;

 (xiii) previous spinal or pelvic trauma or disease;

 (xiv) drug dependency;

 (xv) thrombophilia;

 (xvi) significant maternal obesity;

 (xvii) advanced maternal age;

 (xviii) abdominal pain or mass;

 (xix) uncertain dates;

 (xx) high risk pregnancy;

 (xxi) previous post dates delivery;

 (xxii) previous caesarean section;

 (xxiii) poor obstetric history;

 (xxiv) suspicion of ectopic pregnancy;

 (xxv) risk of miscarriage;

 (xxvi) diminished symptoms of pregnancy;

 (xxvii) suspected or known cervical incompetence;

 (xxviii) suspected or known uterine abnormality;

 (xxix) pregnancy after assisted reproduction;

 (xxx) risk of fetal abnormality (NR) (NK)

55710

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if:

 (a) the patient is referred by a medical practitioner or participating midwife; and

 (b) the dating of the pregnancy (as confirmed by ultrasound) is 12 to 16 weeks of gestation; and

 (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

35.00

 (d) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 (e) if the patient is referred by a participating midwife — the referring midwife does not have a business or financial arrangement with the providing practitioner; and

 (f) 1 or more of the following conditions are present:

 (i) hyperemesis gravidarum;

 (ii) diabetes mellitus;

 (iii) hypertension;

 (iv) toxaemia of pregnancy;

 (v) liver or renal disease;

 (vi) autoimmune disease;

 (vii) cardiac disease;

 (viii) alloimmunisation;

 (ix) maternal infection;

 (x) inflammatory bowel disease;

 (xi) bowel stoma;

 (xii) abdominal wall scarring;

 (xiii) previous spinal or pelvic trauma or disease;

 (xiv) drug dependency;

 (xv) thrombophilia;

 (xvi) significant maternal obesity;

 (xvii) advanced maternal age;

 (xviii) abdominal pain or mass;

 (xix) uncertain dates;

 (xx) high risk pregnancy;

 (xxi) previous post dates delivery;

 (xxii) previous caesarean section;

 (xxiii) poor obstetric history;

 (xxiv) suspicion of ectopic pregnancy;

 (xxv) risk of miscarriage;

 (xxvi) diminished symptoms of pregnancy;

 (xxvii) suspected or known cervical incompetence;

 (xxviii) suspected or known uterine abnormality;

 (xxix) pregnancy after assisted reproduction;

 (xxx) risk of fetal abnormality (R) (NK)

55711

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if:

 (a) the patient is not referred by a medical practitioner or participating midwife; and

 (b) the dating of the pregnancy (as confirmed by ultrasound) is 12 to 16 weeks of gestation; and

 (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

17.50

 (d) 1 or more of the following conditions are present:

 (i) hyperemesis gravidarum;

 (ii) diabetes mellitus;

 (iii) hypertension;

 (iv) toxaemia of pregnancy;

 (v) liver or renal disease;

 (vi) autoimmune disease;

 (vii) cardiac disease;

 (viii) alloimmunisation;

 (ix) maternal infection;

 (x) inflammatory bowel disease;

 (xi) bowel stoma;

 (xii) abdominal wall scarring;

 (xiii) previous spinal or pelvic trauma or disease;

 (xiv) drug dependency;

 (xv) thrombophilia;

 (xvi) significant maternal obesity;

 (xvii) advanced maternal age;

 (xviii) abdominal pain or mass;

 (xix) uncertain dates;

 (xx) high risk pregnancy;

 (xxi) previous post dates delivery;

 (xxii) previous caesarean section;

 (xxiii) poor obstetric history;

 (xxiv) suspicion of ectopic pregnancy;

 (xxv) risk of miscarriage;

 (xxvi) diminished symptoms of pregnancy;

 (xxvii) suspected or known cervical incompetence;

 (xxviii) suspected or known uterine abnormality;

 (xxix) pregnancy after assisted reproduction;

 (xxx) risk of fetal abnormality (NR) (NK)

55713

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, if:

 (a) the patient is referred by a medical practitioner or participating midwife; and

 (b) the dating for the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks of gestation; and

 (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

50.00

 (d) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 (e) if the patient is referred by a participating midwife — the referring midwife does not have a business or financial arrangement with the providing practitioner; and

 (f) the service is not performed in the same pregnancy as item 55709 or 55717 (R) (NK)

55714

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if:

 (a) the patient is referred by a medical practitioner or participating midwife; and

 (b) the pregnancy (as confirmed by ultrasound) is dated by a fetal crown rump length of 45 to 84 mm; and

35.00

 (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (d) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 (e) if the patient is referred by a participating midwife — the referring midwife does not have a business or financial arrangement with the providing practitioner; and

 (f) at least 1 condition mentioned in paragraph (f) of item 55704 or 55710 is present; and

 (g) nuchal translucency measurement is performed to assess the risk of fetal abnormality; and

 (h) the service is not performed with item 55700, 55701, 55702, 55703, 55704, 55705, 55710 or 55711 on the same patient within 24 hours (R) (NK)

55716

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if:

 (a) the patient is not referred by a medical practitioner or participating midwife; and

 (b) the pregnancy (as confirmed by ultrasound) is dated by a crown rump length of 45 to 84 mm; and

 (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (d) at least 1 condition mentioned in paragraph (f) of item 55704 or 55710 is present; and

 (e) nuchal translucency measurement is performed to assess the risk of fetal abnormality; and

 (f) the service is not performed with item 55700, 55701, 55702, 55703, 55704, 55705, 55710 or 55711on the same patient within 24 hours (NR) (NK)

17.50

55717

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, if:

 (a) the patient is not referred by a medical practitioner; and

 (b) the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks of gestation; and

19.00

 (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (d) the service is not performed in the same pregnancy as item 55706 or 55713 (NR) (NK)

55719

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, if:

 (a) the patient is referred by a medical practitioner who:

 (i) is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists; or

 (ii) has a Diploma of Obstetrics; or

57.50

 (iii) has a qualification recognised by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as being equivalent to a Diploma of Obstetrics; or

 (iv) has obstetric privileges at a non‑metropolitan hospital; and

 (b) the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks of gestation; and

 (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (d) the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 (e) further examination is clinically indicated after performance, in the same pregnancy, of a scan mentioned in item 55706, 55709, 55713 or 55717 (R) (NK)

55720

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, performed by or on behalf of a medical practitioner who is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, if:

20.00

 (a) the patient is not referred by a medical practitioner; and

 (b) the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks of gestation; and

 (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (d) further examination is clinically indicated after performance, in the same pregnancy, of a scan mentioned in item 55706, 55709, 55713 or 55717 (NR) (NK)

55722

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if:

 (a) the patient is referred by a medical practitioner or participating midwife; and

 (b) the dating of the pregnancy (as confirmed by ultrasound) is after 22 weeks of gestation; and

 (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

50.00

 (d) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 (e) if the patient is referred by a participating midwife — the referring midwife does not have a business or financial arrangement with the providing practitioner; and

 (f) the service is not performed in the same pregnancy as item 55723 or 55726; and

 (g) 1 or more of the following conditions are present:

 (i) known or suspected fetal abnormality or fetal cardiac arrhythmia;

 (ii) fetal anatomy (late booking or incomplete mid‑trimester scan);

 (iii) malpresentation;

 (iv) cervical assessment;

 (v) clinical suspicion of amniotic fluid abnormality;

 (vi) clinical suspicion of placental or umbilical cord abnormality;

 (vii) previous complicated delivery;

 (viii) uterine scar assessment;

 (ix) uterine fibroid;

 (x) previous fetal death in utero or neonatal death;

 (xi) antepartum haemorrhage;

 (xii) clinical suspicion of intrauterine growth retardation;

 (xiii) clinical suspicion of macrosomia;

 (xiv) reduced fetal movements;

 (xv) suspected fetal death;

 (xvi) abnormal cardiotocography;

 (xvii) prolonged pregnancy;

 (xviii) premature labour;

 (xix) fetal infection;

 (xx) pregnancy after assisted reproduction;

 (xxi) trauma;

 (xxii) diabetes mellitus;

 (xxiii) hypertension;

 (xxiv) toxaemia of pregnancy;

 (xxv) liver or renal disease;

 (xxvi) autoimmune disease;

 (xxvii) cardiac disease;

 (xxviii) alloimmunisation;

 (xxix) maternal infection;

 (xxx) inflammatory bowel disease;

 (xxxi) bowel stoma;

 (xxxii) abdominal wall scarring;

 (xxxiii) previous spinal or pelvic trauma or disease;

 (xxxiv) drug dependency;

 (xxxv) thrombophilia;

 (xxxvi) gross maternal obesity;

 (xxxvii) advanced maternal age;

(xxxviii) abdominal pain or mass (R) (NK)

(Item is subject to subclause 2.1.5(2) of the diagnostic imaging services table)

55724

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if:

 (a) the patient is referred by a medical practitioner who:

 (i) is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists; or

 (ii) has a Diploma of Obstetrics; or

 (iii) has a qualification recognised by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as being equivalent to a Diploma of Obstetrics; or

57.50

 (iv) has obstetric privileges at a non‑metropolitan hospital; and

 (b) the dating of the pregnancy (as confirmed by ultrasound) is after 22 weeks of gestation; and

 (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (d) the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 (e) further examination is clinically indicated in the same pregnancy to which item 55718, 55722, 55723 or 55726 applies (R) (NK)

55726

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if:

 (a) the patient is not referred by a medical practitioner; and

19.00

 (b) the dating of the pregnancy (as confirmed by ultrasound) is after 22 weeks of gestation; and

 (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (d) the service is not performed in the same pregnancy as item 55718 or 55722; and

 (e) 1 or more of the following conditions are present:

 (i) known or suspected fetal abnormality or fetal cardiac arrhythmia;

 (ii) fetal anatomy (late booking or incomplete mid‑trimester scan);

 (iii) malpresentation;

 (iv) cervical assessment;

 (v) clinical suspicion of amniotic fluid abnormality;

 (vi) clinical suspicion of placental or umbilical cord abnormality;

 (vii) previous complicated delivery;

 (viii) uterine scar assessment;

 (ix) uterine fibroid;

 (x) previous fetal death in utero or neonatal death;

 (xi) antepartum haemorrhage;

 (xii) clinical suspicion of intrauterine growth retardation;

 (xiii) clinical suspicion of macrosomia;

 (xiv) reduced fetal movements;

 (xv) suspected fetal death;

 (xvi) abnormal cardiotocography;

 (xvii) prolonged pregnancy;

 (xviii) premature labour;

 (xix) fetal infection;

 (xx) pregnancy after assisted reproduction;

 (xxi) trauma;

 (xxii) diabetes mellitus;

 (xxiii) hypertension;

 (xxiv) toxaemia of pregnancy;

 (xxv) liver or renal disease;

 (xxvi) autoimmune disease;

 (xxvii) cardiac disease;

 (xxviii) alloimmunisation;

 (xxix) maternal infection;

 (xxx) inflammatory bowel disease;

 (xxxi) bowel stoma;

 (xxxii) abdominal wall scarring;

 (xxxiii) previous spinal or pelvic trauma or disease;

 (xxxiv) drug dependency;

 (xxxv) thrombophilia;

 (xxxvi) gross maternal obesity;

 (xxxvii) advanced maternal age;

(xxxviii) abdominal pain or mass (NR) (NK)

(Item is subject to subclause 2.1.5(2) of the diagnostic imaging services table)

55727

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, performed by or on behalf of a medical practitioner who is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, if:

 (a) the patient is not referred by a medical practitioner; and

 (b) the dating of the pregnancy (as confirmed by ultrasound) is after 22 weeks of gestation; and

20.00

 (c) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (d) further examination is clinically indicated in the same pregnancy to which item 55718, 55722, 55723 or 55726 applies (NR) (NK)

55730

Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of the umbilical artery, and measured assessment of amniotic fluid volume after the 24th week of gestation, if the patient is referred by a medical practitioner for this procedure and if there is reason to suspect intrauterine growth retardation or a significant risk of fetal death, not being a service associated with a service to which an item in this group applies — examination and report (R) (NK)

13.65

55732

Pelvis, female, ultrasound scan of, by any or all approaches, if:

 (a) the patient is referred by a medical practitioner; and

 (b) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

49.00

 (c) the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 (d) the service is not performed with item 55014, 55017, 55036 or 55038 on the same patient within 24 hours (R) (NK)

55734

Pelvis, female, ultrasound scan of, by any or all approaches, if:

 (a) the patient is not referred by a medical practitioner; and

 (b) the service is not associated with a service to which an item in Subgroup 2 or 3 applies (NR) (NK)

17.50

55735

Pelvis, female, ultrasound scan of, in association with saline infusion of the endometrial cavity, by any or all approaches, if:

 (a) the patient is referred by a medical practitioner; and

 (b) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

63.50

 (c) the referring medical practitioner is not a member of a group of medical practitioners of which the providing practitioner is a member; and

 (d) a previous transvaginal ultrasound has revealed an abnormality of the uterus or fallopian tube (R) (NK)

55737

Pelvis, female, ultrasound scan of, in association with saline infusion of the endometrial cavity, by any or all approaches, if:

 (a) the patient is not referred by a medical practitioner; and

 (b) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (c) a previous transvaginal ultrasound has revealed an abnormality of the uterus or fallopian tube (NR) (NK)

28.50

55760

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, if:

 (a) the patient is referred by a medical practitioner; and

 (b) ultrasound of the same pregnancy confirms a multiple pregnancy; and

75.00

 (c) the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks gestation; and

 (d) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (e) the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 (f) the service described in item 55706, 55709, 55712, 55713, 55715, 55717, 55719, 55720, 55762 or 55763 is not performed in conjunction with the scan during the same pregnancy (R) (NK)

55763

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, if:

 (a) the patient is not referred by a medical practitioner; and

 (b) ultrasound of the same pregnancy confirms a multiple pregnancy; and

30.00

 (c) the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks gestation; and

 (d) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (e) the service described in item 55706, 55709, 55712, 55713, 55715, 55717, 55719, 55720, 55759 or 55760 is not performed in conjunction with the scan during the same pregnancy (NR) (NK)

55765

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, if:

80.00

 (a) the patient is referred by a medical practitioner who:

 (i) is a Member or Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists; or

 (ii) has a Diploma of Obstetrics; or

 (iii) has a qualification recognised by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as equivalent to a Diploma of Obstetrics; or

 (iv) has obstetric privileges at a non‑metropolitan hospital; and

 (b) ultrasound of the same pregnancy confirms a multiple pregnancy; and

 (c) the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks gestation; and

 (d) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (e) the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 (f) further examination is clinically indicated in the same pregnancy in which item 55759, 55760, 55762 or 55763 has been performed; and

 (g) the service described in item 55706, 55709, 55712, 55713, 55715, 55717, 55719 or 55720 is not performed in conjunction with the scan during the same pregnancy (R) (NK)

55767

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, performed by or on behalf of a medical practitioner, who is a Member or Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, if:

 (a) the patient is not referred by a medical practitioner; and

 (b) ultrasound of the same pregnancy confirms a multiple pregnancy; and

 (c) the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks of gestation; and

32.50

 (d) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (e) further examination is clinically indicated in the same pregnancy in which item 55759, 55760, 55762 or 55763 has been performed; and

 (f) the service described in item 55706, 55709, 55712, 55713, 55715, 55717, 55719 or 55720 is not performed in conjunction with the scan during the same pregnancy (NR) (NK)

55769

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if:

 (a) dating of the pregnancy (as confirmed by ultrasound) is after 22 weeks of gestation; and

 (b) the ultrasound confirms a multiple pregnancy; and

 (c) the patient is referred by a medical practitioner or participating nurse practitioner; and

75.00

 (d) the service is not performed in the same pregnancy as item 55770 or 55771; and

 (e) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (f) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 (g) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner; and

 (h) the service described in item 55718, 55721, 55722, 55723, 55724, 55725, 55726 or 55727 is not performed in conjunction with the scan during the same pregnancy (R) (NK)

55771

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if:

 (a) dating of the pregnancy as confirmed by ultrasound is after 22 weeks of gestation; and

 (b) the patient is not referred by a medical practitioner or participating nurse practitioner; and

30.00

 (c) the service is not performed in the same pregnancy as item 55768 or 55769; and

 (d) the pregnancy as confirmed by ultrasound is a multiple pregnancy; and

 (e) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (f) the service described in item 55718, 55721, 55722, 55723, 55724, 55725, 55726 or 55727 is not performed in conjunction with the scan during the same pregnancy (NR) (NK)

55773

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if:

 (a) dating of the pregnancy as confirmed by ultrasound is after 22 weeks of gestation; and

80.00

 (b) the patient is referred by a medical practitioner who:

 (i) is a Member or Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists; or

 (ii) has a Diploma of Obstetrics; or

 (iii) has a qualification recognised by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as equivalent to a Diploma of Obstetrics; or

 (iv) has obstetric privileges at a non‑metropolitan hospital; and

 (c) further examination is clinically indicated in the same pregnancy to which item 55768, 55769, 55770 or 55771 has been performed; and

 (d) the pregnancy as confirmed by ultrasound is a multiple pregnancy; and

 (e) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (f) the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 (g) the service described in item 55718, 55721, 55722, 55723, 55724, 55725, 55726 or 55727 is not performed in conjunction with the scan during the same pregnancy (R) (NK)

55775

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, performed by or on behalf of a medical practitioner who is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, if:

 (a) dating of the pregnancy as confirmed by ultrasound is after 22 weeks of gestation; and

 (b) the patient is not referred by a medical practitioner; and

 (c) further examination is clinically indicated in the same pregnancy to which item 55768, 55769, 55770 or 55771 has been performed; and

 (d) the pregnancy as confirmed by ultrasound is a multiple pregnancy; and

32.50

 (e) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (f) the service described in item 55718, 55721, 55722, 55723, 55724, 55725, 55726 or 55727 is not performed in conjunction with the scan during the same pregnancy (NR) (NK)

Subgroup 6 — Musculoskeletal ultrasound

55801

Hand or wrist, 1 or both sides, ultrasound scan of, if:

 (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the patient is referred by a medical practitioner or participating nurse practitioner; and

 (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK)

54.55

55803

Hand or wrist, 1 or both sides, ultrasound scan of, if:

 (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK)

18.95

55805

Forearm or elbow, 1 or both sides, ultrasound scan of, if:

 (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the patient is referred by a medical practitioner or participating nurse practitioner; and

 (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK)

54.55

55807

Forearm or elbow, 1 or both sides, ultrasound scan of, if:

 (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

18.95

 (b) the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK)

55809

Shoulder or upper arm, 1 or both sides, ultrasound scan of, if:

 (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the patient is referred by a medical practitioner or participating nurse practitioner; and

 (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner; and

 (e) the service is used for the assessment of 1 or more of the following suspected or known conditions:

 (i) an injury to a muscle, tendon or muscle/tendon junction;

 (ii) rotator cuff tear, calcification or tendinosis (biceps, subscapular, supraspinatus, infraspinatus);

54.55

 (iii) biceps subluxation;

 (iv) capsulitis and bursitis;

 (v) a mass, including a ganglion;

 (vi) an occult fracture;

 (vii) acromioclavicular joint pathology (R) (NK)

55811

Shoulder or upper arm, 1 or both sides, ultrasound scan of, if:

 (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the patient is not referred by a medical practitioner or participating nurse practitioner; and

 (c) the service is used for the assessment of 1 or more of the following suspected or known conditions:

 (i) an injury to a muscle, tendon or muscle/tendon junction;

 (ii) rotator cuff tear, calcification or tendinosis (biceps, subscapular, supraspinatus, infraspinatus);

 (iii) biceps subluxation;

18.95

 (iv) capsulitis and bursitis;

 (v) a mass, including a ganglion;

 (vi) an occult fracture;

 (vii) acromioclavicular joint pathology (NR) (NK)

55813

Chest or abdominal wall, 1 or more areas, ultrasound scan of, if:

 (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the patient is referred by a medical practitioner or participating nurse practitioner; and

 (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK)

54.55

55815

Chest or abdominal wall, 1 or more areas, ultrasound scan of, if:

 (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK)

18.95

55817

Hip or groin, 1 or both sides, ultrasound scan of, if:

 (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the patient is referred by a medical practitioner or participating nurse practitioner; and

 (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

54.55

 (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK)

55819

Hip or groin, 1 or both sides, ultrasound scan of, if:

 (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK)

18.95

55821

Paediatric hip examination for dysplasia, 1 or both sides, ultrasound scan of, if:

 (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the patient is referred by a medical practitioner or participating nurse practitioner; and

 (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK)

54.55

55823

Paediatric hip examination for dysplasia 1 or both sides, ultrasound scan of, if:

 (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK)

18.95

55825

Buttock or thigh, 1 or both sides, ultrasound scan of, if:

 (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the patient is referred by a medical practitioner or participating nurse practitioner; and

 (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

54.55

 (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK)

55827

Buttock or thigh, 1 or both sides, ultrasound scan of, if:

 (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK)

18.95

55829

Knee, 1 or both sides, ultrasound scan of, if:

 (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the patient is referred by a medical practitioner or participating nurse practitioner; and

 (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner; and

54.55

 (e) the service is used for the assessment of 1 or more of the following suspected or known conditions:

 (i) abnormality of tendons or bursae about the knee;

 (ii) a meniscal cyst, popliteal fossa cyst, mass or pseudomass;

 (iii) a nerve entrapment or a nerve or nerve sheath tumour;

 (iv) an injury of collateral ligaments (R) (NK)

55831

Knee, 1 or both sides, ultrasound scan of, if:

 (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the patient is not referred by a medical practitioner or participating nurse practitioner; and

18.95

 (c) the service is used for the assessment of 1 or more of the following suspected or known conditions:

 (i) abnormality of tendons or bursae about the knee;

 (ii) a meniscal cyst, popliteal fossa cyst, mass or pseudomass;

 (iii) a nerve entrapment or a nerve or nerve sheath tumour;

 (iv) an injury of collateral ligaments (NR) (NK)

55833

Lower leg, 1 or both sides, ultrasound scan of, if:

 (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the patient is referred by a medical practitioner or participating nurse practitioner; and

 (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK)

54.55

55835

Lower leg, 1 or both sides, ultrasound scan of, performed by or on behalf of a medical practitioner, if:

 (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK)

18.95

55837

Ankle or hind foot, 1 or both sides, ultrasound scan of, if:

 (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the patient is referred by a medical practitioner or participating nurse practitioner; and

 (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

54.55

 (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK)

55839

Ankle or hind foot, 1 or both sides, ultrasound scan of, if:

 (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK)

18.95

55841

Mid foot or fore foot, 1 or both sides, ultrasound scan of, if:

 (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the patient is referred by a medical practitioner or participating nurse practitioner; and

 (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK)

54.55

55843

Mid foot or fore foot, 1 or both sides, ultrasound scan of, if:

 (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK)

18.95

55845

Assessment of a mass associated with the skin or subcutaneous structures, not being a part of the musculoskeletal system, 1 or more areas, ultrasound scan of, if:

 (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the patient is referred by a medical practitioner or participating nurse practitioner; and

43.70

 (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK)

55847

Assessment of a mass associated with the skin or subcutaneous structures, not being a part of the musculoskeletal system, 1 or more areas, ultrasound scan of, if:

 (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK)

18.95

55849

Musculoskeletal cross‑sectional echography, in conjunction with a surgical procedure using interventional techniques, not being a service associated with a service to which any other item in this group applies, and not performed in conjunction with item 55026 or 55054 (R) (NK)

54.55

55851

Musculoskeletal cross‑sectional echography, in conjunction with a surgical procedure using interventional techniques, inclusive of a diagnostic musculoskeletal ultrasound service, if:

 (a) the patient is referred by a medical practitioner or participating nurse practitioner; and

 (b) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 (c) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial relationship with the providing practitioner; and

 (d) the referring medical practitioner or nurse practitioner has indicated on a referral for a musculoskeletal ultrasound that an ultrasound guided intervention be performed if clinically indicated; and

76.45

 (e) the service is not performed in conjunction with items 55026, 55054, or 55800 to 55849 (R) (NK)

55853

Paediatric spine, spinal cord and overlying subcutaneous tissues, ultrasound scan of, if:

 (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the patient is referred by a medical practitioner or participating nurse practitioner; and

 (c) if the patient is referred by a medical practitioner — the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

 (d) if the patient is referred by a participating nurse practitioner — the referring nurse practitioner does not have a business or financial arrangement with the providing practitioner (R) (NK)

54.55

55855

Paediatric spine, spinal cord and overlying subcutaneous tissues, ultrasound scan of, if:

 (a) the service is not associated with a service to which an item in Subgroup 2 or 3 applies; and

 (b) the patient is not referred by a medical practitioner or participating nurse practitioner (NR) (NK)

18.95

Subgroup 1 — Radiographic examination of extremities

57529

Hand, wrist, forearm, elbow or humerus (NR) (NK)

14.90

57530

Hand, wrist, forearm, elbow or humerus (R) (NK)

19.90

57532

Hand and wrist, or hand, wrist and forearm, or forearm and elbow, or elbow and humerus (NR) (NK)

20.25

57533

Hand and wrist, or hand, wrist and forearm, or forearm and elbow, or elbow and humerus (R) (NK)

27.00

57535

Foot, ankle, leg, knee or femur (NR) (NK)

16.25

57536

Foot, ankle, leg, knee or femur (R) (NK)

21.70

57538

Foot and ankle, or ankle and leg, or leg and knee, or knee and femur (NR) (NK)

24.70

57539

Foot and ankle, or ankle and leg, or leg and knee, or knee and femur (R) (NK)

32.90

Subgroup 2 — Radiographic examination of shoulder or pelvis

57702

Shoulder or scapula (NR) (NK)

20.25

57705

Shoulder or scapula (R) (NK)

27.00

57708

Clavicle (NR) (NK)

16.25

57711

Clavicle (R) (NK)

21.70

57714

Hip joint (R) (NK)

23.60

57717

Pelvic girdle (R) (NK)

30.45

57723

Femur, internal fixation of neck or intertrochanteric (pertrochanteric) fracture (R) (NK)

49.65

Subgroup 3 — Radiographic examination of head

57911

Skull, not in association with item 57902 or 57914 (R) (NK)

32.25

57914

Cephalometry, not in association with item 57901 or 57911 (R) (NK)

32.25

57917

Sinuses (R) (NK)

23.65

57920

Mastoids (R) (NK)

32.25

57923

Petrous temporal bones (R) (NK)

32.25

57926

Facial bones — orbit, maxilla or malar, any or all (R) (NK)

23.60

57929

Mandible, not by orthopantomography technique (R) (NK)

23.60

57932

Salivary calculus (R) (NK)

23.60

57935

Nose (R) (NK)

23.60

57938

Eye (R) (NK)

23.60

57941

Temporo‑mandibular joints (R) (NK)

24.85

57944

Teeth — single area (R) (NK)

16.45

57947

Teeth — full mouth (R) (NK)

39.15

57950

Palato‑pharyngeal studies with fluoroscopic screening (R) (NK)

32.25

57953

Palato‑pharyngeal studies without fluoroscopic screening (R) (NK)

24.85

57956

Larynx, lateral airways and soft tissues of the neck, not being a service associated with a service to which item 57939,  57942, 57950 or 57953 applies (R) (NK)

21.70

57959

Orthopantomography for diagnosis or management (or both) of trauma, infection, tumour or a congenital or surgical condition of the teeth or maxillofacial region (R) (NK)

23.70

57962

Orthopantomography for diagnosis or management (or both) of any of the following conditions, if the signs and symptoms of the condition is present:

 (a) impacted teeth;

 (b) caries;

 (c) periodontal pathology;

 (d) periapical pathology (R) (NK)

23.70

57965

Orthopantomography for diagnosis or management (or both) of missing or crowded teeth, or developmental anomalies of the teeth or jaws (R) (NK)

23.70

57968

Orthopantomography for diagnosis or management (or both) of temporo‑mandibular joint arthroses or dysfunction (R) (NK)

23.70

Subgroup 4 — Radiographic examination of spine

58102

Spine — cervical (R) (NK)

33.60

58105

Spine — thoracic (R) (NK)

27.55

58111

Spine — lumbo‑sacral (R) (NK)

38.50

58114

Spine — 4 regions, cervical, thoracic, lumbosacral and sacrococcygeal (R) (NK)

55.00

58117

Spine — sacro‑coccygeal (R) (NK)

23.50

58123

Spine — 2 examinations of the kind mentioned in items 58100, 58102, 58103, 58105, 58106, 58109, 58111 and 58117 (R) (NK)

48.65

58124

Spine — 3 examinations of the kind mentioned in items 58100, 58102, 58103, 58105, 58106, 58109, 58111 and 58117 (R) (NK)

55.00

58126

Spine — 4 regions, cervical, thoracic, lumbosacral and sacrococcygeal (R) (NK), if the service to which item 58120, 58121, 58126 or 58127 applies has not been performed on the same patient within the same calendar year

55.00

58127

Spine — 3 examinations of the kind mentioned in items 58100, 58102, 58103, 58105, 58106, 58109, 58111 and 58117 (R) (NK), if the service to which item 58120, 58121, 58126 or 58127 applies has not been performed on the same patient within the same calendar year

55.00

Subgroup 5 — Bone age study and skeletal survey

58302

Bone age study (R) (NK)

20.05

58308

Skeletal survey (R) (NK)

44.70

Subgroup 6 — Radiographic examination of thoracic region

58502

Chest (lung fields) by direct radiography (NR) (NK)

17.70

58505

Chest (lung fields) by direct radiography (R) (NK)

23.60

58508

Chest (lung fields) by direct radiography with fluoroscopic screening (R) (NK)

30.40

58511

Thoracic inlet or trachea (R) (NK)

19.90

58523

Left ribs, right ribs or sternum (R) (NK)

21.70

58526

Left and right ribs, left ribs and sternum, or right ribs and sternum (R) (NK)

28.25

58529

Left ribs, right ribs and sternum (R) (NK)

34.70

Subgroup 7 — Radiographic examination of urinary tract

58702

Plain renal only (R) (NK)

23.05

58708

Intravenous pyelography, with or without preliminary plain films and with or without tomography (R) (NK)

78.95

58717

Antegrade or retrograde pyelography with or without preliminary plain films and with preparation and contrast injection, 1 side (R) (NK)

75.80

58720

Retrograde cystography or retrograde urethrography with or without preliminary plain films and with preparation and contrast injection (R) (NK) (Anaes.)

63.05

58723

Retrograde micturating cysto‑urethrography, with preparation and contrast injection (R) (NK) (Anaes.)

69.15

Subgroup 8 — Radiographic examination of alimentary tract and biliary system

58902

Plain abdominal only, not being a service associated with a service to which item 58909, 58911, 58912, 58914, 58915, 58917, 58924 or 58926 applies (NR) (NK)

17.85

58905

Plain abdominal only, not being a service associated with a service to which item 58909, 58911,58912, 58914, 58915, 58917, 58924 or 58926 applies (R) (NK)

23.80

58911

Barium or other opaque meal of 1 or more of pharynx, oesophagus, stomach or duodenum, with or without preliminary plain films of pharynx, chest or duodenum, not being a service associated with a service to which item 57939, 57942, 57945,  57950, 57953 or 57956 applies (R) (NK)

45.00

58914

Barium or other opaque meal of oesophagus, stomach, duodenum and follow through to colon, with or without screening of chest and with or without preliminary plain film (R) (NK)

55.15

58917

Barium or other opaque meal, small bowel series only, with or without preliminary plain film (R) (NK)

39.50

58920

Small bowel enema, barium or other opaque study of the small bowel, including duodenal intubation, with or without preliminary plain films, not being a service associated with a service to which item 30488 applies (R) (NK) (Anaes.)

69.25

58923

Opaque enema, with or without air contrast study and with or without preliminary plain films (R) (NK)

67.65

58926

Graham’s test (cholecystography), with preliminary plain films and with or without tomography (R) (NK)

42.05

58929

Cholegraphy direct, with or without preliminary plain films and with preparation and contrast injection, not being a service associated with a service to which item 30439 applies (R) (NK)

38.25

58935

Cholegraphy, percutaneous transhepatic, with or without preliminary plain films and with preparation and contrast injection (R) (NK)

102.80

58938

Cholegraphy, drip infusion, with or without preliminary plain films, with preparation and contrast injection and with or without tomography (R) (NK)

98.00

58941

Defaecogram (R) (NK)

69.65

Subgroup 9 — Radiographic examination for localisation of foreign bodies

59104

Localisation of foreign body, if provided in conjunction with a service described in Subgroups 1 to 12 of Group I3 (R) (NK)

10.65

Subgroup 10 — Radiographic examination of breasts

59301

Mammography of both breasts if there is reason to suspect the presence of malignancy because of:

 (a) the past occurrence of breast malignancy in the patient or members of the patient’s family; or

44.75

 (b) symptoms or indications of malignancy found on examination of the patient by a medical practitioner (R) (NK)

59304

Mammography of 1 breast if:

 (a) the patient is referred with a specific request for a unilateral mammogram; and

 (b) there is reason to suspect the presence of malignancy because of:

 (i) the past occurrence of breast malignancy in the patient or members of the patient’s family; or

27.00

 (ii) symptoms or indications of malignancy found on examination of the patient by a medical practitioner (R) (NK)

59307

Mammary ductogram (galactography) — 1 breast (R) (NK)

50.15

59310

Mammary ductogram (galactography) — 2 breasts (R) (NK)

100.30

59313

Radiographic examination of both breasts, in conjunction with a surgical procedure on each breast, using interventional techniques (R) (NK)

43.50

59315

Radiographic examination of 1 breast, in conjunction with a surgical procedure using interventional techniques (R) (NK)

26.25

59319

Radiographic examination of excised breast tissue to confirm satisfactory excision of 1 or more lesions in 1 breast or both following pre‑operative localisation in conjunction with a service under item 31536 (R) (NK)

23.55

Subgroup 11 — Radiographic examination in connection with pregnancy

59504

Pelvimetry, not being a service associated with a service to which item 57201 or 57247  applies (R) (NK)

44.70

Subgroup 12 — Radiographic examination with opaque or contrast media

59701

Discography, each disc, with or without preliminary plain films and with preparation and contrast injection (R) (NK) (Anaes.)

48.30

59704

Dacryocystography, 1 side, with or without preliminary plain film and with preparation and contrast injection (R) (NK)

37.95

59713

Hysterosalpingography, with or without preliminary plain films and with preparation and contrast injection (R) (NK) (Anaes.)

56.85

59716

Bronchography, 1 side, with or without preliminary plain films and with preparation and contrast injection (R) (NK) (Anaes.)

71.80

59719

Phlebography, 1 side, with or without preliminary plain films and with preparation and contrast injection (R) (NK) (Anaes.)

67.35

59725

Myelography, 1 or more regions, with or without preliminary plain films and with preparation and contrast injection, not being a service associated with a service to which item 56219 or 56259  applies (R) (NK) (Anaes.)

113.25

59734

Sialography, 1 side, with preparation and contrast injection, not being a service associated with a service to which item 57918 or 57932 applies (R) (NK)

53.85

59737

Vasoepididymography, 1 side (R) (NK)

31.00

59740

Sinogram or fistulogram, 1 or more regions, with or without preliminary plain films and with preparation and contrast injection (R) (NK)

36.90

59752

Arthrography, each joint, excluding the facet (zygapophyseal) joints of the spine, single or double contrast study, with or without preliminary plain films and with preparation and contrast injection (R) (NK)

69.60

59755

Lymphangiography, 1 or both sides, with preliminary plain films and follow‑up radiography and with preparation and contrast injection (R) (NK)

109.70

59761

Peritoneogram (herniography) with or without contrast medium including preparation — performed on a person over 14 years of age (R) (NK)

57.60

59764

Air insufflation during video — fluoroscopic imaging including associated consultation (R) (NK)

66.95

Subgroup 14 — Tomography

60101

Tomography of any region (R) (NK) (Anaes.)

30.40

60501

Fluoroscopy, with general anaesthesia (not being a service associated with a radiographic examination) (R) (NK) (Anaes.)

21.70

60504

Fluoroscopy, without general anaesthesia (not being a service associated with a radiographic examination) (R) (NK)

14.90

60507

Fluoroscopy using a mobile image intensifier, in conjunction with a surgical procedure lasting less than 1 hour, not being a service associated with a service to which another item in this table applies (R) (NK)

31.90

60510

Fluoroscopy using a mobile image intensifier, in conjunction with a surgical procedure lasting 1 hour or more, not being a service associated with a service to which another item in this table applies (R) (NK)

49.45