Group I1 — Ultrasound

Subgroup 1 — General

55028

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)

99.90

55029

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)

34.65

55030

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)

99.90

55031

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)

34.65

55032

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)

99.90

55033

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)

34.65

55036

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

101.95

 (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 55038, 55044 or 55731 is not performed on the same patient by the providing practitioner (R)

55037

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

34.65

55038

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

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

99.90

 (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 55036, 55044 or 55731 is not performed on the same patient by the providing practitioner (R)

55039

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)

34.65

55044

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

 (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 55036 or 55038 is not performed on the same patient by the providing practitioner (R)

101.95

55045

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)

34.65

55048

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)

100.30

55049

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)

34.65

55054

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)

99.90

55070

Breast, one, ultrasound scan of, 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

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

90.00

55073

Breast, one, ultrasound scan of, 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)

31.20

55076

Breasts, both, ultrasound scan of, 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

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

99.90

55079

Breasts, both, ultrasound scan of, 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)

34.65

Subgroup 2 — Cardiac

55113

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:

 (a) with:

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

230.65

 (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 item 55054) or 3, or another item in this Subgroup (except items 55118 and 55130), applies (R)

55114

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

230.65

 (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 item 55054) or 3, or another item in this Subgroup (except items 55118 and 55130), applies (R)

55115

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

 (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 item 55054) or 3, or another item in this Subgroup (except items 55118 and 55130), applies (R)

230.65

55116

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

 (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 item 55054) or 3, or another item in this Subgroup (except items 55118 and 55130), applies (R)

256.50

55117

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

256.50

 (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 item 55054) or 3, or another item in this Subgroup (except items 55118 and 55130), applies (R)

55118

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) pulsed wave Doppler examination; and

 (ii) real time colour flow mapping; and

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

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

275.50

55130

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 (R) (Anaes.)

353.60

Subgroup 3 — Vascular

55238

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 item 55054) or 4 applies (R)

155.25

55244

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 item 55054) or 4 applies (R)

155.25

55246

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 item 55054) or 4 applies (R)

155.25

55248

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 item 55054) or 4 applies (R)

155.25

55252

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 item 55054) or 4 applies (R)

155.25

55274

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 item 55054) or 4 applies (R)

155.25

55276

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 item 55054) or 4 applies (R)

155.25

55278

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 item 55054) or 4 applies (R)

155.25

55280

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 item 55054) or 4 applies (R)

155.25

55282

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

155.25

 (c) where 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) where that 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 item 55054) or 4 applies (R)

55284

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

155.25

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

 (i) priapism; or

 (ii) fibrosis of any type; or

 (iii) fracture of the tunica; or

 (iv) arteriovenous malformations; and

 (c) where 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) where that 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 item 55054) or 4 applies (R)

55292

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 item 55054) or 4 applies (R)

155.25

55294

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 item 55054), 3 or 4 applies (R)

155.25

55296

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 item 55054), 3 or 4 applies (R)

101.70

Subgroup 4 — Urological

55600

Prostate, bladder base and urethra, transrectal ultrasound scan of, where 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 megahertz or a nominal frequency range which includes frequencies of 7 to 7.5 megahertz; 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

 (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)

99.90

55603

Prostate, bladder base and urethra, transrectal ultrasound scan of, where 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 megahertz or a nominal frequency range which includes frequencies of 7 to 7.5 megahertz; 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

99.90

 (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)

Subgroup 5 — Obstetric and gynaecological

55700

Pelvis or abdomen, pregnancy-related or pregnancy complication, ultrasound scan of, by any or all approaches, where:

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

60.00

 (e) one 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 foetal abnormality (R)

55703

Pelvis or abdomen, pregnancy-related or pregnancy complication, ultrasound scan of, by any or all approaches, where:

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

35.00

 (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 foetal abnormality (NR)

55704

Pelvis or abdomen, pregnancy-related or pregnancy complication, foetal development and anatomy, ultrasound scan of, by any or all approaches, where:

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

70.00

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

 (e) one 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 foetal abnormality (R)

55705

Pelvis or abdomen, pregnancy-related or pregnancy complication, foetal development and anatomy, ultrasound scan of, by any or all approaches, where:

 (a) the patient is not referred by a medical practitioner; 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) one 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 foetal abnormality (NR)

55706

Pelvis or abdomen, pregnancy-related or pregnancy complication, foetal development and anatomy, ultrasound scan (not exceeding 1 service in any 1 pregnancy) of, by any or all approaches, with measurement of all parameters for dating purposes, where:

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

100.00

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

 (e) the service is not performed in the same pregnancy as item 55709 (R)

55709

Pelvis or abdomen, pregnancy-related or pregnancy complication, foetal development and anatomy, ultrasound scan (not exceeding 1 service in any 1 pregnancy) of, by any or all approaches, with measurement of all parameters for dating purposes, where:

 (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) the service is not performed in the same pregnancy as item 55706 (NR)

38.00

55712

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

 (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

115.00

 (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 or 55709 (R)

55715

Pelvis or abdomen, pregnancy-related or pregnancy complication, foetal 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, where:

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

40.00

 (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 or 55709 (NR)

55718

Pelvis or abdomen, pregnancy-related or pregnancy complication, foetal development and anatomy, ultrasound scan (not exceeding 1 service in any 1 pregnancy) of, by any or all approaches, where:

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

100.00

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

 (e) the service is not performed in the same pregnancy as item 55723; and

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

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

 (ii) foetal 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 foetal death in utero or neonatal death;

 (xi) antepartum haemorrhage;

 (xii) clinical suspicion of intrauterine growth retardation;

 (xiii) clinical suspicion of macrosomia;

 (xiv) reduced foetal movements;

 (xv) suspected foetal death;

 (xvi) abnormal cardiotocography;

 (xvii) prolonged pregnancy;

 (xviii) premature labour;

 (xix) foetal 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)

55721

Pelvis or abdomen, pregnancy-related or pregnancy complication, foetal development and anatomy, ultrasound scan of, by any or all approaches, where:

 (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

115.00

 (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

 (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 or 55723 applies (R)

55723

Pelvis or abdomen, pregnancy-related or pregnancy complication, foetal development and anatomy, ultrasound scan of (not exceeding 1 service in any 1 pregnancy), by any or all approaches, where:

 (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

 (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; and

38.00

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

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

 (ii) foetal 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 foetal death in utero or neonatal death;

 (xi) antepartum haemorrhage;

 (xii) clinical suspicion of intrauterine growth retardation;

 (xiii) clinical suspicion of macrosomia;

 (xiv) reduced foetal movements;

 (xv) suspected foetal death;

 (xvi) abnormal cardiotocography;

 (xvii) prolonged pregnancy;

 (xviii) premature labour;

 (xix) foetal 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)

55725

Pelvis or abdomen, pregnancy-related or pregnancy complication, foetal 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, where:

 (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

40.00

 (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 or 55723 applies (NR)

55728

Pelvis or abdomen, pregnancy-related or pregnancy complication, foetal development and anatomy, ultrasound scan of, by any or all approaches, where:

 (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

100.00

 (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 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) it can be demonstrated that a clinical condition other than a condition mentioned in paragraph (f) of item 55718 or paragraph (e) of item 55723 is present (R)

55729

Measurement of umbilical blood flow using pulsed wave or continuous wave Doppler techniques after the 26th week of gestation where the patient is referred by a medical practitioner for this procedure and where there is reason to suspect intrauterine growth retardation or a significant risk of foetal death, not being a service associated with a service to which an item in this group applies — examination and report (R)

27.25

55731

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

 (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

98.00

 (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 55036 or 55038 on the same patient within 24 hours (R)

55733

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

 (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)

35.00

55736

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

 (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

127.00

 (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)

55739

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

 (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)

57.00

55759

Pelvis or abdomen, pregnancy-related or pregnancy complication, foetal development and anatomy, ultrasound scan of (not exceeding 1 service in any 1 pregnancy), by any or all approaches, with measurement of all parameters for dating purposes, where:

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

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

150.00

 (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, 55715 or 55762 is not performed in conjunction with the scan during the same pregnancy (R)

55762

Pelvis or abdomen, pregnancy-related or pregnancy complication, foetal development and anatomy, ultrasound scan of (not exceeding 1 service in any 1 pregnancy), by any or all approaches, with measurement of all parameters for dating purposes, where:

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

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

60.00

 (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, 55715 or 55759 is not performed in conjunction with the scan during the same pregnancy (NR)

55764

Pelvis or abdomen, pregnancy-related or pregnancy complication, foetal 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 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

160.00

 (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 or 55762 has been performed; and

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

55766

Pelvis or abdomen, pregnancy-related or pregnancy complication, foetal 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, where:

 (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

65.00

 (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 or 55762 has been performed; and

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

55768

Pelvis or abdomen, pregnancy-related or pregnancy complication, foetal development and anatomy, ultrasound scan of (not exceeding 1 service in any 1 pregnancy), by any or all approaches, where:

 (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; and

150.00

 (d) the service is not performed in the same pregnancy as item 55770; 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, 55723, 55725 or 55728 is not performed in conjunction with the scan during the same pregnancy (R)

55770

Pelvis or abdomen, pregnancy-related or pregnancy complication, foetal development and anatomy, ultrasound scan of (not exceeding 1 service in any 1 pregnancy), by any or all approaches, where:

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

60.00

 (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, 55723, 55725 or 55728 is not performed in conjunction with the scan during the same pregnancy (NR)

55772

Pelvis or abdomen, pregnancy-related or pregnancy complication, foetal 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 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

160.00

 (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 or 55770 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, 55723, 55725 or 55728 is not performed in conjunction with the scan during the same pregnancy (R)

55774

Pelvis or abdomen, pregnancy-related or pregnancy complication, foetal 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, where:

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

65.00

 (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 or 55770 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 service described in item 55718, 55721, 55723, 55725 or 55728 is not performed in conjunction with the scan during the same pregnancy (NR)

Subgroup 6 — Musculoskeletal Ultrasound

55800

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

 (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; and

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

99.90

55802

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

 (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 (NR)

34.65

55804

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

 (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; and

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

99.90

55806

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

 (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 (NR)

34.65

55808

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; and

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

99.90

 (d) 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;

 (iv) capsulitis and bursitis;

 (v) a mass, including a ganglion;

 (vi) an occult fracture;

 (vii) acromioclavicular joint pathology (R)

55810

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; 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;

 (iv) capsulitis and bursitis;

 (v) a mass, including a ganglion;

 (vi) an occult fracture;

 (vii) acromioclavicular joint pathology (NR)

34.65

55812

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

 (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; and

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

99.90

55814

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

 (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 (NR)

34.65

55816

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

 (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; and

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

99.90

55818

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

 (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 (NR)

34.65

55820

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

 (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; and

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

99.90

55822

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

 (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 (NR)

34.65

55824

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

 (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; and

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

99.90

55826

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

 (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 (NR)

34.65

55828

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; and

 (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 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)

99.90

55830

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; and

 (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)

34.65

55832

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

 (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; and

99.90

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

55834

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

 (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 (NR)

34.65

55836

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

 (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; and

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

99.90

55838

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

 (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 (NR)

34.65

55840

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

 (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; and

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

99.90

55842

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

 (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 (NR)

34.65

55844

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, where:

 (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; and

80.00

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

55846

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, where:

 (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 (NR)

34.65

55848

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 55054 (R)

99.90

55850

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

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

 (b) the service is not performed in conjunction with items 55054, or 55800 to 55848; and

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

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

140.00

55852

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

 (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; and

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

99.90

55854

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

 (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 (NR)

34.65

Group I2 — Computed tomography — Examination

56001

Computed tomography — scan of brain without intravenous contrast medium, not being a service to which item 57001 applies (R) (K) (Anaes.)

185.25

56007

Computed tomography — scan of brain with intravenous contrast medium and with any scans of the brain before intravenous contrast injection, when performed, not being a service to which item 57007 applies (R) (K) (Anaes.)

237.50

56010

Computed tomography — scan of pituitary fossa with or without intravenous contrast medium and with or without brain scan when performed (R) (K) (Anaes.)

239.50

56013

Computed tomography — scan of orbits with or without intravenous contrast medium and with or without brain scan when performed (R) (K) (Anaes.)

237.50

56016

Computed tomography — scan of petrous bones in axial and coronal planes in 1 mm or 2 mm sections, with or without contrast medium, with or without scan of brain (R) (K) (Anaes.)

275.50

56022

Computed tomography — scan of facial bones, para nasal sinuses or both without intravenous contrast medium (R) (K) (Anaes.)

213.75

56028

Computed tomography — scan of facial bones, para nasal sinuses or both with intravenous contrast medium and with any scans of the facial bones, para nasal sinuses or both before intravenous contrast injection, when performed (R) (K) (Anaes.)

319.95

56030

Computed tomography — scan of facial bones, para nasal sinuses or both, with scan of brain, without intravenous contrast medium (R) (K) (Anaes.)

213.75

56036

Computed tomography — scan of facial bones, para nasal sinuses or both, with scan of brain, with intravenous contrast medium, where:

 (a) a scan without intravenous contrast medium has been performed; and

 (b) the service is required because the result of the scan mentioned in paragraph (a) is abnormal (R) (K) (Anaes.)

319.95

56041

Computed tomography — scan of brain without intravenous contrast medium, not being a service to which item 57041 applies (R) (NK) (Anaes.)

93.80

56047

Computed tomography — scan of brain with intravenous contrast medium and with any scans of the brain before intravenous contrast injection, when performed, not being a service to which item 57047 applies (R) (NK) (Anaes.)

119.80

56050

Computed tomography — scan of pituitary fossa with or without intravenous contrast medium and with or without brain scan when performed (R) (NK) (Anaes.)

121.75

56053

Computed tomography — scan of orbits with or without intravenous contrast medium and with or without brain scan when performed (R) (NK) (Anaes.)

121.75

56056

Computed tomography — scan of petrous bones in axial and coronal planes in 1 mm or 2 mm sections, with or without intravenous contrast medium, with or without scan of brain (R) (NK) (Anaes.)

147.65

56062

Computed tomography — scan of facial bones, para nasal sinuses or both without intravenous contrast medium (R) (NK) (Anaes.)

107.50

56068

Computed tomography — scan of facial bones, para nasal sinuses or both with intravenous contrast medium and with any scans of the facial bones, para nasal sinuses or both before intravenous contrast injection, when performed (R) (NK) (Anaes.)

160.00

56070

Computed tomography — scan of facial bones, para nasal sinuses or both, with scan of brain, without intravenous contrast medium (R) (NK) (Anaes.)

107.50

56076

Computed tomography — scan of facial bones, para nasal sinuses or both, with scan of brain, with intravenous contrast medium, where:

 (a) a scan without intravenous contrast medium has been performed; and

 (b) the service is required because the result of the scan mentioned in paragraph (a) is abnormal (R) (NK) (Anaes.)

160.00

56101

Computed tomography — scan of soft tissues of neck, including larynx, pharynx, upper oesophagus and salivary glands (not associated with cervical spine) without intravenous contrast medium, not being a service to which item 56801 applies (R) (K) (Anaes.)

218.50

56107

Computed tomography — scan of soft tissues of neck, including larynx, pharynx, upper oesophagus and salivary glands (not associated with cervical spine) — with intravenous contrast medium and with any scans of soft tissues of neck, including larynx, pharynx, upper oesophagus and salivary glands (not associated with cervical spine) before intravenous contrast injection, when undertaken, not being a service associated with a service to which item 56807 applies (R) (K) (Anaes.)

323.00

56141

Computed tomography — scan of soft tissues of neck, including larynx, pharynx, upper oesophagus and salivary glands (not associated with cervical spine) without intravenous contrast medium, not being a service to which item 56841 applies (R) (NK) (Anaes.)

110.60

56147

Computed tomography — scan of soft tissues of neck, including larynx, pharynx, upper oesophagus and salivary glands (not associated with cervical spine) — with intravenous contrast medium and with any scans of soft tissues of neck, including larynx, pharynx, upper oesophagus and salivary glands (not associated with cervical spine) before intravenous contrast injection, when performed, not being a service associated with a service to which item 56847 applies (R) (NK) (Anaes.)

163.00

56219

Computed tomography — scan of spine, 1 or more regions with intrathecal contrast medium, including the preparation for intrathecal injection of contrast medium and any associated plain x‑rays, not being a service to which item 59724 applies (R) (K) (Anaes.)

309.90

56220

Computed tomography — scan of spine, cervical region, without intravenous contrast medium (R) (K) (Anaes.)

228.00

56221

Computed tomography — scan of spine, thoracic region, without intravenous contrast medium (R) (K) (Anaes.)

228.00

56223

Computed tomography — scan of spine, lumbosacral region, without intravenous contrast medium (R) (K) (Anaes.)

228.00

56224

Computed tomography — scan of spine, cervical region, with intravenous contrast medium and with any scans of the cervical region of the spine before intravenous contrast injection when undertaken (R) (K) (Anaes.)

333.80

56225

Computed tomography — scan of spine, thoracic region, with intravenous contrast medium and with any scans of the cervical region of the spine before intravenous contrast injection when undertaken (R) (K) (Anaes.)

333.80

56226

Computed tomography — scan of spine, lumbosacral region, with intravenous contrast medium and with any scans of the cervical region of the spine prior to intravenous contrast injection when undertaken (R) (K) (Anaes.)

333.80

56227

Computed tomography — scan of spine, cervical region, without intravenous contrast medium (R) (NK) (Anaes.)

116.40

56228

Computed tomography — scan of spine, thoracic region, without intravenous contrast medium (R) (NK) (Anaes.)

116.40

56229

Computed tomography — scan of spine, lumbosacral region, without intravenous contrast medium (R) (NK) (Anaes.)

116.40

56230

Computed tomography — scan of spine, cervical region, with intravenous contrast medium and with any scans to the cervical region of the spine before intravenous contrast injection when undertaken (R) (NK) (Anaes.)

168.60

56231

Computed tomography — scan of spine, thoracic region, with intravenous contrast medium and with any scans to the cervical region of the spine before intravenous contrast injection when undertaken (R) (NK) (Anaes.)

168.60

56232

Computed tomography — scan of spine, lumbosacral region, with intravenous contrast medium and with any scans to the cervical region of the spine before intravenous contrast injection when undertaken (R) (NK) (Anaes.)

168.60

56233

Computed tomography — scan of spine, 2 examinations of the kind referred to in items 56220, 56221 and 56223, without intravenous contrast medium (R) (K) (Anaes.)

228.00

56234

Computed tomography — scan of spine, 2 examinations of the kind referred to in items 56224, 56225 and 56226, with intravenous contrast medium and with any scans of these regions of the spine before intravenous contrast injection when undertaken (R) (K) (Anaes.)

333.80

56235

Computed tomography — scan of spine, 2 examinations of the kind referred to in items 56227, 56228 and 56229, without intravenous contrast medium (R) (NK) (Anaes.)

116.35

56236

Computed tomography — scan of spine, 2 examinations of the kind referred to in items 56230, 56231 and 56232, with intravenous contrast medium and with any scans of these regions of the spine before intravenous contrast injection when undertaken (R) (NK) (Anaes.)

168.60

56237

Computed tomography — scan of spine, 3 regions cervical, thoracic and lumbosacral, without intravenous contrast medium (R) (K) (Anaes.)

228.00

56238

Computed tomography — scan of spine, 3 regions, cervical, thoracic and lumbosacral, with intravenous contrast medium and with any scans of these regions of the spine before intravenous contrast injection when undertaken (R) (K) (Anaes.)

333.80

56239

Computed tomography — scan of spine, 3 regions, cervical, thoracic and lumbosacral, without intravenous contrast medium (R) (NK) (Anaes.)

116.35

56240

Computed tomography — scan of spine, 3 regions, cervical, thoracic and lumbosacral, with intravenous contrast medium and with any scans of these regions of the spine before intravenous contrast injection when undertaken (R) (NK) (Anaes.)

168.60

56259

Computed tomography — scan of spine, 1 or more regions with intrathecal contrast medium, including the preparation for intrathecal injection of contrast medium and any associated plain x‑rays, not being a service to which item 59724 applies (R) (NK) (Anaes.)

156.55

56301

Computed tomography — scan of chest, including lungs, mediastinum, chest wall and pleura, with or without scans of the upper abdomen, without intravenous contrast medium, not being a service to which item 56801 or 57001 applies and not including a study performed to exclude coronary artery calcification (R) (K) (Anaes.)

280.25

56307

Computed tomography — scan of chest, including lungs, mediastinum, chest wall and pleura, with or without scans of the upper abdomen, with intravenous contrast medium and with any scans of the chest, including lungs, mediastinum, chest wall or pleura and upper abdomen before intravenous contrast injection, when undertaken, not being a service to which item 56807 or 57007 applies and not including a study performed to exclude coronary artery calcification (R) (K) (Anaes.)

380.00

56341

Computed tomography — scan of chest, including lungs, mediastinum, chest wall and pleura, with or without scans of the upper abdomen, without intravenous contrast medium, not being a service to which item 56841 or 57041 applies and not including a study performed to exclude coronary artery calcification (R) (NK) (Anaes.)

142.00

56347

Computed tomography — scan of chest, including lungs, mediastinum, chest wall and pleura, with or without scans of the upper abdomen, with intravenous contrast medium and with any scans of the chest, including lungs, mediastinum, chest wall or pleura and upper abdomen before intravenous contrast injection, when undertaken, not being a service to which item 56847 or 57047 applies and not including a study performed to exclude coronary artery calcification (R) (NK) (Anaes.)

191.90

56401

Computed tomography — scan of upper abdomen only (diaphragm to iliac crest) without intravenous contrast medium, not being a service to which item 56301, 56501, 56801 or 57001 applies (R) (K) (Anaes.)

237.50

56407

Computed tomography — scan of upper abdomen only (diaphragm to iliac crest), with intravenous contrast medium, and with any scans of upper abdomen (diaphragm to iliac crest) before intravenous contrast injection, when undertaken, not being a service to which item 56307, 56507, 56807 or 57007 applies (R) (K) (Anaes.)

342.00

56409

Computed tomography — scan of pelvis only (iliac crest to pubic symphysis) without intravenous contrast medium not being a service associated with a service to which item 56401 applies (R) (K) (Anaes.)

237.50

56412

Computed tomography — scan of pelvis only (iliac crest to pubic symphysis), with intravenous contrast medium and with any scans of pelvis (iliac crest to pubic symphysis) before intravenous contrast injection, when undertaken, not being a service to which item 56407 applies (R) (K) (Anaes.)

342.00

56441

Computed tomography — scan of upper abdomen only (diaphragm to iliac crest) without intravenous contrast medium, not being a service to which item 56341, 56541, 56841 or 57041 applies (R) (NK) (Anaes.)

120.45

56447

Computed tomography — scan of upper abdomen only (diaphragm to iliac crest), with intravenous contrast medium, and with any scans of upper abdomen (diaphragm to iliac crest) before intravenous contrast injection, when performed, not being a service to which item 56347, 56547, 56847 or 57047 applies (R) (NK) (Anaes.)

172.40

56449

Computed tomography — scan of pelvis only (iliac crest to pubic symphysis) without intravenous contrast medium not being a service associated with a service to which item 56441 applies (R) (NK) (Anaes.)

120.45

56452

Computed tomography — scan of pelvis only (iliac crest to pubic symphysis), with intravenous contrast medium and with any scans of pelvis (iliac crest to pubic symphysis) before intravenous contrast injection, when undertaken, not being a service to which item 56447 applies (R) (NK) (Anaes.)

172.40

56501

Computed tomography — scan of upper abdomen and pelvis without intravenous contrast medium, not being a service to which item 56801 or 57001 applies (R) (K) (Anaes.)

365.75

56507

Computed tomography — scan of upper abdomen and pelvis with intravenous contrast medium and with any scans of upper abdomen and pelvis before intravenous contrast injection, when performed, not being a service to which item 56807 or 57007 applies (R) (K) (Anaes.)

456.00

56541

Computed tomography — scan of upper abdomen and pelvis without intravenous contrast medium, not being a service to which item 56841 or 57041 applies (R) (NK) (Anaes.)

183.45

56547

Computed tomography — scan of upper abdomen and pelvis with intravenous contrast medium and with any scans of upper abdomen and pelvis before intravenous contrast injection, when performed, not being a service to which item 56847 or 57047 applies (R) (NK) (Anaes.)

231.55

56619

Computed tomography — scan of extremities, 1 or more regions without intravenous contrast medium (R) (K) (Anaes.)

209.00

56625

Computed tomography — scan of extremities, 1 or more regions with intravenous contrast medium and with any scans of extremities before intravenous contrast injection, when performed (R) (K) (Anaes.)

317.90

56659

Computed tomography — scan of extremities, 1 or more regions without intravenous contrast medium (R) (NK) (Anaes.)

106.50

56665

Computed tomography — scan of extremities, 1 or more regions with intravenous contrast medium and with any scans of extremities before intravenous contrast injection, when performed (R) (NK) (Anaes.)

159.00

56801

Computed tomography — scan of chest, abdomen and pelvis with or without scans of soft tissues of neck without intravenous contrast medium, not including a study performed to exclude coronary artery calcification (R) (K) (Anaes.)

443.20

56807

Computed tomography — scan of chest, abdomen and pelvis with or without scans of soft tissues of neck with intravenous contrast medium and with any scans of chest, abdomen and pelvis with or without scans of soft tissue of neck before intravenous contrast injection, when performed, not including a study performed to exclude coronary artery calcification (R) (K) (Anaes.)

532.00

56841

Computed tomography — scan of chest, abdomen and pelvis with or without scans of soft tissues of neck without intravenous contrast medium, not including a study performed to exclude coronary artery calcification (R) (NK) (Anaes.)

221.65

56847

Computed tomography — scan of chest, abdomen and pelvis with or without scans of soft tissues of neck with intravenous contrast medium and with any scans of chest, abdomen and pelvis with or without scans of soft tissue of neck before intravenous contrast injection, when performed, not including a study performed to exclude coronary artery calcification (R) (NK) (Anaes.)

269.65

57001

Computed tomography — scan of brain and chest with or without scans of upper abdomen without intravenous contrast medium, not including a study performed to exclude coronary artery calcification (R) (K) (Anaes.)

443.30

57007

Computed tomography — scan of brain and chest with or without scans of upper abdomen with intravenous contrast medium and with any scans of brain and chest and upper abdomen before intravenous contrast injection, when performed, not including a study performed to exclude coronary artery calcification (R) (K) (Anaes.)

539.35

57041

Computed tomography — scan of brain and chest with or without scans of upper abdomen without intravenous contrast medium, not including a study performed to exclude coronary artery calcification (R) (NK) (Anaes.)

221.70

57047

Computed tomography — scan of brain and chest with or without scans of upper abdomen with intravenous contrast medium and with any scans of brain and chest and upper abdomen before intravenous contrast injection, when performed, not including a study performed to exclude coronary artery calcification (R) (NK) (Anaes.)

269.70

57201

Computed tomography — pelvimetry (R) (K) (Anaes.)

147.45

57247

Computed tomography — pelvimetry (R) (NK) (Anaes.)

73.70

57341

Computed tomography, in conjunction with a surgical procedure using interventional techniques, not being a service associated with a service to which another item in this table applies (R) (K) (Anaes.)

446.50

57345

Computed tomography, in conjunction with a surgical procedure using interventional techniques, not being a service associated with a service to which another item in this table applies (R) (NK) (Anaes.)

229.90

57350

Computed tomography — spiral angiography with intravenous contrast medium including any scans performed before intravenous contrast injection — 1 or more spiral data acquisitions, including image editing, and maximum intensity projections or 3 dimensional surface shaded display, with hardcopy recording of multiple projections, where:

 (a) the service is not a service to which another item in this group applies; and

 (b) the service is performed for the exclusion of arterial stenosis, occlusion, aneurysm or embolism; and

484.50

 (c) the service has not been performed on the same patient within the previous 12 months (R) (K) (Anaes.)

57351

Computed tomography — spiral angiography with intravenous contrast medium, including any scans performed before intravenous contrast injection — 1 or more spiral data acquisitions, including image editing, and maximum intensity projections or 3 dimensional surface shaded display, with hardcopy recording of multiple projections, if:

 (a) the service is not a service to which another item in this group applies; and

 (b)  the service is performed for the exclusion of acute or recurrent pulmonary embolism, acute symptomatic arterial occlusion, post operative complication of arterial surgery, acute ruptured aneurysm, or acute dissection of the aorta, carotid or vertebral artery; and

 (c) a service to which item 57350 or 57355 applies has been performed on the same patient within the previous 12 months (R) (K) (Anaes.)

484.50

57355

Computed tomography — spiral angiography with intravenous contrast medium including any scans performed before intravenous contrast injection — 1 or more spiral data acquisitions, including image editing, and maximum intensity projections or 3 dimensional surface shaded display, with hardcopy recording of multiple projections, where:

 (a) the service is not a service to which another item in this group applies; and

 (b) the service is performed for the exclusion of arterial stenosis, occlusion, aneurysm or embolism; and

 (c) the service has not been performed on the same patient within the previous 12 months (R) (NK) (Anaes.)

250.95

57356

Computed tomography — spiral angiography with intravenous contrast medium, including any scans performed before intravenous contrast injection — 1 or more spiral data acquisitions, including image editing, and maximum intensity projections or 3 dimensional surface shaded display, with hardcopy recording of multiple projections, where:

 (a) the service is not a service to which another item in this group applies; and

 (b) the service is performed for the exclusion of acute or recurrent pulmonary embolism, acute symptomatic arterial occlusion, post operative complication of arterial surgery, acute ruptured aneurysm, or acute dissection of the aorta, carotid or vertebral artery; and

 (c) the service to which item 57350 or 57355 applies has been performed on the same patient within the previous 12 months (R) (NK) (Anaes.)

250.95

Group I3 — Diagnostic radiology

Subgroup 1 — Radiographic examination of extremities

57506

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

28.05

57509

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

37.50

57512

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

38.15

57515

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

50.90

57518

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

30.65

57521

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

40.90

57524

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

46.55

57527

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

62.00

Subgroup 2 — Radiographic examination of shoulder or pelvis

57700

Shoulder or scapula (NR)

38.15

57703

Shoulder or scapula (R)

50.90

57706

Clavicle (NR)

30.65

57709

Clavicle (R)

40.90

57712

Hip joint (R)

44.45

57715

Pelvic girdle (R)

57.45

57721

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

93.55

Subgroup 3 — Radiographic examination of head

57901

Skull, not in association with item 57902 (R)

60.80

57902

Cephalometry, not in association with item 57901 (R)

60.80

57903

Sinuses (R)

44.55

57906

Mastoids (R)

60.80

57909

Petrous temporal bones (R)

60.80

57912

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

44.45

57915

Mandible, not by orthopantomography technique (R)

44.45

57918

Salivary calculus (R)

44.45

57921

Nose (R)

44.45

57924

Eye (R)

44.45

57927

Temporo-mandibular joints (R)

46.80

57930

Teeth — single area (R)

31.00

57933

Teeth — full mouth (R)

73.75

57939

Palato-pharyngeal studies with fluoroscopic screening (R)

60.80

57942

Palato-pharyngeal studies without fluoroscopic screening (R)

46.80

57945

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