Schedule 1 Amendments

(regulation 3)

[1] Schedule 1, Part 2, subrule 6 (1)

omit

172, 193 to

[2] Schedule 1, Part 2, subrules 15 (6) and (7)

omit

[3] Schedule 1, Part 2, after subrule 15 (8)

insert

(9) In items 15230, 15233, 15236, 15239, 15242, 15260, 15263, 15266, 15269 and 15272, amount under rule 15 means an amount equal to the sum of:

(a) $48.40; and

(b) $30.75 for each field separately treated in excess of 1.

[4] Schedule 1, Part 2, after rule 16

insert

16A Cleft lip and cleft palate services

An item in Group C1, C2 or C3 applies only to a service provided to a prescribed dental patient.

Note For the meaning of prescribed dental patient, see section 3 of the Act.

[5] Schedule 1, Part 2, rule 17

omit

practitioner practising as a dentist.

insert

practitioner.

[6] Schedule 1, Part 2, after rule 74

insert

75 Injection of botulinum toxin

Each of items 18350 to 18370 applies only to a service provided by a medical practitioner who is registered by the Commission to participate in the arrangements made, under paragraph 100 (1) (b) of the National Health Act 1953, for the purpose of providing an adequate pharmaceutical service for persons requiring treatment with botulinum toxin.

[7] Schedule 1, Part 3, item 106, column 2

omit

item 10801, 10802, 10803, 10804, 10805, 10806, 10807, 10808, 10809 or 10816

insert

any of items 10801 to 10816

[8] Schedule 1, Part 3, item 106, column 3

omit

57.15

insert

57.55

[9] Schedule 1, Part 3, items 193 and 195

substitute

193	Professional attendance by a general practitioner at a place other than a hospital: (a) involving taking a selective history, examination of the patient with implementation of a management plan in relation to 1 or more problems; or (b) being attendance of less than 20 minutes duration involving components of a service to which item 197 or 199 applies; at which acupuncture is performed by the general practitioner by application of stimuli on or through the surface of the skin by any means, including any consultation on the same occasion and any other attendance on the same day related to the condition for which the acupuncture was performed	29.45
195	Professional attendance by a general practitioner on 1 or more patients at a hospital on 1 occasion: (a) involving taking a selective history, examination of each patient with implementation of a management plan in relation to 1 or more problems; or (b) being attendance of less than 20 minutes duration involving components of a service to which item 197 or 199 applies; at which acupuncture is performed by the general practitioner by application of stimuli on or through the surface of the skin by any means, including any consultation on the same occasion and any other attendance on the same day related to the condition for which the acupuncture was performed	Amount under rule 8
197	Professional attendance by a general practitioner at a place other than a hospital: (a) involving taking a detailed history, an examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more problems, and lasting at least 20 minutes; or (b) being attendance of at least 20 minutes, but less than 40 minutes, duration involving components of a service to which item 199 applies; at which acupuncture is performed by the general practitioner by application of stimuli on or through the surface of the skin by any means, including any consultation on the same occasion and any other attendance on the same day related to the condition for which the acupuncture was performed	55.95
199	Professional attendance by a general practitioner at a place other than a hospital: (a) involving taking an exhaustive history, a comprehensive examination of multiple systems, arranging any necessary investigations and implementing a management plan in relation to 1 or more complex problems, and lasting at least 40 minutes; or (b) being attendance of at least 40 minutes duration for implementation of a management plan; at which acupuncture is performed by the general practitioner by application of stimuli on or through the surface of the skin by any means, including any consultation on the same occasion and any other attendance on the same day related to the condition for which the acupuncture was performed	82.40

[10] Schedule 1, Part 3, items 11024 and 11027, column 2

omit

event — related potentials

insert

event‑related potentials or involving multifocal multichannel objective perimetry

[11] Schedule 1, Part 3, item 11221, column 2

omit

threshold)

insert

threshold), not being a service involving multifocal multichannel objective perimetry,

[12] Schedule 1, Part 3, item 11222

substitute

11222

Full quantitative computerised perimetry (automated absolute static threshold), not being a service involving multifocal multichannel objective perimetry, performed by or on behalf of a specialist in the practice of his or her specialty, with assessment and report, bilateral, where it can be demonstrated that a further examination is indicated in the same 12 month period to which item 11221 applies due to presence of 1 of the following conditions:

(a) established glaucoma (where surgery is being considered) where there has been definite progression of damage over a 12 month period;

54.95

(b) established neurologic disease (whether or not progressive) where a visual field is necessary for the management of the patient;

(c) for the monitoring of ocular disease caused by systemic drug toxicity, where there is also other disease such as glaucoma or neurologic disease;

each additional examination

[13] Schedule 1, Part 3, item 11224, column 2

omit

— (automated absolute static threshold)

insert

(automated absolute static threshold), not being a service involving multifocal multichannel objective perimetry,

[14] Schedule 1, Part 3, item 11225

substitute

11225

Full quantitative computerised perimetry (automated absolute static threshold), not being a service involving multifocal multichannel objective perimetry, performed by or on behalf of a specialist in the practice of his or her specialty, with assessment and report, unilateral, where it can be demonstrated that a further examination is indicated in the same 12 month period to which item 11224 applies due to presence of 1 of the following conditions:

(a) established glaucoma (where surgery is being considered) where there has been definite progression of damage over a 12 month period;

(b) established neurologic disease (whether or not progressive) where a visual field is necessary for the management of the patient;

(c) for the monitoring of ocular disease caused by systemic drug toxicity, where there is also other disease such as glaucoma or neurologic disease;

each additional examination

33.10

[15] Schedule 1, Part 3, item 11603, column 2

omit

to which item 11612 or 11615

insert

associated with a service to which item 11612, 32500 or 32501

[16] Schedule 1, Part 3, item 11606, column 2

omit

11612 or 11615

insert

11612, 32500 or 32501

[17] Schedule 1, Part 3, item 11609, column 2

omit

to which item 11612 or 11615

insert

associated with a service to which item 11612, 32500 or 32501

[18] Schedule 1, Part 3, item 11918

renumber as item 11919

[19] Schedule 1, Part 3, items 15203 to 15208

omit

[20] Schedule 1, Part 3, after item 15214

insert

15215	Radiation oncology treatment, using a single photon energy linear accelerator, with or without electron facilities — each attendance at which treatment is given — 1 field — treatment delivered to primary site (lung)	48.40
15218	Radiation oncology treatment, using a single photon energy linear accelerator, with or without electron facilities — each attendance at which treatment is given — 1 field — treatment delivered to primary site (prostate)	48.40
15221	Radiation oncology treatment, using a single photon energy linear accelerator, with or without electron facilities — each attendance at which treatment is given — 1 field — treatment delivered to primary site (breast)	48.40
15224	Radiation oncology treatment, using a single photon energy linear accelerator, with or without electron facilities — each attendance at which treatment is given — 1 field — treatment delivered to primary site for a cancer not covered by item 15215, 15218 or 15221	48.40
15227	Radiation oncology treatment, using a single photon energy linear accelerator, with or without electron facilities — each attendance at which treatment is given — 1 field — treatment delivered to secondary site	48.40
15230	Radiation oncology treatment, using a single photon energy linear accelerator, with or without electron facilities — each attendance at which treatment is given — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields) — treatment delivered to primary site (lung)	Amount under rule 15
15233	Radiation oncology treatment, using a single photon energy linear accelerator, with or without electron facilities — each attendance at which treatment is given — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields) — treatment delivered to primary site (prostate)	Amount under rule 15
15236	Radiation oncology treatment, using a single photon energy linear accelerator, with or without electron facilities — each attendance at which treatment is given — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields) — treatment delivered to primary site (breast)	Amount under rule 15
15239	Radiation oncology treatment, using a single photon energy linear accelerator, with or without electron facilities — each attendance at which treatment is given — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields) — treatment delivered to primary site for a cancer not covered by item 15230, 15233 or 15236	Amount under rule 15
15242	Radiation oncology treatment, using a single photon energy linear accelerator, with or without electron facilities — each attendance at which treatment is given — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields) — treatment delivered to secondary site	Amount under rule 15
15245	Radiation oncology treatment, using a dual photon energy linear accelerator with a minimum higher energy of at least 10MV photons, with electron facilities — each attendance at which treatment is given — 1 field — treatment delivered to primary site (lung)	48.40
15248	Radiation oncology treatment, using a dual photon energy linear accelerator with a minimum higher energy of at least 10MV photons, with electron facilities — each attendance at which treatment is given — 1 field — treatment delivered to primary site (prostate)	48.40
15251	Radiation oncology treatment, using a dual photon energy linear accelerator with a minimum higher energy of at least 10MV photons, with electron facilities — each attendance at which treatment is given — 1 field — treatment delivered to primary site (breast)	48.40
15254	Radiation oncology treatment, using a dual photon energy linear accelerator with a minimum higher energy of at least 10MV photons, with electron facilities — each attendance at which treatment is given — 1 field — treatment delivered to primary site for a cancer not covered by item 15245, 15248 or 15251	48.40
15257	Radiation oncology treatment, using a dual photon energy linear accelerator with a minimum higher energy of at least 10MV photons, with electron facilities — each attendance at which treatment is given — 1 field — treatment delivered to secondary site	48.40
15260	Radiation oncology treatment, using a dual photon energy linear accelerator with a minimum higher energy of at least 10MV photons, with electron facilities — each attendance at which treatment is given — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields) — treatment delivered to primary site (lung)	Amount under rule 15
15263	Radiation oncology treatment, using a dual photon energy linear accelerator with a minimum higher energy of at least 10MV photons, with electron facilities — each attendance at which treatment is given — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields) — treatment delivered to primary site (prostate)	Amount under rule 15
15266	Radiation oncology treatment, using a dual photon energy linear accelerator with a minimum higher energy of at least 10MV photons, with electron facilities — each attendance at which treatment is given — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields) — treatment delivered to primary site (breast)	Amount under rule 15
15269	Radiation oncology treatment, using a dual photon energy linear accelerator with a minimum higher energy of at least 10MV photons, with electron facilities — each attendance at which treatment is given — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields) — treatment delivered to primary site for a cancer not covered by item 15260, 15263 or 15266	Amount under rule 15
15272	Radiation oncology treatment, using a dual photon energy linear accelerator with a minimum higher energy of at least 10MV photons, with electron facilities — each attendance at which treatment is given — 2 or more fields up to a maximum of 5 additional fields (rotational therapy being 3 fields) — treatment delivered to secondary site	Amount under rule 15

[21] Schedule 1, Part 3, item 16003, column 2

omit

paracentesis)

insert

paracentesis and not being a service associated with selective internal radiation therapy)

[22] Schedule 1, Part 3, item 18290, column 2

omit

agent

insert

agent, not being a service associated with the injection of botulinum toxin

[23] Schedule 1, Part 3, item 18292, column 2

after

applies

insert

or a service associated with the injection of botulinum toxin

[24] Schedule 1, Part 3, after item 18298

insert

18350	Botulinum toxin (Botox), injection of, for hemifacial spasm in a patient over 12 years of age, including all such injections on any 1 day	101.20
18352	Botulinum toxin (Botox or Dysport), injection of, for cervical dystonia (spasmodic torticollis), including all such injections on any 1 day	202.50
18354	Botulinum toxin (Botox or Dysport), injection of, for dynamic equinus foot deformity due to spasticity in an ambulant cerebral palsy patient between the ages of 2 and 17 (inclusive), including all such injections on any 1 day for all or any of the muscles subserving 1 functional activity and supplied by 1 motor nerve — applicable only to the first 2 treatments of each limb of the patient on any 1 day (Anaes.)	101.20
18356	Botulinum toxin (Botox or Dysport), injection of, for dynamic equinovarus foot deformity due to spasticity in an ambulant cerebral palsy patient between the ages of 2 and 17 (inclusive), including all such injections on any 1 day for all or any of the muscles subserving 1 functional activity and supplied by 1 motor nerve — applicable only to the first 2 treatments of each limb of the patient on any 1 day (Anaes.)	101.20
18358	Botulinum toxin (Botox or Dysport), injection of, for dynamic equinovalgus foot deformity due to spasticity in an ambulant cerebral palsy patient between the ages of 2 and 17 (inclusive), including all such injections on any 1 day for all or any of the muscles subserving 1 functional activity and supplied by 1 motor nerve — applicable only to the first 2 treatments of each limb of the patient on any 1 day (Anaes.)	101.20
18370	Botulinum toxin, injection of, for blepharospasm, including all such injections on any 1 day (Anaes.)	36.55

[25] Schedule 1, Part 3, after item 20420

insert

20440

Initiation of management of anaesthesia for percutaneous bone marrow biopsy of the sternum

66.00

[26] Schedule 1, Part 3, after item 21110

insert

21112	Initiation of management of anaesthesia for percutaneous bone marrow biopsy of the anterior iliac crest	66.00
21114	Initiation of management of anaesthesia for percutaneous bone marrow biopsy of the posterior iliac crest	82.50
21116	Initiation of management of anaesthesia for percutaneous bone marrow harvesting from the pelvis	99.00

[27] Schedule 1, Part 3, item 30165, column 2

omit

apron

insert

apron, not being a service performed within 12 months after the end of a pregnancy of the patient

[28] Schedule 1, Part 3, item 30177, column 2

omit

umbilicus

insert

umbilicus, not being a service performed within 12 months after the end of a pregnancy of the patient

[29] Schedule 1, Part 3, item 30195, column 2

omit

Neoplastic skin lesions,

insert

Benign neoplasm of skin,

[30] Schedule 1, Part 3, items 30196 to 30202, column 2

omit

Cancer

insert

Malignant neoplasm

[31] Schedule 1, Part 3, items 30203 and 30205

substitute

30203	Malignant neoplasm of skin or mucous membrane proven by histopathology or confirmed by specialist opinion, removal of, by liquid nitrogen cryotherapy using repeat freeze-thaw cycles (10 or more lesions)	138.05
30205	Malignant neoplasm of skin proven by histopathology, removal of, by liquid nitrogen cryotherapy using repeat freeze-thaw cycles if the malignant neoplasm extends into cartilage (Anaes.)	102.40

[32] Schedule 1, Part 3, items 31255 to 31290, column 2

omit

suture and histological

insert

suture, and where the specimen excised is sent for histological examination and

[33] Schedule 1, Part 3, item 31295, column 2

omit everything after

sternomastoid

insert

muscles) — where removal is by surgical excision and suture, and where the specimen excised is sent for histological examination and confirmation of malignancy has been obtained (Anaes.)

[34] Schedule 1, Part 3, items 31300 to 31335, column 2

omit

suture and histological

insert

suture, and where the specimen excised is sent for histological examination and

[35] Schedule 1, Part 3, after item 31345

insert

31346

Liposuction (suction assisted lipolysis) to 1 regional area for treatment of contour problems of abdominal fat due to repeated insulin injections, where the lesion is subcutaneous and greater than 50 mm in diameter (Anaes.)

170.95

[36] Schedule 1, Part 3, item 32500, column 2

after

injections

insert

of sclerosant

[37] Schedule 1, Part 3, item 32501

substitute

32501

Varicose veins where varicosity measures 2.5 mm or greater in diameter, multiple injections of sclerosant using continuous compression techniques, including associated consultation — 1 or both legs — not being a service associated with any other varicose vein operation on the same leg (excluding after-care) — where it can be demonstrated that truncal reflux in the long or short saphenous veins has been excluded by duplex examination and that a 7th or subsequent treatment (including any treatments to which item 32500 applies) is indicated in a 12 month period

89.00

[38] Schedule 1, Part 3, after item 35330

insert

35335	Percutaneous transluminal rotational atherectomy of 1 coronary artery, including balloon angioplasty with no stent insertion, where: (a) no lesion of the coronary artery has been stented; and (b) each lesion of the coronary artery is complex and heavily calcified; and (c) balloon angioplasty with or without stenting is not suitable; excluding associated radiological services or preparation, and excluding after-care (Anaes.) (Assist.)	717.90
35338	Percutaneous transluminal rotational atherectomy of 1 coronary artery, including balloon angioplasty with insertion of 1 or more stents, where: (a) no lesion of the coronary artery has been stented; and (b) each lesion of the coronary artery is complex and heavily calcified; and (c) balloon angioplasty with or without stenting is not suitable; excluding associated radiological services or preparation, and excluding after-care (Anaes.) (Assist.)	918.15
35341	Percutaneous transluminal rotational atherectomy of more than 1 coronary artery, including balloon angioplasty with no stent insertion, where: (a) no lesion of the coronary arteries has been stented; and (b) each lesion of the coronary arteries is complex and heavily calcified; and (c) balloon angioplasty with or without stenting is not suitable; excluding associated radiological services or preparation, and excluding after-care (Anaes.) (Assist.)	985.75
35344	Percutaneous transluminal rotational atherectomy of more than 1 coronary artery, including balloon angioplasty with insertion of 1 or more stents, where: (a) no lesion of the coronary arteries has been stented; and (b) each lesion of the coronary arteries is complex and heavily calcified; and (c) balloon angioplasty with or without stenting is not suitable; excluding associated radiological services or preparation, and excluding after-care (Anaes.) (Assist.)	1 286.15

[39] Schedule 1, Part 3, item 36836, column 2

omit

36839,

insert

36840,

[40] Schedule 1, Part 3, item 36839

substitute

36840

Cystoscopy, with resection, diathermy or visual laser destruction of bladder tumour or other lesion of the bladder, not being a service associated with a service to which item 36845 applies (Anaes.)

262.05

[41] Schedule 1, Part 3, after item 37223

insert

37224

Prostate, diathermy or visual laser destruction of lesion of, not being a service associated with a service to which item 37201, 37202, 37203, 37206, 37207, 37208 or 37215 applies (Anaes.)

262.05

[42] Schedule 1, Part 3, items 41869, 42827 and 42830

omit

[43] Schedule 1, Part 3, item 45528

substitute

45528

Mammaplasty, augmentation, bilateral, not being a service to which item 45527 applies, where it can be demonstrated that surgery is indicated because of congenital malformation, disease or trauma of the breast (other than trauma resulting from previous elective cosmetic surgery) (Anaes.) (Assist.)

901.90

[44] Schedule 1, Part 3, items 45557 and 45558

substitute

45557

Breast ptosis, correction by mastopexy of (unilateral), following pregnancy and lactation, when performed not less than 1 year, and not more than 7 years, after the end of the most recent pregnancy of the patient, and where it can be demonstrated that the nipple is inferior to the

infra-mammary groove (Anaes.) (Assist.)

621.05

45558

Breast ptosis, correction by mastopexy of (bilateral), following pregnancy and lactation, when performed not less than 1 year, and not more than 7 years, after the end of the most recent pregnancy of the patient, and where it can be demonstrated that the nipple is inferior to the

infra-mammary groove (Anaes.) (Assist.)

931.55

[45] Schedule 1, Part 3, item 45585

substitute

45585	Liposuction (suction assisted lipolysis) to 1 regional area, where it can be demonstrated that the treatment is for pathological lipodystrophy of hips, buttocks, thighs, knees or lower legs (Barraquer-Simon’s syndrome), gynaecomastia or lymphoedema (Anaes.)	512.20
45586	Liposuction (suction assisted lipolysis) for reduction of a buffalo hump, where it can be demonstrated that the buffalo hump is secondary to an endocrine disorder or pharmacological treatment of a medical condition (Anaes.)	512.20

[46] Schedule 1, Part 3, item 45588

substitute

45588

Meloplasty (excluding browlifts and chinlift platysmaplasties), bilateral, where it can be demonstrated that surgery is indicated because of congenital conditions, disease or trauma (other than trauma resulting from previous elective cosmetic surgery) (Anaes.) (Assist.)

1 083.50

[47] Schedule 1, Part 3, item 45638, column 2

omit

post-traumatic deformity or nasal obstruction,

insert

nasal obstruction or post-traumatic deformity (other than deformity resulting from previous elective cosmetic surgery),

[48] Schedule 1, Part 3, item 48636, column 2

omit

levels

insert

levels, not being a service associated with intradiscal electrothermal annuloplasty

[49] Schedule 1, Part 3, item 75156, column 2

omit

treatment

insert

treatment, where the patient is referred by an accredited orthodontist

[50] Schedule 1, Part 3, item 75206, column 2

omit

rendered (AOS)

insert

rendered, where the patient is referred by an accredited orthodontist (AD)

[51] Schedule 1, Part 3, item 75612, column 2

omit

(first stage)

insert

(first stage), where the patient is referred by an accredited orthodontist

[52] Schedule 1, Part 3, item 75615, column 2

omit

implant)

insert

implant), where the patient is referred by an accredited orthodontist

[53] Schedule 1, Part 3, item 75618, column 2

omit

syndrome

insert

syndrome, where the patient is referred by an accredited orthodontist

[54] Schedule 1, Part 3, item 75621

substitute

75621

The provision and fitting of surgical template in conjunction with orthognathic surgical procedures in association with:

(a) an item in the series 52342 to 52375; or

(b) item 52380 or 52382;

where the patient is referred by an accredited orthodontist

(AOS)

187.80

[55] Further amendments

Provision	omit	insert
Schedule 1, Part 2, subrule 12 (2)	11918,	11919,
Schedule 1, Part 3, item 173	Attendance	Professional attendance
Schedule 1, Part 3, items 2600 to 2727	who practices	who practises
Schedule 1, Part 3, item 11900	11918	11919
Schedule 1, Part 3, items 11903 to 11917	11918,	11919,
Schedule 1, Part 3, items 31205 to 31220	31335, where specimen sent	31335 — where the specimen excised is sent
Schedule 1, Part 3, items 31225 to 31240	specimen sent	the specimen excised is sent
Schedule 1, Part 3, item 31250	where the specimen	— where the specimen excised
Schedule 1, Part 3, items 31345 and 31350	specimen	the specimen excised
Schedule 1, Part 3, items 75021 and 75023	(AOS)	(AOS) (AO)
Schedule 1, Part 3, item 75203	(AOS)	(AD)

Notes

1. These Regulations amend Statutory Rules 2002 No. 244, as amended by 2002 No. 254.

2. Notified in the Commonwealth of Australia Gazette on 28 April 2003.