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SR 1991 No. 442 Regulations as made
Principal Regulations; Repeals the (1991-1992 Pathology Services Table) Regulations.
Tabling HistoryDate
Tabled HR25-Feb-1992
Tabled Senate25-Feb-1992
Gazetted 19 Dec 1991
Date of repeal 01 Nov 1992
Repealed by Repealed by Health Insurance (1992-1993 Pathology Services Table) Regulations (SR 1992 No. 336).

1991 No. 442*1* HEALTH INSURANCE (1992 PATHOLOGY SERVICES TABLE) REGULATIONS

*1*Notified in the Commonwealth of Australia Gazette on 19 December 1991.

1991 No. 442 HEALTH INSURANCE (1992 PATHOLOGY SERVICES TABLE) REGULATIONS -
REG 1
Citation

1. These Regulations may be cited as the Health Insurance (1992 Pathology Services Table) Regulations.

1991 No. 442 HEALTH INSURANCE (1992 PATHOLOGY SERVICES TABLE) REGULATIONS -
REG 2
Commencement

2. These Regulations commence on 1 February 1992.

1991 No. 442 HEALTH INSURANCE (1992 PATHOLOGY SERVICES TABLE) REGULATIONS -
REG 3
Repeal

3. Statutory Rule 1991 No. 353 is repealed.

1991 No. 442 HEALTH INSURANCE (1992 PATHOLOGY SERVICES TABLE) REGULATIONS -
REG 4
Pathology services table

4. The table of pathology services in the Schedule is prescribed for the purposes of subsection 4A (2) of the Health Insurance Act 1973.

1991 No. 442 HEALTH INSURANCE (1992 PATHOLOGY SERVICES TABLE) REGULATIONS -
SCHEDULE

SCH

SCHEDULE Regulation 4

TABLE OF PATHOLOGY SERVICES
RULES OF INTERPRETATION
1. (1) In this table, unless the contrary intention appears:
"patient episode" means a pathology service, or pathology
services whether listed in 1 or more items, for a single patient
whose need for which was determined under subsection 16A (1) of
the Act on the same day, whether rendered by 1 or more approved
pathology practitioners on 1 or more days;
"recognised pathologist" means a medical practitioner
recognised as a specialist in pathology under a determination
under subsection 61 (3) of the Act ;
"the Act" means the Health Insurance Act 1973.

(2) In these Rules, a reference to a request to an approved
pathology practitioner includes a reference to a request for a
pathologist-determinable service to which subsection 16A (6) of
the Act applies.

2. (1) If a service is described:
(a) in an item in general terms; and
(b) in another item in specific terms;
only the item that describes the service in specific terms
applies to the service.

(2) If:
(a) a service is described in 2 or more items; and
(b) subrule (1) does not apply;
only the item that provides the lower or lowest fee for the
service applies to the service.

3. (1) In subrule (2), "service" includes an assay, estimation and test.

(2) 2 or more pathology services rendered for a patient
following 2 or more requests are taken to have been rendered
following a single request if:
(a) the services are listed in the same item; and
(b) the patient s need for the services was determined under
subsection 16A (1) of the Act on the same day even if
they are rendered by an approved pathology practitioner on more than one day.

4. If:
(a) a pathology service to which an item of the table
applies is rendered for a patient in accordance with a
request; and
(b) another pathology service is rendered for the patient in
accordance with the request; and
(c) an item of the table:
(i) applies to the other service ; and
(ii) is referred to in the item mentioned in paragraph
(a);
the other service is treated as if it were part of the service
referred to in paragraph (a).

Example:
Dr Proctor requests an extended blood grouping test
(covered by item 65019) and the test includes a basic
blood grouping test (covered by item 65017). Item 65017
is referred to in item 65019. Benefit is payable under
item 65019 for the extended blood grouping test but
benefit is not payable separately under item 65017 for
the basic blood grouping test.

5. For the purposes of items 65001 to 66200 (inclusive):
(a) if pathology services of a kind referred to in item
65017, 65018, 65019 or 65020 are rendered for a patient
during a period when the patient is in hospital, the
item applies only to the first pathology service of that
kind rendered for the patient during that period; and
(b) tests (except the tests mentioned in items 65023 and
65024) carried out on material stored from a previous
patient episode in response to a later request are
treated as part of that previous patient episode if the
second request is made within 14 days of that previous
patient episode.

6. For the purposes of items 66201 to 69200 (inclusive):
(a) if a pathology service involving the measurement of a
substance in urine requires a 24 hour urine collection,
or calculation of a substance/ creatinine ratio, the
service is treated as including any estimation of
creatinine in other fluids necessary for the
calculation; and
(b) tests carried out on material stored from a previous
patient episode in response to a later request are
treated as part of that previous patient episode if the
second request is made within 14 days of that previous
patient episode.

7. For the purposes of items 69201 to 71000 (inclusive):
(a) "serial examinations or cultures" means examinations
or cultures requested on 1 occasion whether or not:
(i) the materials are received on different days by the
approved pathology practitioner; or
(ii) the examinations or cultures were requested on 1 or
more request forms by the treating practitioner;
and
(b) tests carried out on material stored from a previous
patient episode in response to a later request are
treated as part of that previous patient episode if the
second request occurs within 14 days of that previous
patient episode.

8. For the purposes of items 71001 to 72800 (inclusive):
(a) in items 71025, 71026, 71027, 71028, 71029, 71030, 71031
and 71032, the estimation of a single antibody includes
qualitative and quantitative assays for that antibody;
and
(b) tests carried out on material stored from a previous
patient episode in response to a later request are
treated as part of that previous patient episode if the
second request occurs within 14 days of that previous
patient episode.

9. For the purposes of items 72801 to 73040 (inclusive):
(a) "biopsy material" means all tissue received by the
approved pathology practitioner from an operation, or a
group of operations, performed on a patient at the same
time, other than a bone marrow biopsy; and
(b) if:
(i) a pathology service that is the examination of
biopsy material is rendered under any of those
items; and
(ii) a further pathology service mentioned in any of
those items is also rendered using that biopsy
material;
those pathology services are treated as 1 pathology
service.

10. For the purposes of items 73041 to 73280 (inclusive),
"serial examinations" means examinations requested on 1
occasion whether or not:
(a) the materials are received on different days by the
approved pathology practitioner; or
(b) the examinations were requested on 1 or more request
forms by the treating practitioner.

11. (1) For the purposes of this rule and items 73901 to
73921 (inclusive):
"approved pathology authority has the same meaning as in
Division 4A of Part IIA of the Act;
"institution" means a place (other than a hospital, a nursing
home or accommodation for aged persons that is attached to a
nursing home or situated within a nursing home complex) at which
residential accommodation or day care is, or both residential
accommodation and day care are, made available to:
(a) disadvantaged children; or
(b) juvenile offenders; or
(c) aged persons; or
(d) chronically ill psychiatric patients; or
(e) homeless persons; or
(f) unemployed persons; or
(g) persons suffering from alcoholism; or
(h) persons addicted to drugs; or
(i) physically or mentally handicapped persons.
"licensed collection centre" has the same meaning as in Part
IIA of the Act;
"prescribed laboratory" means a laboratory operated by:
(a) the Commonwealth; or
(b) a State; or
(c) an authority of a State or Territory; or
(d) the Northern Territory; or
(e) the Australian Capital Territory; or
(f) an Australian tertiary education institution.
"specimen collection centre" has the same meaning as in Part
IIA of the Act;
"temporary collection centre" has the same meaning as in Part
IIA of the Act;
"treating practitioner" has the same meaning as in paragraph
16A (1) (a) of the Act.

(2) A service mentioned in items 73901 to 73921 (inclusive)
applies to a pathology service when rendered by, or on behalf
of, an approved pathology practitioner who is a recognised
pathologist unless:
(a) the service is rendered upon a request made in the
course of an out-patient service at a recognised
hospital; or
(b) the service is rendered upon a request made for a
patient who is a private patient in a recognised
hospital when the request was made; or
(c) the pathology equipment of a recognised hospital, or
prescribed laboratory, is used in rendering the service;
or
(d) a member of the staff of a recognised hospital, or
prescribed laboratory, participates in the service in
the course of the member s employment with the hospital
or laboratory.

(3) A service mentioned in items 73901 to 73921 (inclusive)
does not apply to a pathology service to which subsection 16A
(7) of the Act applies.

(4) If one item of items 73901 to 73917 (inclusive) applies
to a patient episode, none of the remainder of those items apply
to that patient episode.

(5) Item 73921:
(a) applies only to the approved pathology practitioner or
approved pathology authority to whom the specimen
mentioned in the item was referred; and
(b) applies to a service even if any item in items 73901 to
73917 (inclusive) also applies to the service.

12. The abbreviations at the end of the table may be used to
identify particular pathology services or groups of pathology
services.
Item Pathology service Fee
GROUP P1 - HAEMATOLOGY
65001 Blood count consisting of erythrocyte count,
C-reactive protein, erythrocyte sedimentation rate,
blood viscosity, haematocrit, haemoglobin, platelet
count, leucocyte count, reticulocyte count - one or
two procedures
$5.40
65003 Three or more procedures to which item 65001 applies,
including any calculation or measurement of
erythrocyte or other indices
$7.40
65005 Examination of blood film, with or without five part
differential cell count, or five part differential
cell count with or without examination of blood film,
and if performed, any of these additional services -
Direct Coombs test, tests for heterophile antibodies,
cold agglutinins, examination of blood film by
special stains to demonstrate Heinz bodies, parasites
or iron, or examination of a blood film with
alpha-naphthyl acetate esterase, choloroacetate
esterase, neutrophil alkaline phosphotase, nitro blue
tetrazolium, periodic acid Schiff, Sudan Black
stains, or Kleihauer test for HbF on blood film,
including any services specified in item 65027
$9.70
65007 Full blood examination consisting of items 65003 and
65005
$16.40
65009 Erythrocytes, qualitative or quantitative assessment
of haemolysis or metabolic enzymes by - erythrocyte
autohaemolysis test, erythrocyte fragility test,
sugar water test, erythrocyte metabolic enzyme test,
heat denaturation test, isopropanol precipitation
test, acid haemolysis test, and quantitation of
muramidase in serum or urine - one or more procedures
$22.50
65011 Tests for the diagnosis of haemoglobinopathy
consisting of haemoglobin electrophoresis and two of
the following - examination for HbH, quantitation of
HbA2 or HbF, including any services specified in
items 65001, 65003, 65005 and 65007
$35.00
65013 Histopathological examination of sections of bone
marrow trephine biopsy including where indicated,
examination of marrow smears and any special stains
and immuno-chemical techniques, including any
services specified in items 65001, 65003, 65005,
65007 and 65015
$108.00
65015 Bone marrow examination of aspirated material
including any special stains, immuno-chemical
techniques and clot sections where necessary,
including any services specified in items 65001,
65003, 65005 and 65007
$78.00
65017 Blood grouping, including back-grouping when
performed - ABO and Rh (D antigen)
$9.50
65019 Blood grouping - Rh phenotypes, Kell system, Duffy
system, M and N factors or any other blood group
system - one or more systems, including any services
specified in item 65017
$18.80
65021 Blood grouping, including back-grouping when
performed, and examination of serum for Rh and other
blood group antibodies, including identification and
quantitative estimation of any antibodies detected,
and including any services specified in items 65001,
65003, 65005 and 65007
$35.00
65023 Compatibility testing, including all necessary
grouping checks of patient and donor, examination for
antibodies, identification and, if necessary,
quantitative estimation of any antibodies detected
and any services specified in items 65001, 65003,
65005, 65007, 65017 and 65021 including all testing
performed on any one day
$86.00
65025 Examination of serum for blood group antibodies
including identification and, if necessary,
quantitative estimation of any antibodies detected
$15.60
65027 Direct Coombs test, qualitative or quantitative test
for cold agglutinins, or heterophile antibodies,
qualitative spectroscopic examination of blood for
abnormal haemoglobins, qualitative test for red cell
porphyrins and detection of metalbumin (Schumm's
test) including those services specified in items
65005 and 65007 - one or more tests
$8.60
65029 Skin bleeding time, coagulation time, prothrombin
time, activated partial thromboplastin time, thrombin
time (including test for presence of an inhibitor and
serial tests for fibrinolysis), test for factor XIII
deficiency, fibrinogen, or one of - fibrinogen
degradation products, fibrin monomer or D-dimer - one
estimation
$11.80
65031 Two estimations specified in item 65029
$15.70
65033 Three estimations specified in item 65029
$19.60
65035 Four or more estimations specified in item 65029
$23.50
65037 Quantitative assay, by one or more techniques, of
plasminogen, antithrombin III, Protein C, Protein S,
heparin co-factor II, Euglobulin clot lysis time and
test for lupus anticoagulant - one estimation
$23.50
65039 Four or more estimations specified in item 65037
$74.00
65041 Platelet aggregation in response to ADP, collagen,
5HT, ristocetin or similar substance - one or more
estimations
$46.50
65043 Heparin assay, only when monitoring a patient on
subcutaneous heparin or low molecular weight heparin
- one or more estimations
$31.00
65045 Quantitative assay of Von Willebrand's factor antigen
(factor VIII related antigen), Von Willebrand's
factor (ristocetin cofactor), factor II, factor V,
factor VII, factor VIII, factor IX, factor X, factor
XI, factor XII, factor XIII, Fletcher factor,
Fitzgerald factor, Passovy factor - one estimation
$31.00
65047 Two estimations as specified in item 65045
$44.50
65049 Three or more estimations as specified in item 65045
$58.00
GROUP P2 - CHEMICAL
66201 Quantitative estimation in serum, plasma, urine or
any other body fluid, by any method except by reagent
strip with or without reflectance meter or
electrophoresis of - alanine amino-transferase,
albumin, alkaline phosphatase, amylase, aspartate
aminotransferase, bicarbonate, bilirubin (total and
any fractions), calcium (total, dialysed or ionized),
chloride, cholesterol, creatine kinase, creatine
kinase isoenzymes (when not performed as specified in
item 66245), creatinine, fructosamine, gamma glutamyl
transpeptidase, globulin, glucose, lactate
dehydrogenase, lipase, lithium, magnesium, phosphate,
potassium, total protein, sodium, triglycerides,
urate, urea - one estimation
$9.60
66203 Two estimations specified in item 66201
$11.60
66205 Three estimations specified in item 66201
$13.60
66207 Four estimations specified in item 66201
$15.60
66209 Five estimations specified in item 66201
$17.60
66211 Six or more estimations specified in item 66201
$19.10
66213 Qualitative estimation by any method, except by
reagent strip or dip-stick of the followingurine
constituents - bilirubin, cystine (cysteine),
haemoglobin, melanin (melanogen), myoglobin,
porphobilinogen, porphyrins, urobilinogen or pH
measurement of body fluids other than urine
(excepting urine acidification test), or
cryoglobulins or cryofibrinogen in plasma - one or
more estimations
$9.30
66217 Qualitative estimation by any method except by
reagent strip or dip-stick of the following faecal
constituents - haemoglobin, porphyrins, reducing
substances - each estimation, to a maximum of three
estimations, taken on separate days
$6.20
66219 Immunological detection of human haemoglobin in
faeces, including any additional services specified
in item 66217 - one estimation in any twenty eight
day period
$11.80
66223 Osmolality, estimation by osmometer, in serum or in
urine - one or more estimations
$23.50
66225 Quantitative estimation of blood gases including
tests performed from - pO2, oxygen saturation, pCO2,
bicarbonate, pH, and any other measurement (eg.
haemoglobin, potassium) or calculation performed on
the same specimen _ one or more estimations on one
specimen
$32.00
66227 Estimation of blood gases as specified in item 66225
on each specimen in excess of 1 to a maximum of 6
specimens within any one day
$8.40
66229 Calculus, analysis of one or more
$29.00
66231 Drug or chemical assays - including all qualitative
and quantitative tests on blood, urine or other body
fluid for a drug or drugs of abuse, including illegal
drugs and legally available drugs taken other than in
appropriate dosage, ingested or absorbed toxic
chemicals including any services specified in items
66235, 66237 and 66239, but excluding the
surveillance of sports people and athletes for
performance improving substances - one or more assays
$39.00
66233 Drug assays - including all qualitative and
quantitative estimations on blood, urine or other
body fluid for a drug or drugs of abuse or a
therapeutic drug on a sample collected from a patient
participating in a drug abuse treatment programme, or
being treated for drug effects or under a court order
or parole board supervision, but excluding the
detection of nicotine and metabolites in smoking
withdrawal programmes - each assay to a maximum of
four assays within any twenty eight day period
$19.60
66235 Drug assay - quantitative estimation on blood or
other body fluid by any method or methods of a drug
being used therapeutically for the patient from whom
the specimen was taken and not elsewhere specified in
the Schedule - one estimation
$19.60
66237 Two estimations specified in item 66235
$27.30
66239 Three or more estimations specified in item 66235
$35.00
66243 Amniotic fluid, spectrophotometric examination of,
estimation of lecithin/sphingomyelin ratio, palmitic
acid, phosphatidylglycerol or lamellar body
phospholipid - one or more examinations or
estimations
$31.00
66245 Electrophoresis, quantitative or qualitative of
serum, urine or other body fluid to demonstrate
protein classes or presence and amount of
paraprotein, or the isoenzymes of lactate
dehydrogenase, alkaline phosphatase and creatine
kinase or lipoprotein electrophoresis (only when the
Cholesterol is >6.5mmol/l and Triglyceride >3.0
mmol/l or in the diagnosis of types III and IV
hyperlipidaemia), including the preliminary
quantitation of total protein, albumin and globulin
or of total relevant enzyme activity - one
examination to a maximum of two examinations in any
twelve month period
$29.00
66247 Electrophoresis, quantitative or qualitative of
concurrently collected, or collected within a twenty
eight day period, serum, urine or other body fluid to
demonstrate protein classes or presence and amount of
paraprotein, including the preliminary quantitation
of total protein, albumin and globulin, or of total
relevant enzyme activity - two or more examinations
$43.00
66251 Alpha-feto protein, Alpha-1 antitrypsin, Alpha-2
macroglobulin, beta-2 microglobulin, C-1 esterase
inhibitor, Caeruloplasmin, Ferritin (unless specified
in item 66263), Haptoglobins, Microalbumin (in proven
diabetes mellitus), Prealbumin, Prostate Specific
Antigen, Prostatic Acid Phosphotase,Transferrin
(unless specified in item 66263), and, in the follow
up of proven malignancy, Mucin-like carcinoma
associated antigen, CA-125 antigen, CA-19.9 antigen,
CA-15.3 antigen, Carcinoembryonic antigen, Mammary
serum antigen, Neuron specific enolase, Thyroglobulin
- quantitative estimation in serum, urine or other
body fluid - one estimation
$18.80
66253 Two or more estimations specified in item 66251
$35.00
66263 Iron studies consisting of quantitative analysis of
iron, transferrin or iron binding capacity and
ferritin
$37.00
66265 Serum B12, serum folate - one or more estimations
within any twenty eight day period
$23.50
66267 Red cell folate and serum B12 and, if required, serum
folate, to a maximum of three estimations in any
twelve month period
$42.50
66269 Vitamins, quantitative estimation in blood, urine or
other body fluid, by direct or indirect means, of
Vitamins A, B1, B2, B3, B6, C, and E - one or more
estimations within any six month period
$29.00
66271 Vitamin D or D fractions - one or more estimations
$29.00
66273 Acetoacetate, alcohol, aminoacids, ammonia,
angiotensin converting enzyme, betahydroxybutyrate,
cholinesterase, cystine (cysteine), total free fatty
acids, histamine, hydroxyindoleacetic acid,
hydroxyproline, lactate, neonatal bilirubin (one or
more fractions), oxalate, pyruvate, serotonin,
xylose, zinc - one quantitative estimation
$23.50
66275 Two or more estimations specified in item 66273
$36.50
66277 Aluminium, arsenic, beryllium, cadium, copper,
chromium, gold, manganese, mercury, nickel, selenium,
strontium - in blood, urine or other body fluid or
tissue - one or more estimations within any six month
period
$33.00
66279 Blood lead estimation, other than for occupational
health screening purposes, to a maximum of three
estimations in any six month period - each estimation
$29.00
66281 Porphyrins (one or more fractions), Catecholamines
(one or more fractions), Hydroxy Methoxy Mandelic
Acid (HMMA), Homovanillic Acid (HVA), Metanephrines,
Methoxy Hydroxy Phenylethylene Glycol (MHPG), Phenyl
Acetic Acid (PAA) - quantitative including any
qualitative estimations - one or more estimations
$37.50
66283 Faecal fat, Breath Hydrogen measurements in response
to loading with disaccharides - one or more
quantitative estimations within any twenty eight day
period
$37.50
66285 Solid tissue or tissues excluding blood elements -
assay of one or two enzymes
$37.50
66287 Assay of three to five enzymes as specified in item
66285
$70.00
66289 Assay of six or more enzymes as specified in item
66285
$93.00
66291 Thyroid function tests, including thyrotrophin (TSH)
and at least one or more of the following tests -
free thyroxine index, free thyroxine, free T3, total
T3, thyroxine binding globulin
$39.00
66293 Thyrotrophin releasing hormone (TRH) test, including
provision and administration of TRH and all necessary
estimations of hormones
$46.50
66295 Growth hormone suppression by glucose loading, Growth
hormone stimulation by exercise, Dexamethasone
suppression test, L-Dopa stimulation of growth
hormone, where physically performed by a recognised
pathologist - one or more procedures
$11.00
66297 Gonadotrophin releasing hormone stimulation test,
Synacthen stimulation test, Glucagon stimulation test
with C-peptide measurement, Pentagastrin stimulation
of thyrocalcitonin release, Secretin stimulation of
gastrin release, Insulin hypoglycaemia, Arginine
infusion, where physically performed by a recognised
pathologist - one procedure
$37.00
66299 Two or more tests specified in item 66297
$59.00
66301 Hormones and hormone binding proteins, quantitative
estimation by any method of - ACTH, Aldosterone,
Androstenedione, C-peptide, Calcitonin, Cortisol,
Cyclic AMP, DHEAS, 11-Deoxycortisol,
Dihydrotestosterone, FSH, Gastrin, Glucagon, Growth
hormone, Human Placental Lactogen,
Hydroxyprogesterone, Insulin, LH, Oestradiol,
Oestriol, Oestrone, Progesterone, Prolactin, PTH,
Renin, Sex hormone binding globulin, Somatomedin
C(IgF1), free or total Testosterone, TSH (where not
requested as part of a thyroid function test), Urine
steroid fraction or fractions, Vasoactive intestinal
peptide, Vasopressin (anti diuretic hormone) - one
estimation
$30.00
66303 Two estimations specified in item 66301
$40.60
66305 Three estimations specified in item 66301
$51.20
66307 Four estimations specified in item 66301
$61.80
66309 Five estimations specified in item 66301
$72.40
66311 Six or more estimations specified in item 66301
$83.00
66315 Hormone receptor assay on proven primary breast or
ovarian carcinoma or a metastasis from a breast or
ovarian carcinoma or a subsequent lesion in the
breast - one or more assays
$76.00
66317 HDL cholesterol, or apolipoprotein B/A1 ratio,
estimation of, in patients with serum cholesterol
>5.5mmol/l or those on prescribed lipid lowering
drugs - each estimation to a maximum of four
estimations in any twelve month period
$11.80
66319 Glycosylated haemoglobin only when performed in the
management of established diabetes - each estimation
to a maximum of four estimations in any twelve month
period
$15.80
GROUP P3 - MICROBIOLOGY
69201 Microscopic examination of material other than blood,
from one or more sites, obtained directly from a
patient and excluding material from cultures - wet
film, inlcuding differential cell count if performed,
examination for dermatophytes or dark ground
illumination, or stained preparation or preparations
using any relevant stain or stains - one or more
examinations
$7.00
69203 Microscopic examination of faeces for parasites using
concentration techniques including the use of
appropriate stains, to a maximum of three estimations
taken on separate days including any services
specified in item 69201 - each estimation
$11.80
69205 The cultural examination and microscopical
examination when indicated (including the detection
of antigens not elsewhere specified in the Schedule)
to determine the presence of pathogenic
micro-organisms, including fungi but excluding
viruses, from nasal swabs, throat swabs, eye swabs
and ear swabs, including pathogen identification and
antibiotic sensitivity testing, including any
services specified in items 69201 - one or more sites

$18.40
69207 Microscopical and cultural examination (including the
detection of antigens not elsewhere specified in the
Schedule) to determine the presence of pathogenic
micro-organisms, including fungi but excluding
viruses, from the following sites - skin or other
superficial sites, urethra, vagina, cervix or rectum
(except for faecal pathogens), or specimens of sputum
(except when part of item 69213), including
pathogenic identification and antibiotic sensitivity
testing, including any services specified in items
69201 and 69205 - one or more examinations on one or
more specimens
$27.00
69209 Microscopical and cultural examination (including the
detection of antigens not elsewhere specified in the
Schedule) of post-operative wounds, aspirations of
body cavities, synovial fluid CSF and operative or
biopsy specimens for the presence of pathogenic
micro-organisms, including fungi but excluding
viruses, involving aerobic and anaerobic culture and
the use of different culture media and including
pathogen identification and antibiotic sensitivity
testing, including any services specified in items
69201, 69205 and 69207 - one or more sites
$36.50
69211 Cultural examination (including the detection of
Clostridial toxins or antigens not elsewhere
specified in the Schedule) of faeces to determine the
presence or absence of faecal pathogens, involving
the use of at least two selective or enrichment media
as well as culture in at least two different
atmospheres and includes pathogen identification and
antibiotic sensitivity testing, including any
services specified in item 69201, to a maximum of
three specimens in any seven day period - each examination
$44.50
69213 Microscopy with appropriate stains and cultural
examinations of three specimens of sputum, urine or
other bodily fluids for mycobacteria and any other
bacterial pathogens, including pathogen
identification and antibiotic sensitivity testing and
including any services specified in item 69201
$62.00
69215 Blood culture to determine the presence or absence of
pathogenic micro-organisms excluding viruses,
including serial cultures and sub-cultures, any
relevant cultural methods and any tests necessary to
identify any cultured pathogen and necessary
antibiotic sensitivity testing - each set of cultures
to a maximum of three sets
$16.20
69217 Urine examination including serial examination, with
cell count, relevant stained preparations, cultur,
colony count by any method, identification of any
cultured pathogens, antibiotic sensitivity testing
when necessary, and with any relevant general
examination for pH, specific gravity, blood, albumin,
urobilinogen, sugar, acetone or bile salts (Simple
culture by dip slide is excluded fromthis item)
$19.00
69219 Direct detection of the antigens of Haemophilus
influenzae, Streptococcus pneumoniae, Neisseria
meningitidis, Group B streptococcus (in CSF and urine
specimens only), RSV, cryptococcal antigens and
Varicella zoster or detection of Clostridium
difficile toxin except where item 69211 has been
performed - one or more estimations
$15.60
69221 Direct detection of Chlamydia from clinical material,
not cultures - one or more estimations
$9.30
69223 Direct detection of Herpes simplex from clinical
material, not cultures - one or more estimations
$9.30
69225 Investigation for Herpes simplex virus (one or more
types) or Chlamydia trachomatis, in material obtained
directly from a patient, by one or more cultural
methods, including any services specified in items
69221 and 69223
$27.00
69227 All microbiological serology during pregnancy, which
must include the determination of Rubella immune
status, syphilis serology and Hepatitis B surface
antigen and including all services in Items 69229,
69243 and 69245, except in the investigation of a
clinically apparent intercurrent microbial illness
during that pregnancy
$27.00
69229 Antibodies to microbial or exogenous antigens not
elsewhere specified in the Schedule - estimation of
one antibody
$13.30
69231 Two estimations specified in item 69229
$20.30
69233 Three estimations specified in item 69229
$27.30
69235 Four estimations specified in item 69229
$34.30
69237 Five estimations specified in item 69229
$41.30
69239 Six or more estimations specified in item 69229
$48.30
69243 Hepatitis B surface antigen test
$13.20
69245 Hepatitis B serology to define the immune status of
an individual, including at least Hepatitis B surface
antibody or Hepatitis B core antibody tests,
including services specified in items 69243, 69247
and 69249
$17.80
69247 All serological tests performed for the
identification of the agent causing acute Hepatitis,
which must include Hepatitis B surface antigen,
Hepatitis B core antibody and Hepatitis A IgM
antibody tests and those services specified in items
69243, 69245 and 69249
$35.00
69249 All tests performed in the follow up of a patient
with proven Hepatitis B, including Hepatitis B
surface antigen and either Hepatitis Be antigen or
Hepatitis B surface antibody tests, including
services specified in items 69243 and 69245
$25.50
69251 Antibiotics or anti-microbial chemo-therapeutic
agents, concentration in serum, urine or other body
fluid, by direct quantitative measurement of the
agent - one or more estimations
$23.50
GROUP P4 - IMMUNOLOGY
71001 Examination for, and identification of, a paraprotein
(not previously identified), the presence of which is
suggested by other tests (eg item 66245, 66247 or
71005), on serum, urine or other body fluid, or
examination of CSF for oligoclonal proteins by
immunoelectrophoresis or immunofixation - one or more
procedures
$29.00
71003 Examination for, and identification of, a paraprotein
(not previously identified), the presence of which is
suggested by other tests (eg item 66245, 66247 or
71005) on serum and urine concurrently collected -
two or more procedures
$43.00
71005 Immunoglobulins G, A, M or D, quantitative estimation
in serum, urine or other body fluid, by any
method estimation
of one immunoglobin
$14.00
71007 Two estimations specified in item 71005
$21.70
71009 Three or more estimations specified in item 71005
$29.40
71011 Subclasses of Immunoglobulin G, 1 to 4, estimation
where there is a reduced level of clinical
significance of either total IgG or IgA - one or more
estimations
$43.00
71013 Immunoglobulin E (total), quantitative estimation by
any method or methods, with a maximum of two
estimations in any twelve month period
$24.50
71015 Specific IgG or IgE antibodies to potential allergens
- one or more tests for single or multiple allergens
with a maximum of four estimations in any twelve
month period
$22.50
71017 Antinuclear antibodies, detection in serum or other
body fluids, including quantitation if required
$23.50
71019 Measurment of DNA binding (by Farr or equivalent
assay, but excluding the Crithidia method), performed
only where a positive antinuclear antibody titre of
1:40 or greater has been obtained
$28.50
71021 Antibodies to extractable nuclear antigens, detection
of in serum or other body fluids
$19.60
71023 Characterization of antibodies to extractable nuclear
antigens, performed only where a positive result is
obtained including services specified in item 71021
$31.00
71025 Antibodies to tissue antigens which are not elsewhere
specified in an item in the Schedule - estimation of
one antibody
$23.00
71027 Two estimations specified in item 71025
$27.00
71029 Three estimations specified in item 71025
$31.00
71031 Four or more estimations specified in item 71025
$35.00
71033 Rheumatoid factor, detection of by any technique
$9.30
71035 Quantitation of Rheumatoid factor where detected,
including services specified in item 71033
$18.40
71037 Complement - total and components - one quantitative
estimation
$15.40
71039 Two estimations as specified in item 71037
$23.10
71041 Three or more estimations as specified in item 71037
$30.80
71043 Leucocyte fractionation as a preliminary to leucocyte
marker or leucocyte function tests
$29.00
71045 Functional tests for leucocytes, including use of all
appropriate techniques (except E. rosette technique
or similar) and any test specified in Group P1 -
Haematology in the Schedule
$48.50
71047 Leucocyte surface marker characterization by
immunofluorescence or immunoenzyme techniquesto
assess lymphoid populations using a minimum of three
monoclonal antibodies, including any services in item
71049 - one or more estimations
$62.00
71049 Leucocyte surface marker characterization by
immunofluorescence or immunoenzyme techiques in the
investigation of a probable haematological malignancy
using a minimum of seven monoclonal antibodies,
including any services in item 71047 - one or more
estimations
$148.00
71051 HLA typing comprising A, B, C and DR phenotypes
$66.00
71053 HLA typing, excluding any services specified in item
71051 - one or more antigens
$27.00
71055 Mantoux test
$9.30
GROUP P5 - HISTOPATHOLOGY
72801 Histopathology examination of biopsy material
including all tissue processing, staining and
professional opinion or opinions
$75.00
72803 Immediate frozen section diagnosis of biopsy
material, including any other histopathology
examination
$122.00
72805 Immunohistochemical investigation of biopsy material
by one or more of immunofluorescent, immunoperoxidase
or other labelled antibody techniques including any
other histopathology examination
$93.00
72807 Electron microscopy of biopsy material including any
other histopathology examination
$99.00
GROUP P6 - CYTOPATHOLOGY
73043 Cytological examination including serial examinations
of smears from skin, nipple discharge, lip, mouth,
nose or anus for detection of pre-cancerous or
cancerous changes - one or more examinations
$14.40
73045 Cytological examination including serial examinations
for malignant cells of body fluids, sputum (single
specimen), urine (single specimen), washings or
brushings not specified in item 73043 and any
histopathological service performed on that cytology
specimen - one or more examinations
$28.00
73047 Cytological examination including examination of a
series of three sputum or urine specimens for
malignant cells
$58.00
73049 Cytological examination of material obtained from a
patient by fine needle aspiration of solid tissue or
tissues
$35.00
73051 Cytological examination of material obtained from a
patient by fine needle aspiration of solid tissue or
tissues where the aspiration is performed by a
recognised pathologist; or where a recognised
pathologist attends the aspiration and performs
cytological examination during the attendance
$66.00
73053 Routine cytological examination of smears from cervix
for detection of pre-cancerous or cancerous changes
in women with no symptoms, signs or recent history
suggestive of cervical neoplasia and smears repeated
due to an unsatisfactory routine smear - each
examination
$12.00
73055 Cytological examination of smears from cervix in
association with the management of previously
detected abnormalities including pre-cancerous or
cancerous conditions, or the investigation of women
with symptoms, signs or recent history suggestive of
cervical neoplasia, not associated with Item 73053 -
each examination
$12.00
73057 Cytological examination of smears from vagina, not
associated with Items 73053 or 73055 - each
examination
$12.00
GROUP P7 - CYTOGENETICS
73281 Chromosome studies, including preparation, count and
karyotyping of one or more of amniotic fluid, bone
marrow, skin and any other tissue or fluid excluding
blood - one or more estimations
$128.00
73283 Chromosome studies, including preparation, count and
karyotyping of blood
$116.00
73285 Chromosome identification by banding techniques
(using fluorescein, Giemsa, or centromere staining or
high resolution analysis); or by fragile X-site
determination - one or more identifications
$99.00
GROUP P8 - INFERTILITY AND PREGNANCY TESTS
73521 Semen examination for presence of spermatozoa or
examination of cervical mucus for spermatozoa
(Huhner's test)
$6.50
73523 Semen examination, involving measurement of volume,
sperm count, motility, examination of stained
preparations, morphology, and, if performed,
differential count and one or more chemical tests,
with a maximum of four examinations in any twelve
month period
$27.00
73525 Sperm antibodies, sperm penetrating ability - one or
more tests
$17.40
73527 Chorionic gonadotrophin (beta - HCG), qualitative
estimation in serum or urine by one or more methods,
including serial dilution if performed, for diagnosis
of pregnancy - one or more estimations
$9.50
73529 Chorionic gonadotrophin (beta-HCG), qualitative (if
performed) and quantitative estimation in serum by
one or more methods for diagnosis of hydatidiform
mole, HCG - secreting neoplasm, threatened abortion
or follow-up of abortion
$27.00
GROUP P9 - SIMPLE BASIC PATHOLOGY TESTS
73801 Seminal examination for presence of spermatozoa
$6.20
73802 Blood count consisting of leucocyte count,
erythrocyte sedimentation rate, examination of blood
film (including differential leucocyte count) or any
or all of haemoglobin estimation, haematocrit
estimation or erythrocyte count - one procedure
$4.15
73803 Two procedures specified in item 73802
$6.20
73804 Three or more procedures specified in item 73802
$8.25
73805 Microscopical examination of urine
$4.15
73806 Pregnancy test by one or more immunochemical methods
$10.15
73807 Microscopical examination of wet film other than
urine
$6.20
73808 Microscopical examination of gram stained film
$7.85
73809 Chemical tests for occult blood in faeces by reagent
stick, strip, tablet or similar method
$2.10
73810 Microscopical examination screening for fungi in
skin, hair or nails - one or more sites
$6.20
73811 DESCRIPTION DOES NOT EXIST
$10.15
GROUP P10 - PATIENT EPISODE
INITIATION
73901 Initiation of a patient episode by collection of
specimen for a service specified in item 73053, 73055
or 73057 from a person who is not in a recognised
hospital or a prescribed laboratory
$7.50
73903 Initiation of a patient episode by collection of
specimen for a service specified in item 72801 from a
person who is an in-patient of a hospital other than
a recognised hospital
$13.50
73905 Initiation of a patient episode by collection of
specimen for a service specified in item 72801 from a
person who is not an in-patient of a private hospital
and not a patient of a recognised hospital
$7.50
73907 Patient episode initiated by collection of specimen
for a service other than a service specified in items
73901, 73903, 73905 and 73801 to 73811 (inclusive)
where the specimen is collected in a licensed
collection centre other than a temporary licensed
collection centre
$15.50
73909 Patient episode initiated by collection of specimen
for a service other than a service specified in items
73901, 73903, 73905 and 73801 to 73811 (inclusive)
where the specimen is collected by an approved
pathology practitioner or an employee of an approved
pathology authority from a person who is an in-patient
of a hospital other than a recognised hospital
$15.50
73911 Patient episode initiated by collection of specimen
for a service other than a service specified in items
73901, 73903, 73905 and 73801 to 73811 (inclusive)
where the specimen is collected by an approved
pathology practitioner or an employee of an approved
pathology authority, from a person in the place where
the person was residing or in a nursing home or
institution

$15.50
73913 Patient episode initiated by collection of specimen
for a service other than a service specified in items
73901, 73903, 73905 and 73801 to 73811 (inclusive)
where the specimen is collected from the person by
the person
$9.50
73915 Patient episode initiated by collection of specimen
for a service other than a service specified in items
73901, 73903, 73905 and 73801 to 73811 (inclusive)
where the specimen is collected by or on behalf of
the treating practitioner
$9.50
73917 Patient episode initiated by collection of specimen
for a service other than a service specified in items
73901, 73903, 73905 and 73801 to 73811 (inclusive)
where the specimen is collected in a temporary
licensed collection centre
$9.50
GROUP P11 - SPECIMEN REFERRED
73921 Referral of specimen by an approved pathology
practitioner of an approved pathology authority to
another approved pathology practitioner of another
approved pathology authority or to another approved
pathology authority
$9.50
(ABBREVIATIONS FOR GROUPS OF TESTS OMITTED)