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SLI 2011 No. 188 Regulations as amended, taking into account amendments up to Health Insurance (Pathology Services Table) Amendment Regulation 2012 (No. 1)
These Regulations repeal the Health Insurance (Pathology Services Table) Regulations 2010 and prescribe a new pathology services table for the 12 month period commencing on 1 November 2011.
Administered by: Health
Registered 01 May 2012
Start Date 01 May 2012
End Date 31 Jul 2012
Date of repeal 01 Nov 2012
Repealed by Health Insurance (Pathology Services Table) Regulation 2012
Table of contents.

Commonwealth Coat of Arms

Health Insurance (Pathology Services Table) Regulations 2011

Select Legislative Instrument 2011 No. 188 as amended

made under the

Health Insurance Act 1973

This compilation was prepared on 1 May 2012
taking into account amendments up to SLI 2012 No. 58

Prepared by the Office of Legislative Drafting and Publishing,
Attorney-General’s Department, Canberra


Contents

                        1      Name of Regulations [see Note 1]                                    4

                        2      Commencement                                                              4

                        3      Repeal                                                                            4

                        4      Dictionary                                                                       4

                        5      Pathology services table                                                 4

Schedule 1                  Pathology services table                                                5

Part 1                             Preliminary                                                                      5

Division 1.1                 Interpretation                                                                  

Division 1.2                 General application provisions                                       

Part 2                             Services and fees                                                         13

Division 2.1                 Group P1 — Haematology                                              

Division 2.2                 Group P2 — Chemical                                                    

Division 2.3                 Group P3 — Microbiology                                              

Division 2.4                 Group P4 — Immunology                                               

Division 2.5                 Group P5 — Tissue pathology                                        

Division 2.6                 Group P6 — Cytology                                                     

Division 2.7                 Group P7 — Genetics                                                     

Division 2.8                 Group P8 — Infertility and pregnancy tests                     

Division 2.9                 Group P9 — Simple basic pathology tests                      

Division 2.10              Group P10 — Patient episode initiation                          

Division 2.11              Group P11 — Specimen referred                                    

Division 2.12              Group P12 — Management of bulk‑billed services          

Division 2.13              Group P13 — Bulk billing incentive for episodes consisting of a P10 service       

Part 3                             Abbreviations                                                                83

Part 4                             Complexity levels for histopathology items                   117

Dictionary                                                                                                  

Notes                                                                                                        129

 


  

  

1              Name of Regulations [see Note 1]

                These Regulations are the Health Insurance (Pathology Services Table) Regulations 2011.

2              Commencement

                These Regulations commence on 1 November 2011.

3              Repeal

                The Health Insurance (Pathology Services Table) Regulations 2010 are repealed.

4              Dictionary

                The Dictionary at the end of these Regulations defines certain words and expressions and includes references to certain words and expressions that are defined elsewhere in these Regulations.

5              Pathology services table

                For subsection 4A (1) of the Act, these Regulations prescribe a table of pathology services set out in Schedule 1.


Schedule 1        Pathology services table

(regulation 5)

Part 1          Preliminary

Division 1.1           Interpretation

1.1.1       Abbreviations

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

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

Division 1.2           General application provisions

1.2.1       Precedence of items

     (1)       If a service is described:

                (a)    in an item in general terms; and

               (b)    in another item in specific terms;

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

     (2)       Subject to subclause (3), if:

                (a)    subclause (1) does not apply; and

               (b)    a service is described in 2 or more items;

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

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

1.2.2       Circumstances in which services rendered following 2 requests to be taken to have been rendered following 1 request

     (1)       In subclause (2):

service includes assay, estimation and test.

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

                (a)    the services are listed in the same item; and

               (b)    that item is not item 74990 or 74991; and

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

1.2.3       Services to which clause 1.2.2 does not apply

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

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

               (b)    the tests are performed within 6 months of the request; and

                (c)    the account for the service is endorsed ‘Rule 3 Exemption’.

Note   Rule 3 in the Health Insurance (Pathology Services Table) Regulations 2009 has been replaced by clause 1.2.2.

     (2)       For subclause (1), the pathology services are:

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

               (b)    quantitative estimation of lithium for a patient undergoing lithium therapy; and

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

               (d)    a service described in item 65070 in relation to clozaril, ticlopidine hydrochloride, methotrexate, gold, sulphasalazine or penicillamine therapy of a patient; and

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

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

                          (i)    cis‑platinum or cyclosporin therapy of a patient; or

                         (ii)    chronic renal failure of a patient being treated in a dialysis program conducted by a recognised hospital; and

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

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

1.2.4       Referral of designated tests by 1 pathology practitioner to another

     (1)       In this clause:

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

     (2)       This clause applies if 1 or more designated tests are referred by a referring APP to a receiving APP in another approved pathology authority.

     (3)       If a referring APP has rendered 1 or more designated tests:

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

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

     (4)       If a referring APP has not rendered a designated test:

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

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

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

                (a)    for item 66652, 66715, 66790, 66817, 66821 or 66827:

               (b)    for item 65158, 66805, 69498 or 71092:

                (c)    for item 71156 or 71170:

               (d)    for item 65181 or 66724:

where:

X is the number of designated tests rendered by a referring APP.

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

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

               (b)    for item 65158, 66805, 69498 or 71092 — 2;

                (c)    for item 71156 or 71170 — 3;

               (d)    for item 65181 or 66724 — 4.

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

1.2.5       Items not to be split

                Except as stated in clause 1.2.4 the amount mentioned in an item is payable only to 1 approved pathology practitioner for a single patient episode.

1.2.6       Certain pathology services to be treated as 1 service

     (1)       In this clause:

general practitioner has the meaning given by subclause 1.2.7 (1).

set of pathology services has the meaning given by subclause 1.2.7 (2).

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

     (3)       If the fee mentioned in 1 item that describes any of the services in the set of pathology services is higher than the fees mentioned in the other items that describe the services in the set:

                (a)    the pathology service described in the first‑mentioned item is to be treated as 1 pathology service; and

               (b)    either:

                          (i)    the pathology service in the set that is described in the item that mentions the second‑highest fee is to be treated as 1 pathology service; or

                         (ii)    if 2 or more items that describe any of those services mentions the second‑highest fee — the pathology service described in the item that mentions the second‑highest fee, and has the lowest item number, is to be treated as 1 pathology service; and

                (c)    the pathology services in the set, other than the services that are to be treated as 1 pathology service under paragraphs (a) and (b), are to be treated as 1 pathology service.

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

                (a)    the pathology service in the set that is described in the item that mentions the highest fee, and has the lowest item number, is to be treated as 1 pathology service; and

               (b)    the pathology service in the set that is described in the item that mentions the highest fee, and has the second‑lowest item number, is to be treated as 1 pathology service; and

                (c)    the pathology services in the set, other than the services that are to be treated as 1 pathology service under paragraphs (a) and (b), are to be treated as 1 pathology service.

     (5)       If pathology services are to be treated as 1 pathology service under paragraph (3) (c) or (4) (c), the fee for the 1 pathology service is the highest fee mentioned in any of the items that describe the pathology services that are to be treated as the 1 pathology service.

1.2.7       Meaning of general practitioner and set of pathology services

     (1)       In clause 1.2.6:

general practitioner means a medical practitioner who:

                (a)    is not a consultant physician in any specialty; and

               (b)    is not a specialist in any specialty.

     (2)       In clause 1.2.6 and subject to subclause (3):

set of pathology services means a group of pathology services:

                (a)    that consists of services that are described in at least 4 different items; and

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

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

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

     (3)       In clause 1.2.6, an item mentioned in this subclause is to be excluded from a set of pathology services:

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

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

     (4)       An approved pathology authority is related to another approved pathology authority for paragraph (3) (a) if:

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

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

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

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

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

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

1.2.8       Satisfying requirements described in pathology service

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

                (a)    for a requirement for information — the information:

                          (i)    is included in the request for the service; or

                         (ii)    was supplied in writing on an earlier occasion to the approved pathology authority that rendered the service, and has been kept by the approved pathology authority; or

               (b)    for a requirement for laboratory test results — the results are:

                          (i)    included in the request for the service; or

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

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

Part 2          Services and fees

Division 2.1           Group P1 — Haematology

2.1.1       Services to which clause 1.2.2 does not apply

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

                (a)    the service is rendered in relation to 1 or more specimens taken on any of not more than 6 occasions in a period of 24 hours; and

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

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

               (d)    the account for the service is endorsed ‘Rule 3 Exemption’.

Note   Rule 3 in the Health Insurance (Pathology Services Table) Regulations 2009 has been replaced by clause 1.2.2.

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

                (a)    the service is rendered:

                          (i)    for a service described in item 65109 — on 1 of not more than 5 occasions in a period of 24 hours; and

                         (ii)    for a service described in item 65110 — on 1 of not more than 2 occasions in a period of 24 hours; and

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

                (c)    the account for the service is endorsed ‘Rule 3 Exemption’.

Note   Rule 3 in the Health Insurance (Pathology Services Table) Regulations 2009 has been replaced by clause 1.2.2.

2.1.2       Item taken to refer only to the first service of a particular kind

     (1)       For an item in Group P1 (Haematology):

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

               (b)    if:

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

                         (ii)    specimen material from the patient episode is stored; and

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

                        the later tests and the earlier tests are taken to be part of 1 patient episode.

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

     (3)       For items 65099 and 65102:

compatibility tests by crossmatch means that, in addition to all the tests mentioned in paragraphs (a) and (b) of the item, donor red cells from each unit must have been tested directly against the serum of the patient by 1 or more accepted crossmatching techniques.

Group P1 — Haematology

Item

Pathology service

Fee ($)

65060

Haemoglobin, erythrocyte sedimentation rate, blood viscosity — 1 or more tests

7.90

65066

Examination of:

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

10.45

 

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

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

  (d)  a urinary sediment for haemosiderin;

including a service described in item 65072

 

65070

Erythrocyte count, haematocrit, haemoglobin, calculation or measurement of red cell index or indices, platelet count, leucocyte count and manual or instrument generated differential count (not being a service where haemoglobin only is requested) — 1 or more instrument‑generated set of results from a single sample and (if performed):

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

  (b)  any service in item 65060 or 65072

17.05

65072

Examination for reticulocytes including a reticulocyte count by any method — 1 or more tests

10.25

65075

Haemolysis or metabolic enzymes — assessment by 1 or more of the following tests:

   (a)  erythrocyte autohaemolysis test;

  (b)  erythrocyte osmotic fragility test;

   (c)  sugar water test;

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

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

   (f)  acid haemolysis test;

52.30

 

   (g)  quantitation of muramidase in serum or urine;

  (h)  Donath Landsteiner antibody test;

   (i)  other erythrocyte metabolic enzyme tests

90.80

65078

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

   (a)  examination for HbH; or

  (b)  quantitation of HbA2; or

90.80

 

   (c)  quantitation of HbF;

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

 

65079

A test described in item 65078 if rendered by a receiving APP — 1 or more tests

90.80

65081

Tests for the investigation of haemoglobinopathy consisting of haemoglobin electrophoresis or chromatography and at least 1 of:

   (a)  heat denaturation test; or

97.25

 

  (b)  isopropanol precipitation test; or

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

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

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

 

65082

A test described in item 65081 if rendered by a receiving APP — 1 or more tests

97.25

65084

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

166.95

65087

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

83.65

65090

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

11.20

65093

Blood grouping — Rh phenotypes, Kell system, Duffy system, M and N factors or any other blood group system — 1 or more systems, including item 65090 (if performed)

22.15

65096

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

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

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

41.30

65099

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

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

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

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

109.65

65102

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

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

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

165.70

 

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

 

65105

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

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

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

109.65

 

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

 

65108

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

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

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

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

165.70

65109

Release of fresh frozen plasma or cryoprecipitate for the use in a patient for the correction of a coagulopathy — 1 release

13.00

65110

Release of compatible fresh platelets for the use in a patient for platelet support as prophylaxis to minimize bleeding or during active bleeding — 1 release

13.00

65111

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

23.35

65114

1 or more of the following tests:

   (a)  direct Coombs (antiglobulin) test;

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

9.15

65117

1 or more of the following tests:

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

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

20.40

65120

Prothrombin time (including INR where appropriate), activated partial thromboplastin time, thrombin time (including test for the presence of heparin), test for factor XIII deficiency (qualitative), Echis test, Stypven test, reptilase time, fibrinogen, or 1 of fibrinogen degradation products, fibrin monomer or D‑dimer — 1 test

13.80

65123

2 tests described in item 65120

20.50

65126

3 tests described in item 65120

28.05

65129

4 or more tests described in item 65120

35.75

65137

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

25.50

65142

Confirmation or clarification of an abnormal or indeterminate result of a test mentioned in item 65175, by testing a specimen collected on a different day — 1 or more tests

25.50

65144

Platelet aggregation in response to ADP, collagen, 5HT, ristocetin or other substances; or heparin, low molecular weight heparins, heparinoid or other drugs — 1 or more tests

56.95

65147

Quantitation of anti‑Xa activity when monitoring is required for a patient receiving a low molecular weight heparin or heparinoid — 1 test

38.15

65150

Quantitation of von Willebrand factor antigen, von Willebrand factor activity (ristocetin cofactor assay), von Willebrand factor collagen binding activity, factor II, factor V, factor VII, factor VIII, factor IX, factor X, factor XI, factor XII, factor XIII, Fletcher factor, Fitzgerald factor, circulating coagulation factor inhibitors other than by Bethesda assay — 1 test

71.40

65153

2 tests described in item 65150

142.80

65156

3 or more tests described in item 65150

214.20

65157

A test described in item 65150, if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP — 1 test

71.40

65158

A test described in item 65150, if rendered by a receiving APP, where 1 or more tests in the item have been rendered by the referring APP — 1 test

71.40

65159

Quantitation of circulating coagulation factor inhibitors by Bethesda assay — 1 test

71.40

65162

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

10.50

65165

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

34.70

65166

A test described in item 65165 if rendered by a receiving APP — 1 or more tests

34.70

65171

A test for the presence of antithrombin III deficiency, protein C deficiency, protein S deficiency or activated protein C resistance in a first degree relative of a person who has a proven deficiency mentioned in this item — 1 or more tests

25.50

65175

A test for the presence of antithrombin III deficiency, protein C deficiency, protein S deficiency, lupus anticoagulant, activated protein C resistance, if the request for the test specifically identifies that the patient has a history of venous thromboembolism — quantitation by 1 or more techniques — 1 test

25.50

65176

2 tests described in item 65175

49.00

65177

3 tests described in item 65175

72.45

65178

4 tests described in item 65175

95.85

65179

5 tests described in item 65175

119.30

65180

A test described in item 65175, if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP — 1 test

25.50

65181

A test described in item 65175, if rendered by a receiving APP, where 1 or more tests in the item have been rendered by the referring APP — 1 test

23.45

Division 2.2           Group P2 — Chemical

2.2.1       Creatinine ratios

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

                (a)    involves the measurement of a substance in urine; and

               (b)    requires calculation of a substance/creatinine ratio;

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

2.2.2       Services to which clause 1.2.2 does not apply

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

                (a)    the service is rendered in relation to 1 or more specimens taken on any of not more than 6 occasions in a period of 24 hours; and

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

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

               (d)    the account for the service is endorsed ‘Rule 3 Exemption’.

Note   Rule 3 in the Health Insurance (Pathology Services Table) Regulations 2009 has been replaced by clause 1.2.2.

2.2.3       Limitation on certain items

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

                (a)    items 66539 and 66607;

               (b)    item 66605, 66606 or 66610.

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

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

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

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

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

2.2.4       Serum B12 and red cell folate testing

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

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

2.2.5       Thyroid function testing

     (1)       For item 66719:

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

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

     (3)       The written statement from the medical practitioner must indicate:

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

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

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

2.2.6       Limitation on certain items

     (1)       For any particular patient, each of items 66655, 66659 and 69482 is applicable not more than once in a 12 month period.

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

2.2.7       Nutritional and toxicity metals testing

     (1)       For this clause:

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

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

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

                (a)    that item; or

               (b)    the other item in the same group; or

                (c)    an item in the other group.

Group P2 — Chemical

Item

Pathology service

Fee ($)

66500

Quantitation in serum, plasma, urine or other body fluid (except amniotic fluid), by any method, except reagent tablet or reagent strip, (with or without reflectance meter) of acid phosphatase, alanine aminotransferase, albumin, alkaline phosphatase, ammonia, amylase, aspartate aminotransferase, bicarbonate, bilirubin (total), bilirubin (any fractions), C‑reactive protein, calcium (total or corrected for albumin), chloride, creatine kinase, creatinine, gamma glutamyl transferase, globulin, glucose, lactate dehydrogenase, lipase, magnesium, phosphate, potassium, sodium, total cholesterol, total protein, triglycerides, urate or urea — 1 test

9.75

66503

2 tests described in item 66500

11.75

66506

3 tests described in item 66500

13.75

66509

4 tests described in item 66500

15.75

66512

5 or more tests described in item 66500

17.80

66517

Quantitation of bile acids in blood in pregnancy

19.80

66518

Investigation of cardiac or skeletal muscle damage by quantitative measurement of creatine kinase isoenzymes, troponin or myoglobin in blood — tests performed on only 1 specimen in a 24 hour period

20.20

66519

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

40.40

66536

Quantitation of HDL cholesterol

11.10

66539

Electrophoresis of serum for demonstration of lipoprotein subclasses:

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

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

30.80

66542

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

   (a)  administration of glucose; and

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

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

19.10

66545

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

   (a)  administration of glucose; and

  (b)  1 or 2 measurements of blood glucose; and

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

15.90

66548

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

   (a)  administration of glucose; and

20.05

 

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

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

 

66551

Quantitation of glycosylated haemoglobin performed in the management of established diabetes

16.90

66554

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

16.90

66557

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

9.75

66560

Microalbumin — quantitation in urine 

20.25

66563

Osmolality, estimation by osmometer, in serum or in urine — 1 or more tests

24.85

66566

Quantitation of:

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

33.95

 

  (b)  bicarbonate and pH;

including any other measurement (eg haemoglobin, lactate, potassium or ionised calcium) or calculation performed on the same specimen — 1 or more tests on 1 specimen

 

66569

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

42.90

66572

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

51.90

66575

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

60.85

66578

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

69.80

66581

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

78.80

66584

Quantitation of ionised calcium (except if performed as part of item 66566) — 1 test

9.75

66587

Urine acidification test for the diagnosis of renal tubular acidosis including the administration of an acid load, and pH measurements on 4 or more urine specimens and at least 1 blood specimen

47.85

66590

Calculus, analysis of 1 or more

30.80

66593

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

18.10

66596

Iron studies, consisting of quantitation of:

   (a)  serum iron; and

  (b)  transferrin or iron binding capacity; and

   (c)  ferritin

32.75

66599

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

23.75

66602

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

43.25

66605

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

30.80

66606

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

30.80

66607

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

76.25

66608

Vitamin D or D fractions — one or more tests

42.55

66609

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

42.55

66610

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

76.25

66623

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

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

  (b)  ingested or absorbed toxic chemicals;

41.80

 

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

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

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

 

66626

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

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

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

24.25

66629

Beta‑2‑microglobulin — quantitation in serum, urine or other body fluids — 1 or more tests

20.25

66632

Caeruloplasmin, haptoglobins, or prealbumin — quantitation in serum, urine or other body fluids — 1 or more tests

20.25

66635

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

20.25

66638

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

49.40

66639

A test described in item 66638 if rendered by a receiving APP — 1 or more tests

29.40

66641

Electrophoresis of serum or other body fluid to demonstrate:

   (a)  the isoenzymes of lactate dehydrogenase; or

  (b)  the isoenzymes of alkaline phosphatase;

including the preliminary quantitation of total relevant enzyme activity — 1 or more tests

29.40

66642

A test described in item 66641 if rendered by a receiving APP — 1 or more tests

29.40

66644

C‑1 esterase inhibitor — quantitation

20.30

66647

C‑1 esterase inhibitor — functional assay

45.40

66650

Alpha‑fetoprotein, CA‑15.3 antigen (CA15.3), CA‑19.9 antigen (CA19.9), CA‑125 antigen (C125), cancer associated serum antigen (CASA), carcinoembryonic antigen (CEA), human chorionic gonadotrophin (HCG), neuron specific enolase (NSE) thyroglobulin in serum or other body fluid, in the monitoring of malignancy or in the detection or monitoring of gestational trophoblastic disease or a hepatic or germ cell tumour — quantitation — 1 test

24.50

66651

A test described in item 66650, if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP — 1 test

24.50

66652

A test described in item 66650, if rendered by a receiving APP, where 1 or more tests in the item have been rendered by the referring APP — 1 test

20.45

66653

2 or more tests described in item 66650

44.90

66655

Prostate specific antigen — quantitation

20.30

66656

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

20.30

66659

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

37.55

66660

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

37.55

66662

Quantitation of hormone receptors on proven primary breast or ovarian carcinoma or a metastasis from a breast or ovarian carcinoma or a subsequent lesion in the breast — 1 or more tests

80.50

66663

A test described in item 66662 if rendered by a receiving APP — 1 or more tests

80.50

66665

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

30.80

66666

A test described in item 66665 if rendered by a receiving APP — 1 or more tests

30.80

66667

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

30.80

66671

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

37.15

66674

Quantitation of:

   (a)  faecal fat; or

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

1 or more tests within a 28 day period

40.20

66677

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

11.25

66680

Quantitation of disaccharidases and other enzymes in intestinal tissue — 1 or more tests

74.95

66683

Enzymes — quantitation in solid tissue or tissues other than blood elements or intestinal tissue — 1 or more tests

74.95

66686

Performance of 1 or more of the following procedures:

   (a)  growth hormone suppression by glucose loading;

  (b)  growth hormone stimulation by exercise;

   (c)  dexamethasone suppression test;

  (d)  sweat collection by iontophoresis for chloride analysis;

   (e)  pharmacological stimulation of growth hormone

51.00

66695

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

30.70

66696

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

30.70

66697

A test described in item 66695, if rendered by a receiving APP, where 1 or more tests in the item have been rendered by the referring APP — each test to a maximum of 4 tests

13.30

66698

2 tests described in item 66695

44.00

66701

3 tests described in item 66695

57.30

66704

4 tests described in item 66695

70.60

66707

5 or more tests described in item 66695

83.90

66711

Quantitation in saliva of cortisol in:

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

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

1 test

30.35

66712

2 tests described in item 66711

43.35

66714

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

30.35

66715

A test described in item 66711, if rendered by a receiving APP, where 1 test in the item has been rendered by the referring APP — 1 test

12.95

66716

TSH quantitation

25.20

66719

Thyroid function tests (comprising the service described in item 66716 and 1 or more of the following tests — free thyroxine, free T3, for a patient, if at least 1 of the following conditions is satisfied:

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

35.05

 

  (b)  the tests are performed:

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

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

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

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

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

 

 

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

 

66722

TSH quantitation described in item 66716 and 1 test described in item 66695

38.15

66723

A test described in item 66722, if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP — 1 test

38.15

66724

A test described in item 66722, if rendered by a receiving APP, where 1 or more tests in the item have been rendered by the referring APP — 1 test

13.25

66725

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

51.40

66728

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

64.65

66731

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

77.90

66734

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

91.15

66743

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

20.25

66749

Amniotic fluid, spectrophotometric examination of, and quantitation of:

   (a)  lecithin/sphingomyelin ratio; or

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

33.15

 

   (c)  bilirubin, including correction for haemoglobin;

1 or more tests

 

66750

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

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

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

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

40.00

 

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

 

 

   (e)  unconjugated oestriol (uE3);

   (f)  alpha‑fetoprotein (AFP);

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

 

66751

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

55.60

66752

Quantitation of acetoacetate, beta‑hydroxybutyrate, citrate, oxalate, total free fatty acids, cysteine, homocysteine, cystine, lactate, pyruvate or other amino acids and hydroxyproline (except if performed as part of item 66773 or 66776) — 1 test

24.85

66755

2 or more tests described in item 66752

39.10

66756

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

98.95

66757

Quantitation of 10 or more amino acids for monitoring of previously diagnosed inborn errors of metabolism in 1 tissue type

98.95

66758

Quantitation of angiotensin converting enzyme, or cholinesterase — 1 or more tests

24.85

66761

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

13.25

66764

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

8.95

66767

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

17.95

66770

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

26.90

66773

Quantitation of products of collagen breakdown or formation for the monitoring of patients with proven low bone mineral density and, if performed, a service described in item 66752 — 1 or more tests

24.80

66776

Quantitation of products of collagen breakdown or formation for the monitoring of patients with metabolic bone disease or Paget’s disease of bone and, if performed, a service described in item 66752 — 1 or more tests

24.80

66779

Adrenaline, noradrenaline, dopamine, histamine, hydroxyindoleacetic acid (5HIAA), hydroxymethoxymandelic acid (HMMA), homovanillic acid (HVA), metanephrines, methoxyhydroxyphenylethylene glycol (MHPG), phenylacetic acid (PAA) or serotonin — quantitation — 1 or more tests

40.20

66780

A test described in item 66779 if rendered by a receiving APP — 1 or more tests

40.20

66782

Porphyrins or porphyrins precursors — detection in plasma, red cells, urine or faeces — 1 or more tests

13.25

66783

A test described in item 66782 if rendered by a receiving APP — 1 or more tests

13.25

66785

Porphyrins or porphyrins precursors — quantitation in plasma, red cells, urine or faeces — 1 test

40.20

66788

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

66.30

66789

A test described in item 66785 if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP — 1 test

40.20

66790

A test described in item 66785, if rendered by a receiving APP, where 1 or more tests in the item have been rendered by the referring APP — 1 test

26.05

66791

Porphyrin biosynthetic enzymes — measurement of activity in blood cells or other tissues — 1 or more tests

74.95

66792

A test described in item 66791 if rendered by a receiving APP — 1 or more tests

74.95

66800

Quantitation in blood, urine or other body fluid by any method (except reagent tablet or reagent strip) of any of the following used therapeutically by the patient from whom the specimen was taken: amikacin, carbamazepine, digoxin, disopyramide, ethanol, ethosuximide, gentamicin, lignocaine, lithium, netilmicin, paracetamol, phenobarbitone, phenytoin, primidone, procainamide, quinidine, salicylate, theophylline, tobramycin, valproate or vancomycin — 1 test

18.25

66803

2 tests described in item 66800

30.70

66804

A test described in item 66800 if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP — 1 test

18.25

66805

A test described in item 66800, if rendered by a receiving APP, where 1 or more tests in the item have been rendered by the referring APP — 1 test

12.45

66806

3 tests described in item 66800

42.15

66812

Quantitation, not elsewhere described in this table by any method or methods, in blood, urine or other body fluid, of a drug being used therapeutically by the patient from whom the specimen was taken — 1 test

35.05

66815

2 tests described in item 66812

59.95

66816

A test described in item 66812 if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP — 1 test

35.05

66817

A test described in item 66812, if rendered by a receiving APP, where 1 or more tests in the item have been rendered by the referring APP — 1 test

24.90

66819

Quantitation of copper, manganese, selenium or zinc (except if item 66667 applies), in blood, urine or other body fluid — 1 test

30.80

66820

A test described in item 66819 if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP — 1 test

30.80

66821

A test described in item 66819, if rendered by a receiving APP, where 1 or more tests in the item have been rendered by the referring APP — 1 test

21.95

66822

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

52.80

66825

Quantitation of aluminium (except if item 66671 applies), arsenic, beryllium, cadmium, chromium, gold, mercury, nickel or strontium, in blood, urine or other body fluid or tissue — 1 test

30.80

66826

A test described in item 66825 if rendered by a receiving APP where no tests have been rendered by the referring APP — 1 test

30.80

66827

A test described in item 66825, if rendered by a receiving APP, where 1 or more tests in the item have been rendered by the referring APP — 1 test

21.95

66828

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

52.80

66830

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

58.90

66831

Quantitation of copper or iron in liver tissue biopsy

31.15

66832

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

31.15

66900

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

   (a)  the confirmation of Helicobactor pylori colonisation; or

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

78.15

Division 2.3           Group P3 — Microbiology

2.3.1       Meaning of serial examinations or cultures

                For an item in Group P3 (Microbiology):

                (a)    serial examinations or cultures means a series of 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)    if:

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

                         (ii)    specimen material from the patient episode is stored; and

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

                        the later tests and the earlier tests are taken to be part of 1 patient episode.

2.3.2       Antigen detection

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

2.3.3       Investigation for hepatitis serology

                The fee applying in a single patient episode that includes any of items 69475, 69478 and 69481 is the fee specified for only 1 of those items.

2.3.4       Limitation on certain items

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

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

                (a)    item 69482;

               (b)    item 69491 or 69492;

               (b)    item 69499 or 69500.

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

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

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

2.3.5       Hepatitis C viral RNA testing

                For items 69499 and 69500:

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

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

Group P3 — Microbiology

Item

Pathology service

Fee ($)

69300

Microscopy of wet film material other than blood, from 1 or more sites, obtained directly from a patient (not cultures) including (if performed):

   (a)  differential cell count; or

  (b)  examination for dermatophytes; or

   (c)  dark ground illumination; or

12.60

 

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

1 or more tests

 

69303

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

   (a)  pathogen identification and antibiotic susceptibility testing; or

22.15

 

  (b)  a service described in item 69300;

specimens from 1 or more sites

 

69306

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

   (a)  pathogen identification and antibiotic susceptibility testing; or

34.00

 

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

1 or more tests on 1 or more specimens

 

69309

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

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

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

1 or more tests on 1 or more specimens

48.45

69312

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

   (a)  pathogen identification and antibiotic susceptibility testing; or

34.00

 

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

1 or more tests on 1 or more specimens

 

69316

Detection of Chlamydia trachomatis by any method — 1 test

28.85

69317

This item applies if:

   (a)  1 test described in item 69316 is performed; and

  (b)  1 test described in item 69494 is performed

36.10

69318

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

   (a)  pathogen identification and antibiotic susceptibility testing; or

34.00

 

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

1 or more tests on 1 or more specimens

 

69319

This item applies if:

   (a)  1 test described in item 69316 is performed; and

  (b)  2 tests described in item 69494 are performed

43.25

69321

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

   (a)  pathogen identification and antibiotic susceptibility testing; or

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

specimens from 1 or more sites

48.45

69324

Microscopy (with appropriate stains) and culture for mycobacteria — 1 specimen of sputum, urine or other body fluid or 1 operative or biopsy specimen, including (if performed):

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

  (b)  pathogen identification and antibiotic susceptibility testing;

including a service mentioned in item 69300

43.30

69325

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

43.30

69327

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

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

  (b)  pathogen identification and antibiotic susceptibility testing;

including a service described in item 69300

85.55

69328

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

85.55

69330

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

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

  (b)  pathogen identification and antibiotic susceptibility testing;

including a service described in item 69300

128.85

69331

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

128.85

69333

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

   (a)  cell count; and

  (b)  culture; and

   (c)  colony count; and

  (d)  (if performed) stained preparations; and

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

20.70

 

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

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

 

69336

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

   (a)  a concentration technique; and

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

33.65

 

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

 

69339

Microscopy of faeces for ova, cysts and parasites using concentration techniques examined after examination described in item 69336 performed on a separately collected and identified specimen collected within 7 days of the examination described in item 69336 — not more than 1 examination in a 7 day period

19.25

69345

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

   (a)  pathogen identification and antibiotic susceptibility testing; and

53.25

 

  (b)  the detection of clostridial toxins; and

   (c)  a service described in item 69300;

not more than 1 examination in a 7 day period

 

69354

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

   (a)  identification of any cultured pathogen; and

  (b)  necessary antibiotic susceptibility testing;

to a maximum of 3 sets of cultures — 1 set of cultures

30.95

69357

2 sets of cultures described in item 69354

61.85

69360

3 sets of cultures described in item 69354

92.80

69363

Detection of Clostridium difficile or Clostridium difficile toxin (except if a service described in item 69345 has been performed) — 1 or more tests

28.85

69378

Quantitation of HIV viral RNA load in plasma or serum in the monitoring of a HIV sero‑positive patient not on antiretroviral therapy — 1 or more tests

181.45

69379

A test described in item 69378 if the quantitation is performed by a receiving APP — 1 or more tests on 1 or more specimens

181.45

69380

Genotypic testing for HIV antiretroviral resistance in a patient with confirmed HIV infection if the patient’s viral load is greater than 1 000 copies per ml at any of the following times:

   (a)  at presentation; or

  (b)  before antiretroviral therapy; or

   (c)  when treatment with combination antiretroviral agents fails;

 — maximum of two tests in a 12 month period

775.50

69381

Quantitation of HIV viral RNA load in plasma or serum in the monitoring of a HIV sero‑positive patient on antiretroviral therapy — 1 or more tests on 1 or more specimens

181.45

69382

Quantitation of HIV viral RNA load in cerebrospinal fluid in a HIV sero‑positive patient — 1 or more tests on 1 or more specimens

181.45

69383

A test described in item 69381 if the quantitation is performed by a receiving APP — 1 or more tests on 1 or more specimens

181.45

69384

Quantitation of 1 antibody to microbial antigens not elsewhere described in this table — 1 test

15.75

69387

2 tests described in item 69384

29.20

69390

3 tests described in item 69384

42.65

69393

4 tests described in item 69384

56.10

69396

5 or more tests described in item 69384

69.55

69400

A test described in item 69384 if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP — 1 test

15.75

69401

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

13.45

69405

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

   (a)  the determination of 1 of the following — rubella immune status, specific syphilis serology, carriage of Hepatitis B, Hepatitis C antibody, HIV antibody; and

  (b)  (if performed) a service described in 1 or more of items 69384, 69475, 69478 and 69481

15.75

69408

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

29.20

 

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

  (b)  (if performed) a service described in 1 or more of items 69384, 69475, 69478 and 69481

 

69411

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

42.65

 

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

 

 

  (b)  (if performed) a service described in 1 or more of items 69384, 69475, 69478 and 69481

 

69413

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

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

  (b)  (if performed) a service described in 1 or more of items 69384, 69475, 69478 and 69481

56.10

69415

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

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

  (b)  (if performed) a service described in 1 or more of items 69384, 69475, 69478 and 69481

69.55

69418

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

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

64.00

 

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

 

 

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

1 test

 

69419

A test described in item 69418 if the test is performed by a receiving APP — 1 test

64.00

69445

Detection of hepatitis C viral RNA in a patient undertaking antiviral therapy for chronic HCV hepatitis (including a service described in item 69499) — 1 test

92.80

69451

A test described in item 69445 if the test is performed by a receiving APP — 1 test

92.80

69471

Test of cell‑mediated immunity in blood for the detection of latent tuberculosis in an immunosuppressed or immunocompromised patient — 1 test

35.15

69472

Detection of antibodies to Epstein Barr Virus using specific serology — 1 test

15.75

69474

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

28.85

69475

Detection of hepatitis antigens or antibodies to determine immune status or viral carriage following exposure or vaccination to Hepatitis A, Hepatitis B, Hepatitis C or Hepatitis D — 1 test

15.75

69478

2 tests described in item 69475

29.45

69481

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

40.80

69482

Quantitation of hepatitis B viral DNA in patients who are hepatitis B surface antigen positive and have chronic hepatitis B but are not receiving antiviral therapy — 1 test

153.10

69483

Quantitation of hepatitis B viral DNA in patients who:

   (a)  are hepatitis B surface antigen positive; and

  (b)  have chronic hepatitis B; and

   (c)  are receiving antiviral therapy;

1 test

153.10

69484

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

17.20

69488

Quantitation of HCV RNA load in plasma or serum in:

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

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

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

181.45

69489

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

181.45

69491

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

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

206.20

 

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

 

69492

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

206.20

69494

Detection of a virus, microbial antigen or microbial nucleic acid (not elsewhere described in this table) — 1 test

28.85

69495

2 tests described in item 69494

36.10

69496

3 or more tests described in item 69494

43.35

69497

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

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

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

1 test

28.85

69498

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

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

7.25

 

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

1 test

 

69499

Detection of hepatitis C viral RNA if at least 1 of the following criteria is satisfied:

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

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

92.80

 

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

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

 

 

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

 

69500

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

92.80

Division 2.4           Group P4 — Immunology

2.4.1       Limitation on certain items

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

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

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

2.4.2       Tests in Group P4 relating to antibodies

                For items in Group P4 (Immunology), in items 71119, 71121, 71123 and 71125, if:

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

               (b)    specimen material from the patient episode is stored; and

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

the later tests and the earlier tests are taken to be part of 1 patient episode.

2.4.3       HLA‑B27 typing

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

2.4.4       Antineutrophil cytoplasmic antibody tests

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

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

               (b)    a previous immunofluorescence test was abnormal; or

                (c)    those antibodies have been previously detected.

Group P4 — Immunology

Item

Pathology service

Fee ($)

71057

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

   (a)  protein classes; or

33.10

 

  (b)  presence and amount of paraprotein;

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

 

71058

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

50.85

71059

Immunofixation, immunoelectrophoresis or isoelectric focusing of:

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

35.90

 

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

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

 

71060

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

44.35

71062

Electrophoresis and immunofixation or immunoelectrophoresis or isoelectric focussing of CSF for the detection of oligoclonal bands and including if required electrophoresis of the patient’s serum for comparison purposes — 1 or more tests

44.35

71064

Detection and quantitation of cryoglobulins or cryofibrinogen — 1 or more tests

20.90

71066

Quantitation of total immunoglobulin A (by any method) in serum, urine, or other body fluid — 1 test

14.65

71068

Quantitation of total immunoglobulin G (by any method) in serum, urine, or other body fluid — 1 test

14.65

71069

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

22.90

71071

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

31.15

71072

Quantitation of total immunoglobulin M (by any method) in serum, urine, or other body fluid — 1 test

14.65

71073

Quantitation of all 4 immunoglobulin G subclasses

106.85

71074

Quantitation of total immunoglobulin D (by any method) in serum, urine, or other body fluid — 1 test

14.65

71075

Quantitation of immunoglobulin E (total) — 1 test

23.15

71076

A test described in item 71073 if the test is performed by a receiving APP — 1 test

106.85

71077

Quantitation of immunoglobulin E (total) in the follow up of a patient with proven immunoglobulin‑E‑secreting myeloma, proven congenital immunodeficiency or proven allergic bronchopulmonary aspergillosis — 1 test

27.25

71079

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

27.00

71081

Quantitation of total haemolytic complement

40.80

71083

Quantitation of complement components C3 and C4 or properdin factor B — 1 test

20.30

71085

2 tests described in item 71083

29.15

71087

3 or more tests described in item 71083

37.95

71089

Quantitation of complement components or breakdown products of complement proteins not elsewhere described in an item in this table — 1 test

29.35

71090

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

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

29.35

 

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

1 test

 

71091

2 tests described in item 71089

53.20

71092

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

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

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

1 test

23.85

71093

3 or more tests described in item 71089

76.95

71095

Quantitation of serum or plasma eosinophil cationic protein, or both, to a maximum of 3 assays in 1 year, for monitoring the response to therapy in corticosteroid treated asthma, in a child aged less than 12 years

40.80

71096

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

40.80

71097

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

24.60

71099

Double‑stranded DNA antibodies — quantitation by 1 or more methods other than the Crithidia method

26.70

71101

Antibodies to 1 or more extractable nuclear antigens — detection in serum or other body fluids

17.50

71103

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

52.40

71106

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

11.40

71119

Antibodies to tissue antigens not elsewhere specified in this table — detection, including quantitation if required, of 1 antibody

17.45

71121

Detection of 2 antibodies specified in item 71119

20.95

71123

Detection of 3 antibodies specified in item 71119

24.40

71125

Detection of 4 or more antibodies specified in item 71119

27.85

71127

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

   (a)  proliferation induced by 1 or more mitogens; or

  (b)  proliferation induced by 1 or more antigens; or

177.55

 

   (c)  estimation of 1 or more mixed lymphocyte reactions;

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

 

71129

2 tests described in item 71127

219.30

71131

3 or more tests described in item 71127

261.10

71133

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

10.45

71134

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

104.75

71135

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

   (a)  chemotaxis;

  (b)  phagocytosis;

   (c)  oxidative metabolism;

  (d)  bactericidal activity;

209.35

 

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

 

71137

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

30.45

71139

Characterisation of 3 or more leucocyte surface antigens by immunofluorescence or immunoenzyme techniques to assess lymphoid or myeloid cell populations, including a total lymphocyte count or total leucocyte count by any method, on 1 or more specimens of blood, CSF or serous fluid

104.75

71141

Characterisation of 3 or more leucocyte surface antigens by immunofluorescence or immunoenzyme techniques to assess lymphoid or myeloid cell populations on 1 or more disaggregated tissue specimens

198.70

71143

Characterisation of 6 or more leucocyte surface antigens by immunofluorescence or immunoenzyme techniques to assess lymphoid or myeloid cell populations for the diagnosis (but not monitoring) of an immunological or haematological malignancy, including a service described in 1 or both of items 71139 and 71141 (if performed), on a specimen of blood, CSF, serous fluid or disaggregated tissue

261.75

71145

Characterisation of 6 or more leucocyte surface antigens by immunofluorescence or immunoenzyme techniques to assess lymphoid or myeloid cell populations for the diagnosis (but not monitoring) of an immunological or haematological malignancy, including a service described in 1 or more of items 71139, 71141 and 71143 (if performed) on 2 or more specimens of disaggregated tissues or 1 specimen of disaggregated tissue and 1 or more specimens of blood, CSF or serous fluid

427.35

71146

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

104.75

71147

HLA‑B27 typing

40.80

71148

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

40.80

71149

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

109.00

71151

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

119.65

71153

Testing, for assessment or diagnosis of systemic inflammatory disease or vasculitis, for the presence of an antibody by 1 of the following tests:

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

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

   (c)  antimyeloperoxidase antibody (MPO ANCA) test;

34.80

 

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

 

71154

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

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

34.80

 

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

1 test

 

71155

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

47.75

71156

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

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

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

1 test

12.95

71157

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

60.70

71159

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

73.65

71163

Detection of 1 of the following antibodies (of 1 or more class or isotype) in the assessment or diagnosis of coeliac disease or other gluten hypersensitivity syndromes, including a service described in item 71066 (if performed):

   (a)  antibodies to gliadin;

  (b)  antibodies to endomysium;

   (c)  antibodies to tissue transglutaminase;

1 test

24.90

71164

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

40.15

71165

Antibodies to tissue antigens (acetylcholine receptor, adrenal cortex, heart, histone, insulin, insulin receptor, intrinsic factor, islet cell, lymphocyte, neuron, ovary, parathyroid, platelet, salivary gland, skeletal muscle, skin basement membrane and intercellular substance,

34.80

 

thyroglobulin, thyroid microsome or thyroid stimulating hormone receptor) — detection, including quantitation if required, of 1 antibody

 

71166

Detection of 2 antibodies described in item 71165

47.75

71167

Detection of 3 antibodies described in item 71165

60.70

71168

Detection of 4 or more antibodies described in item 71165

73.65

71169

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

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

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

34.80

71170

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

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

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

1 test

12.95

71180

Antibody to cardiolipin or beta‑2 glycoprotein I – detection, including quantitation if required; 1 antibody specificity (IgG or IgM)

34.80

71183

Detection of 2 antibodies described in item 71180

47.75

71186

Detection of 3 or more antibodies described in item 71180

60.70

71189

Detection of specific IgG antibodies to 1 or more respiratory disease allergens not elsewhere specified

15.60

71192

2 items described in item 71189

28.55

71195

3 or more items described in item 71189

40.30

71198

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

40.80

71200

Detection and quantitation, if present, of free kappa and lambda light chains in serum for the diagnosis or monitoring of amyloidosis, myeloma or plasma cell dyscrasias

60.00

71203

Determination of HLAB5701 status by flow cytometry or cytotoxity assay prior to the initiation of Abacavir therapy including item 73323 if performed

40.80

Division 2.5           Group P5 — Tissue pathology

2.5.1       Tests on biopsy material

     (1)       For items in Group P5 (Tissue pathology):

biopsy material means all tissue received by an approved pathology practitioner:

                (a)    from a medical procedure, or group of medical procedures, performed on a patient at the same time; or

               (b)    after being expelled spontaneously from a patient.

cytology means microscopic examination of 1 or more stained preparations of cells separated naturally or artificially from their normal environment by methods recognised as adequate to demonstrate their structure to a degree sufficient to enable an opinion to be formed about whether they are likely to be normal, abnormal but benign, or abnormal and malignant but, in accordance with customary laboratory practice, does not include examination of a blood film and a bone marrow aspirate.

separately identified specimen means an individual specimen collected, identified so that it is clearly distinguished from any other specimen, and sent for testing by or on behalf of the treating practitioner responsible for the procedure in which the specimen was taken.

     (2)       For Group P5, services in Group P6 include any services described in Group P5 on the material submitted for a test in Group P6.

     (3)       For subclause (2), any sample submitted for cytology from which a cell block is prepared does not qualify for a Group P5 item.

     (4)       If more than 1 of the services mentioned in items 72813, 72816, 72817, 72818, 72823, 72824, 72825, 72826, 72827, 72828, 72830, 72836 and 72838 are performed in a single patient episode, only the fee for the item performed having the highest specified fee is applicable to the services.

     (5)       If more than 1 histopathological examination is performed on separate specimens, of different complexity levels, from a single patient episode, only the fee for the examination having the highest specified fee is applicable to the examinations.

     (6)       In items 72813, 72816, 72817, 72818, 72823, 72824, 72825, 72826, 72827, 72828, 72830, 72836 and 72838 a reference to a complexity level is a reference to the level given to a specimen type mentioned in Part 4 of this table.

     (7)       If:

                (a)    more than 1 of the services mentioned in items 72846, 72847, 72848, 72849 and 72850; or

               (b)    more than 1 of the services mentioned in items 73059, 73060, 73061, 73064 and 73065 of Division 2.6;

are performed in a single patient episode, only the fee for the item performed having the higher or highest specified fee applies to the services.

Group P5 — Tissue pathology

Item

Pathology service

Fee ($)

72813

Examination of complexity level 2 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions — 1 or more separately identified specimens

72.00

72816

Examination of complexity level 3 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions — 1 separately identified specimen

86.95

72817

Examination of complexity level 3 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions — 2 to 4 separately identified specimens

97.45

72818

Examination of complexity level 3 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions — 5 or more separately identified specimens

107.75

72823

Examination of complexity level 4 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions — 1 separately identified specimen

97.80

72824

Examination of complexity level 4 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions — 2 to 4 separately identified specimens

142.30

72825

Examination of complexity level 4 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions — 5 to 7 separately identified specimens

181.45

72826

Examination of complexity level 4 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions — 8 to 11 separately identified specimens

195.90

72827

Examination of complexity level 4 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions  — 12 to 17 separately identified specimens

210.35

72828

Examination of complexity level 4 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions — 18 or more separately identified specimens

224.80

72830

Examination of complexity level 5 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions — 1 or more separately identified specimens

276.00

72836

Examination of complexity level 6 biopsy material with 1 or more tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy and professional opinion or opinions — 1 or more separately identified specimens

420.00

72838

Examination of complexity level 7 biopsy material with multiple tissue blocks, including specimen dissection, all tissue processing, staining, light microscopy, and professional opinion or opinions — 1 or more separately identified specimens

470.00

72844

Enzyme histochemistry of skeletal muscle for investigation of primary degenerative or metabolic muscle diseases or of muscle abnormalities secondary to disease of the central or peripheral nervous system — 1 or more tests

30.95

72846

Immunohistochemical examination of biopsy material by immunofluorescence, immunoperoxidase or other labelled antibody techniques with multiple antigenic specificities per specimen — 1 to 3 antibodies except those mentioned in item 72848

60.00

72847

Immunohistochemical examination of biopsy material by immunofluorescence, immunoperoxidase or other labelled antibody techniques with multiple antigenic specificities per specimen — 4 to 6 antibodies

90.00

72848

Immunohistochemical examination of biopsy material by immunofluorescence, immunoperoxidase or other labelled antibody techniques with multiple antigenic specificities per specimen — 1 to 3 of the following antibodies:

   (a)  oestrogen;

  (b)  progesterone;

   (c)  c‑erb‑B2 (HER2)

75.00

72849

Immunohistochemical examination of biopsy material by immunofluorescence, immunoperoxidase or other labelled antibody techniques with multiple antigenic specificities per specimen — 7 to 10 antibodies

105.00

72850

Immunohistochemical examination of biopsy material by immunofluorescence, immunoperoxidase or other labelled antibody techniques with multiple antigenic specificities per specimen — 11 or more antibodies

120.00

72851

Electron microscopic examination of biopsy material — 1 separately identified specimen

185.60

72852

Electron microscopic examination of biopsy material — 2 or more separately identified specimens

247.45

72855

Intraoperative consultation and examination of biopsy material by frozen section or tissue imprint or smear — 1 separately identified specimen

185.60

72856

Intraoperative consultation and examination of biopsy material by frozen section or tissue imprint or smear — 2 to 4 separately identified specimens

247.45

72857

Intraoperative consultation and examination of biopsy material by frozen section or tissue imprint or smear — 5 or more separately identified specimens

288.70

Division 2.6           Group P6 — Cytology

2.6.1       Tests on biopsy material

     (1)       For Group P6, services in Group P6 include any services described in Group P5 on the material submitted for a test in Group P6.

     (2)       For subclause (1), any sample submitted for cytology from which a cell block is prepared does not qualify for a Group P5 item.

     (3)       If:

                (a)    more than 1 of the services mentioned in items 72846, 72847, 72848, 72849 and 72850 of Division 2.5; or

               (b)    more than 1 of the services mentioned in items 73059, 73060, 73061, 73064 and 73065;

are performed in a single patient episode, only the fee for the item performed having the higher or highest specified fee applies to the services.

         (4)   If more than one of the services mentioned in items 73049, 73051, 73062, 73063, 73066 and 73067 are performed in a single patient episode, the fee for the combined services is:

                (a)    if services mentioned in two items are performed — the higher of the two fees specified; or

               (b)    if services mentioned in more than two items are performed — the highest of the fees specified.

Group P6 — Cytology

Item

Pathology service

Fee ($)

73043

Cytology (including serial examinations) of nipple discharge or smears from skin, lip, mouth, nose or anus for detection of precancerous or cancerous changes — 1 or more tests

23.00

73045

Cytology (including serial examinations) for malignancy (other than an examination mentioned in item 73053), including any Group P5 service (if performed), 1 or more tests on:

   (a)  specimens resulting from washings or brushings from sites not specified in item 73043; or

  (b)  a single specimen of sputum or urine; or

   (c)  1 or more specimens of other body fluids

48.95

73047

Cytology of a series of 3 sputum or urine specimens for malignant cells

95.35

73049

Cytology of material obtained directly from a patient by fine needle aspiration of solid tissue, or tissues — 1 identified site

68.60

73051

Cytology of material obtained directly from a patient at one identified site by fine needle aspiration of solid tissue or tissues if a recognised pathologist:

   (a)  performs the aspiration; or

  (b)  attends the aspiration and performs a cytological examination during the attendance

171.50

73053

Cytology of a smear from cervix, where the smear is prepared by direct application of the specimen to a slide, excluding the use of liquid based slide preparation techniques, and the stained smear is microscopically examined by or on behalf of a pathologist — each examination:

   (a)  for the detection of precancerous or cancerous changes in women with no symptoms, signs or recent history suggestive of cervical neoplasia; or

  (b)  if a further specimen is taken due to an unsatisfactory smear taken for the purposes of paragraph (a); or

   (c)  if there is inadequate information provided to use item 73055

19.60

73055

Cytology of a smear from cervix, not associated with item 73053, where the smear is prepared by direct application of the specimen to a slide, excluding the use of liquid based slide preparation techniques, and the stained smear is microscopically examined by or on behalf of a pathologist — each test:

   (a)  for the management of previously detected abnormalities including precancerous or cancerous conditions; or

  (b)  for the investigation of women with symptoms, signs or recent history suggestive of cervical neoplasia

19.60

73057

Cytology of a smear from vagina, not associated with item 73053 or 73055, and not to monitor hormone replacement therapy, where the smear is prepared by direct application of the specimen to a slide, excluding the use of liquid based slide preparation techniques, and the stained smear is microscopically examined by or on behalf of a pathologist — each test

19.60

73059

Immunocytochemical examination of material obtained by procedures described in items 73045, 73047, 73049, 73051, 73062 and 73063 for the characterisation of a malignancy by immunofluorescence, immunoperoxidase or other labelled antibody techniques with multiple antigenic specificities per specimen — 1 to 3 antibodies except those mentioned in item 73061

43.30

73060

Immunocytochemical examination of material obtained by procedures described in items 73045, 73047, 73049, 73051, 73062 and 73063 for the characterisation of a malignancy by immunofluorescence, immunoperoxidase or other labelled antibody techniques with multiple antigenic specificities per specimen —4 to 6 antibodies

57.75

73061

Immunocytochemical examination of material obtained by procedures described in items 73045, 73047, 73049, 73051, 73062 and 73063 for the characterisation of a malignancy by immunofluorescence, immunoperoxidase or other labelled antibody techniques with multiple antigenic specificities per specimen — 1 to 3 of the following antibodies:

   (a)  oestrogen;

  (b)  progesterone;

   (c)  c‑erb‑B2 (HER2)

51.55

73062

Cytology of material obtained directly from a patient by fine needle aspiration of solid tissue, or tissues — 2 or more separately identified sites

89.60

73063

Cytology of material obtained directly from a patient at one identified site by fine needle aspiration of solid tissue or tissues if an employee of an approved pathology authority attends the aspiration for confirmation of sample adequacy

100.00

73064

Immunocytochemical examination of material obtained by procedures described in items 73045, 73047, 73049, 73051, 73062 and 73063 for the characterisation of a malignancy by immunofluorescence, immunoperoxidase or other labelled antibody techniques with multiple antigenic specificities per specimen — 7 to 10 antibodies

72.20

73065

Immunocytochemical examination of material obtained by procedures described in items 73045, 73047, 73049, 73051, 73062 and 73063 for the characterisation of a malignancy by immunofluorescence, immunoperoxidase or other labelled antibody techniques with multiple antigenic specificities per specimen — 11 or more antibodies

89.60

73066

Cytology of material obtained directly from a patient at two or more separately identified sites by fine needle aspiration of solid tissue or tissues if a recognised pathologist:

   (a)  performs the aspiration; or

  (b)  attends the aspiration and performs cytological examination during the attendance

222.95

73067

Cytology of material obtained directly from a patient at two or more separately identified sites by fine needle aspiration of solid tissue or tissues if an employee of an approved pathology authority attends the aspiration for confirmation of sample adequacy

130.00

Division 2.7           Group P7 — Genetics

2.7.1       Haemochromatosis testing

                For items 73317 and 73318:

elevated serum ferritin, for a patient, means a level of ferritin above the normal reference range for the particular method of assay used to determine the level.

2.7.2       HLA‑B27 typing

                If a pathology service mentioned in item 73320 or 73321 is rendered as a pathologist‑determinable service, the amount mentioned in the item is not payable for a pathology service mentioned in the item unless the recognised pathologist who renders the service records, in writing, the reasons for rendering the service and the result of the pathology service mentioned in item 71147.

Group P7 — Genetics

Item

Pathology service

Fee ($)

73287

Study of the whole of every chromosome by cytogenetics or other techniques, performed on 1 or more of any tissue or fluid except blood (including a service mentioned in item 73293, if performed) — 1 or more tests

397.20

73289

Study of the whole of every chromosome by cytogenetics or other techniques, performed on blood (including a service mentioned in item 73293, if performed) — 1 or more tests

361.35

73290

Study of the whole of every chromosome by cytogenetics or other techniques, performed on blood or bone marrow, to diagnose or monitor haematological malignancy (including a service mentioned in item 73287 or 73289, if performed) — 1 or more tests

397.20

73291

Analysis of 1 or more chromosome regions, performed on blood or fresh tissue, for specific constitutional genetic abnormalities in:

   (a)  diagnostic studies of a person with developmental delay, intellectual disability, autism, or at least 2 congenital abnormalities, in whom a study by cytogenetics or other techniques mentioned in item 73287 or 73289 is normal or has not been performed — 1 or more tests; or

  (b)  studies of a relative of the person for an abnormality previously identified in the person — 1 or more tests

232.50

73292

Analysis of chromosomes by genome‑wide microarray, including targeted assessment of specific regions for constitutional genetic abnormalities in diagnostic studies of a person with developmental delay, intellectual disability, autism, or at least 2 congenital abnormalities (including a service mentioned in item 73287, 73289 or 73291, if performed) — 1 or more tests

593.85

73293

Analysis of 1 or more regions on all chromosomes, performed on fresh tissue, for specific constitutional genetic abnormalities in diagnostic studies of the products of conception, including exclusion of maternal cell contamination — 1 or more tests

232.50

73294

Analysis of the PMP22 gene for constitutional genetic abnormalities causing peripheral neuropathy, as:

   (a)  diagnostic studies of a person with peripheral neuropathy — 1 or more tests; or

  (b)  studies of a relative of the person for an abnormality previously identified in the person — 1 or more tests

232.50

73300

Detection of mutation of the FMR1 gene if:

   (a)  the patient exhibits intellectual disability, ataxia, neurodegeneration, or premature ovarian failure consistent with an FMR1 mutation; or

  (b)  the patient has a relative with an FMR1 mutation;

1 or more tests

102.00

73305

Detection of a mutation of the FMR1 gene by Southern Blot analysis, if the results of a service performed in item 73300 are inconclusive

204.00

73308

Characterisation of the genotype of a patient for Factor V Leiden gene mutation, or detection of other relevant mutations in the investigation of proven venous thrombosis or pulmonary embolism — 1 or more tests

36.70

73309

A test described in item 73308 if the test is performed by a receiving APP — 1 or more tests

36.70

73311

Characterisation of the genotype of a person who is a first degree relative of a person who has been proven to have 1 or more abnormal genotypes under item 73308 — 1 or more tests

36.70

73312

A test described in item 73311 if the test is performed by a receiving APP — 1 or more tests

36.70

73314

Characterisation of gene rearrangement or the identification of mutations within a known gene rearrangement in the diagnosis and monitoring of patients with laboratory evidence of:

   (a)  acute myeloid leukaemia; or

  (b)  acute promyelocytic leukaemia; or

   (c)  acute lymphoid leukaemia; or

232.50

 

  (d)  chronic myeloid leukaemia

 

73315

A service described in item 73314 if the characterisation is performed by a receiving APP — 1 or more tests

232.50

73317

Detection of the C282Y genetic mutation of the HFE gene and, if performed, detection of other mutations for haemochromatosis where:

   (a)  the patient has an elevated transferrin saturation or elevated serum ferritin on testing of repeated specimens; or

  (b)  the patient has a first degree relative with haemochromatosis; or

   (c)  the patient has a first degree relative with homozygosity for the C282Y genetic mutation, or with compound heterozygosity for recognised genetic mutations for haemochromatosis

36.70

73318

A test described in item 73317 if the detection is performed by a receiving APP — 1 or more tests

36.70

73320

Detection of HLA‑B27 by nucleic acid amplification including a service described in item 71147 unless the service in this item is rendered as a pathologist‑determinable service

40.80

73321

A test described in item 73320 if the detection is performed by a receiving APP — 1 or more tests

40.80

73323

Determination of HLAB5701 status by molecular techniques prior to the initiation of Abacavir therapy including item 71203 if performed

40.80

73324

A test described in item 73323 if rendered by a receiving APP — 1 or more tests

41.25

73325

Characterisation of mutations in:

   (a)  the JAK2 gene; or

  (b)  the MPL gene; or

   (c)  both genes;

in the diagnostic work‑up, by or on behalf of a specialist or consultant physician, of a patient with clinical and laboratory evidence of:

   (a)  polycythaemia vera; or

  (b)  essential thrombocythaemia;

 — one or more tests

75.00

73326

Characterisation of the gene rearrangement FIP1L1‑PDGFRA in the diagnostic work‑up and management of a patient with laboratory evidence of:

   (a)  mast cell disease; or

  (b)  idiopathic hypereosinophilic syndrome; or

   (c)  chronic eosinophilic leukaemia;

 — one or more tests

232.50

73327

Detection of genetic polymorphisms in the Thiopurine S‑methyltransferase gene for the prevention of dose‑related toxicity during treatment with thiopurine drugs, including (if performed) any service described in item 65075 — one or more tests

52.30

73328

A test of tumour tissue from a patient with locally advanced or metastatic non-small cell lung cancer requested by, or on behalf of, a specialist or consultant physician to determine if the requirements relating to epidermal growth factor receptor (EGFR) gene status for access to gefitinib under the Pharmaceutical Benefits Scheme (PBS) are fulfilled

400.00

73330

A test of tumour tissue from a patient with metastatic colorectal cancer requested by, or on behalf of, a specialist or consultant physician to determine if the requirements relating to Kirsten ras (KRAS) gene mutation status for access to cetuximab under the Pharmaceutical Benefits Scheme (PBS) are fulfilled

232.50

73332

An in situ hybridization (ISH) test of tumour tissue from a patient with breast cancer (other than in the neoadjuvant setting) requested by, or on behalf of, a specialist or consultant physician to determine if the requirements relating to human epidermal growth factor receptor 2 (HER2) gene mutation status for access to trastuzumab under the Pharmaceutical Benefits Scheme (PBS) or the Herceptin Program are fulfilled

317.50

Division 2.8           Group P8 — Infertility and pregnancy tests

2.8.1       Limitation on item 73523

                For any particular patient, item 73523 is applicable not more than 4 times in a 12 month period.

Group P8 — Infertility and pregnancy tests

Item

Pathology service

Fee ($)

73521

Semen examination for presence of spermatozoa or examination of cervical mucus for spermatozoa (Huhner’s test)

9.75

73523

Semen examination (other than post‑vasectomy semen examination), including:

   (a)  measurement of volume, sperm count and motility; and

  (b)  examination of stained preparations; and

   (c)  morphology; and

  (d)  (if performed) differential count and 1 or more chemical tests

42.05

73525

Sperm antibodies — sperm‑penetrating ability — 1 or more tests

28.55

73527

Human chorionic gonadotrophin (HCG) — detection in serum or urine by 1 or more methods for diagnosis of pregnancy — 1 or more tests

10.05

73529

Human chorionic gonadotrophin (HCG), quantitation in serum by 1 or more methods (except by latex, membrane, strip or other pregnancy test kit) for diagnosis of threatened abortion, or follow up of abortion or diagnosis of ectopic pregnancy, including any services performed in item 73527 — 1 test

28.85

Division 2.9           Group P9 — Simple basic pathology tests

Group P9 — Simple basic pathology tests

Item

Pathology service

Fee ($)

73801

Semen examination for presence of spermatozoa

6.95

73802

Leucocyte count, erythrocyte sedimentation rate, examination of blood film (including differential leucocyte count), haemoglobin, haematocrit or erythrocyte count — 1 test

4.60

73803

2 tests described in item 73802

6.40

73804

3 or more tests described in item 73802

8.20

73805

Microscopy of urine, whether stained or not, or catalase test

4.60

73806

Pregnancy test by 1 or more immunochemical methods

10.20

73807

Microscopy for wet film other than urine, including any relevant stain

6.95

73808

Microscopy of Gram‑stained film, including (if performed) a service described in item 73805 or 73807

8.70

73809

Chemical tests for occult blood in faeces by reagent stick, strip, tablet or similar method

2.35

73810

Microscopy for fungi in skin, hair or nails — 1 or more sites

6.95

73811

Mantoux test

11.30

Division 2.10         Group P10 — Patient episode initiation

2.10.1     Items in Group P10 (Patient episode initiation) not to apply in certain circumstances

     (1)       For this Division:

approved collection centre has the same meaning as in Part IIA of the Act.

institution means a place 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;

but does not include:

                (j)    a hospital; or

               (k)    a residential care facility; or

                (l)    accommodation for aged persons that is attached to a residential care facility or situated within a residential care facility complex.

prescribed laboratory means a laboratory operated by:

                (a)    the Commonwealth; or

               (b)    an authority of the Commonwealth; or

                (c)    a State or internal Territory; or

               (d)    an authority of a State or internal Territory; or

                (e)    an Australian tertiary education institution.

residential care facility means a facility in which residential care, within the meaning of section 41‑3 of the Aged Care Act 1997, is provided.

specimen 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)       If a service mentioned in an item in Group P10 is rendered by, or on behalf of, an approved pathology practitioner who is a recognised pathologist, the relevant item does not apply to the service if:

                (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 to a public patient at a recognised hospital.

     (3)       An item in Group P10 does not apply to a pathology service to which subsection 16A (7) of the Act applies.

     (4)       An item in Group P10 does not apply to a pathology service unless at least 1 item in Groups P1 to P8 also applies to the service.

     (5)       Subject to subclause (6), if 1 item in Group P10 applies to a patient episode, no other item in the Group applies to the patient episode.

     (6)       If, for the same patient episode:

                (a)    services mentioned in 1 or more items in Group P5 and 1 or more of Groups P1, P2, P3, P4, P6, P7 and P8 are rendered by an approved pathology practitioner in the laboratory of another approved pathology authority; or

               (b)    services mentioned in 1 or more items in Group P6 and 1 or more of Groups P1, P2, P3, P4, P5, P7 and P8 are rendered by an approved pathology practitioner in the laboratory of another approved pathology authority;

the fee mentioned in the applicable item in Group P10 applies to both approved pathology practitioners.

     (7)       If more than 1 specimen is collected from a person on the same day for the provision of pathology services:

                (a)    in accordance with more than 1 request; and

               (b)    in or by a single approved pathology authority;

the fee mentioned in the applicable item in Group P10 applies once only to the services unless an exemption mentioned in clause 1.2.3, 2.1.1 or 2.2.2 applies or the Minister has made a direction under subsection 4B (3) of the Act.

Group P10 — Patient episode initiation

Item

Pathology service

Fee ($)

73920

Initiation of a patient episode by collection of a specimen for 1 or more services (other than those described in item 73922, 73924 or 73926) if the specimen is collected in an approved collection centre that the approved pathology authority operates in the same premises as it operates a category GX or GY pathology laboratory

2.40

73922

Initiation of a patient episode that consists of a service described in item 73053, 73055 or 73057 (in circumstances other than those described in item 73923)

8.25

73923

Initiation of a patient episode that consists of a service described in item 73053, 73055 or 73057 if:

   (a)  the person is a private patient in a recognised hospital; or

  (b)  the person receives the service from a prescribed laboratory

2.40

73924

Initiation of a patient episode that consists of 1 or more services described in items 72813, 72816, 72817, 72818, 72823, 72824, 72825, 72826, 72827, 72828, 72830, 72836 and 72838 (in circumstances other than those described in item 73925) from a person who is an in‑patient of a hospital

14.75

73925

Initiation of a patient episode that consists of 1 or more services described in items 72813, 72816, 72817, 72818, 72823, 72824, 72825, 72826, 72827, 72828, 72830, 72836 and 72838 if the person is:

   (a)  a private patient of a recognised hospital; or

2.40

 

  (b)  a private patient of a hospital who receives the service or services from a prescribed laboratory

 

73926

Initiation of a patient episode that consists of 1 or more services described in items 72813, 72816, 72817, 72818, 72823, 72824, 72825, 72826, 72827, 72828, 72830, 72836 and 72838 (in circumstances other than those described in item 73927) from a person who is not a patient of a hospital

8.25

73927

Initiation of a patient episode by a prescribed laboratory that consists of 1 or more services described in items 72813, 72816, 72817, 72818, 72823, 72824, 72825, 72826, 72827, 72828, 72830, 72836 and 72838 from a person who is not a patient of a hospital

2.40

73928

Initiation of a patient episode by collection of a specimen for 1 or more services (in circumstances other than those described in item 73920, 73922, 73923, 73924, 73925, 73926, 73927 or 73929) if the specimen is collected in an approved collection centre

6.00

73929

Initiation of a patient episode by collection of a specimen for 1 or more services (in circumstances other than those described in item 73922, 73923, 73924, 73925, 73926 or 73927) if the specimen is collected in an approved collection centre by:

   (a)  an approved pathology practitioner of a prescribed laboratory; or

  (b)  an employee of an approved pathology authority of a prescribed laboratory

2.40

 

  (b)  an employee of an approved pathology authority of a prescribed laboratory

 

73930

Initiation of a patient episode by collection of a specimen for 1 or more services (in circumstances other than those described in item 73922, 73923, 73924, 73925, 73926, 73927 or 73931) if the specimen is collected from a person who is an in‑patient of a hospital other than a recognised hospital by an approved pathology practitioner or an employee of an approved pathology authority

6.00

73931

Initiation of a patient episode by collection of a specimen for 1 or more services (in circumstances other than those described in item 73922, 73923, 73924, 73925, 73926 or 73927) if the specimen is collected:

   (a)  from a person who is a private patient of a hospital by an approved pathology practitioner of a prescribed laboratory; or

  (b)  from a person who is a private patient of a hospital by an employee of an approved pathology authority that operates a prescribed laboratory; or

2.40

 

   (c)  from a person who is a private patient of a recognised hospital by an approved pathology practitioner of an approved pathology authority; or

  (d)  from a person who is a private patient of a recognised hospital by an employee of an approved pathology authority

 

73932

Initiation of a patient episode by collection of a specimen for 1 or more services (in circumstances other than those described in item 73922, 73923, 73924, 73925, 73926, 73927 or 73933) if the specimen is collected from a person in the place where the person resides, and that place is not an institution, by:

   (a)  an approved pathology practitioner of an approved pathology authority; or

10.30

 

  (b)  an employee of an approved pathology authority

 

73933

Initiation of a patient episode by collection of a specimen for 1 or more services (in circumstances other than those described in item 73922, 73923, 73924, 73925, 73926 or 73927) if the specimen is collected from a person in the place where the person resides, and that place is not an institution, by:

   (a)  an approved pathology practitioner of a prescribed laboratory; or

  (b)  an employee of an approved pathology authority that operates a prescribed laboratory

2.40

73934

Initiation of a patient episode by collection of a specimen for 1 or more services (in circumstances other than those described in item 73922, 73923, 73924, 73925, 73926, 73927 or 73935) if the specimen is collected from a person in an institution by:

   (a)  an approved pathology practitioner; or

  (b)  an employee of an approved pathology authority

17.70

73935

Initiation of a patient episode by collection of a specimen for 1 or more services (in circumstances other than those described in item 73922, 73923, 73924, 73925, 73926 or 73927) if the specimen is collected from a person in an institution by:

   (a)  an approved pathology practitioner of a prescribed laboratory; or

  (b)  an employee of an approved pathology authority that operates a prescribed laboratory

2.40

73936

Initiation of a patient episode by collection of a specimen for 1 or more services (in circumstances other than those described in item 73922, 73923, 73924, 73925, 73926, 73927 or 73937) if the specimen is collected from the person by the person

6.00

73937

Initiation of a patient episode by collection of a specimen for 1 or more services (in circumstances other than those described in item 73922, 73923, 73924, 73925, 73926 or 73927) if the specimen is collected from the person by the person, and:

   (a)  the service is performed in a prescribed laboratory; or

  (b)  the person is a private patient in a recognised hospital

2.40

73938

Initiation of a patient episode by collection of a specimen for 1 or more services (in circumstances other than those described in items 73922, 73923, 73924, 73925, 73926, 73927 or 73939) if the specimen is collected by, or on behalf of, the treating practitioner

8.00

73939

Initiation of a patient episode by collection of a specimen for 1 or more services (in circumstances other than those described in item 73922, 73923, 73924, 73925, 73926 or 73927) if the specimen is collected by, or on behalf of, the treating practitioner and:

   (a)  the service is performed in a prescribed laboratory; or

  (b)  the person is a private patient in a recognised hospital

2.40

Division 2.11         Group P11 — Specimen referred

2.11.1     Items in Group P11 not to apply in certain circumstances

     (1)       An item in Group P11 does not apply to a pathology service to which subsection 16A (7) of the Act applies.

     (2)       An item in Group P11 does not apply to a pathology service unless at least 1 item in Groups P1 to P8 also applies to the service.

     (3)       An item in Group P11 applies only to the approved pathology practitioner or approved pathology authority to whom the specimen mentioned in the item was referred.

     (4)       The fee mentioned in item 73940 applies only once for a single patient episode.

2.11.2     Application of an item in Group P11 to a service excludes certain other items

                If item 73940 applies to a patient episode, none of the items in Group P10 applies to any pathology service rendered by the approved pathology authority or approved pathology practitioner who claimed item 73940 for the patient episode.

2.11.3     Circumstances in which an item in Group P11 does not apply

     (1)       An item in Group P11 does not apply to a referral if:

                (a)    a service for the same patient episode has been carried out by the referring approved pathology authority; and

               (b)    the approved pathology authority to which the referral is made is related to the referring approved pathology authority.

     (2)       An approved pathology authority is related to another approved pathology authority for subclause (1) if:

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

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

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

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

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

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

     (3)       An item in Group P11 does not apply to a referral if the following common tests are referred either singly or in combination (except if the following items are mentioned in combination with other items not similarly specified): 65060, 65070, 65120, 66500, 66503, 66506, 66509, 66512, 66536, 66596, 69300, 69303, 69333 or 73527.

Group P11 — Specimen referred

Item

Pathology service

Fee ($)

73940

Receipt of a specimen by an approved pathology practitioner of an approved pathology authority from another approved pathology practitioner of another approved pathology authority

10.30

Division 2.12         Group P12 — Management of bulk‑billed services

2.12.1     Application of items 74990 and 74991

     (1)       Despite clause 1.2.1:

                (a)    if the pathology service described in item 74991 is provided to a person, either that item or item 74990, but not both those items, applies to the service; and

               (b)    if item 74990 or 74991 applies to a pathology service, the fee specified in that item applies in addition to the fee specified in any other item in this table that applies to the service.

     (2)       For items 74990 and 74991:

bulk‑billed, for a pathology service, means:

                (a)    a medicare benefit is payable to a person for the service; and

               (b)    under an agreement entered into under section 20A of the Act:

                          (i)    the person assigns to the practitioner by whom, or on whose behalf, the service is provided, his or her right to the payment of the medicare benefit; and

                         (ii)    the practitioner accepts the assignment in full payment of his or her fee for the service provided.

Commonwealth concession card holder means a person who is a concessional beneficiary within the meaning given by subsection 84 (1) of the National Health Act 1953.

unreferred service means a pathology service that:

                (a)    is provided to a person by, or on behalf of, a medical practitioner, being a medical practitioner who is not a consultant physician, or specialist, in any speciality (other than a medical practitioner who is, for the purposes of the Act, both a general practitioner and a consultant physician, or specialist, in a particular speciality); and

               (b)    has not been referred to the medical practitioner by another medical practitioner or person with referring rights.

     (3)       For item 74991:

ASGC means the document titled Australian Standard Geographical Classification (ASGC) (ABS catalogue number 1216.0), published by the Australian Statistician in July 2010.

practice location, for the provision of a pathology service, means the place of practice for which the practitioner by whom, or on whose behalf, the service is provided, has been allocated a provider number by the Chief Executive Medicare.

regional, rural or remote area means an area classified as RRMAs 3‑7 under the Rural, Remote and Metropolitan Areas Classification.

Rural, Remote and Metropolitan Areas Classification has the meaning given by the general medical services table.

SLA means a Statistical Local Area specified in the ASGC.

SSD means a Statistical Subdivision specified in the ASGC.

Group P12 — Management of bulk‑billed services

Item

Pathology service

Fee ($)

74990

A pathology service to which an item in this table (other than this item or item 74991) applies if:

   (a)  the service is an unreferred service; and

  (b)  the service is provided to a person who is under the age of 16 or is a Commonwealth concession card holder; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is bulk‑billed in respect of the fees for:

         (i)   this item; and

        (ii)   the other item in this table applying to the service

6.90

74991

A pathology service to which an item in this table (other than this item or item 74990) applies if:

   (a)  the service is an unreferred service; and

  (b)  the service is provided to a person who is under the age of 16 or is a Commonwealth concession card holder; and

   (c)  the person is not an admitted patient of a hospital; and

  (d)  the service is bulk‑billed in respect of the fees for:

10.45

 

         (i)   this item; and

        (ii)   the other item in this table applying to the service; and

 

 

   (e)  the service is provided at, or from, a practice location in:

         (i)   a regional, rural or remote area; or

        (ii)   Tasmania; or

       (iii)   a geographical area included in any of the following SSD spatial units:

               (A)   Beaudesert Shire Part A;

               (B)   Belconnen;

 

 

               (C)   Darwin City;

               (D)   Eastern Outer Melbourne;

                (E)   East Metropolitan Perth;

                (F)   Frankston City;

 

 

               (G)   Gosford‑Wyong;

               (H)   Greater Geelong City Part A;

                 (I)   Gungahlin‑Hall;

                (J)   Ipswich City (Part in BSD);

               (K)   Litchfield Shire;

                (L)   Melton‑Wyndham;

               (M)   Mornington Peninsula Shire;

               (N)   Newcastle;

               (O)   North Canberra;

                (P)   Palmerston‑East Arm;

               (Q)   Pine Rivers Shire;

               (R)   Queanbeyan;

                (S)   South Canberra;

                (T)   South Eastern Outer Melbourne;

               (U)   Southern Adelaide;

               (V)   South West Metropolitan Perth;

              (W)   Thuringowa City Part A;

 

 

               (X)   Townsville City Part A;

               (Y)   Tuggeranong;

                (Z)   Weston Creek‑Stromlo;

 

 

             (ZA)   Woden Valley;

             (ZB)   Yarra Ranges Shire Part A; or

       (iv)   the geographical area included in the SLA spatial unit of Palm Island (AC)

 

Division 2.13         Group P13 — Bulk billing incentive for episodes consisting of a P10 service

Note   The payments mentioned in column 3 of Group P13 are additional payments for bulk billing a patient episode consisting of a pathology service to which a Group P10 item described in column 2 applies.

Group P13 — Bulk billing incentive for episodes consisting of a P10 service

Item

Pathology service

Fee ($)

74992

A patient episode that:

   (a)  consists of a pathology service to which item 73920 applies; and

  (b)  is bulk billed

1.60

74993

A patient episode that:

   (a)  consists of a pathology service to which item 73922 or 73926 applies; and

  (b)  is bulk billed

3.75

74994

A patient episode that:

   (a)  consists of a pathology service to which item 73924 applies; and

  (b) is bulk billed

3.25

74995

A patient episode that:

   (a) consists of a pathology service to which item 73928, 73930 or 73936 applies; and

  (b)  is bulk billed

4.00

74996

A patient episode that:

   (a)  consists of a pathology service to which item 73932 or 73940 applies; and

  (b)  is bulk billed

3.70

74997

A patient episode that:

   (a)  consists of a pathology service item 73934 applies; and

  (b)  is bulk billed

3.30

74998

A patient episode that:

   (a)  consists of a pathology service to which item 73938 applies; and

  (b)  is bulk billed

2.00

74999

A patient episode that:

   (a)  consists of a pathology service to which item 73923, 73925, 73927, 73929, 73931, 73933, 73935, 73937 or 73939 applies; and

  (b)  is bulk billed

1.60

Part 3          Abbreviations

Note   A drug that is not mentioned in this Part must be written in full.

Test

Abbreviation

Item

Abnormal haemoglobins

AH

65117

Acetoacetate

ACAT

66500

Acetylcholine receptor — tissue antigens — antibodies

ARA

71165

Acid phosphatise

ACP

66500

Actinomycetes — microbial antibody testing

ACT

69384

Activated Protein C resistance

APC

65142, 65171, 65175–65179

Adenovirus — microbial antibody testing

ADE

69384

Adrenal cortex — tissue antigens — antibodies

ADR

71165

Adrenocorticotrophic hormone (ACTH)

ACTH

66695

AFB microscopy and culture of sputum — 1 specimen

AFB1

69324

AFB microscopy and culture of sputum — 2 specimens

AFB2

69327

AFB microscopy and culture of sputum — 3 specimens

AFB3

69330

Alanine aminotransferase

ALT

66500

Albumin

ALB

66500

Alcohol (ethanol)

ETOH

66626, 66800

Aldosterone

ALDS

66695

Alkaline phosphatase

ALP

66500

Alkaline phosphatase — isoenzymes

ALPI

66641

Alpha‑1‑antitrypsin

AAT

66635

Alpha‑fetoprotein

AFP

66650–66653, 66743, 66750, 66751

Aluminium

AL

66825, 66828

Aluminium — renal dialysis

ALR

66671

Amikacin

 

66800

Amino acids

AA

66752

Amiodarone

AMIO

66812

Amitriptyline

AMIT

66812

Ammonia

NH3

66500

Amniotic fluid examination

AFE

66749

Amylase

AMS

66500

Amylobarbitone

AMYL

66812

Androstenedione

ANDR

66695

Angiotensin converting enzyme

ACE

66758

Antibiotic and antimicrobial chemotherapeutic agents — quantitation

QAA

66800, 66812

Antibodies to extractable nuclear antigens — characterisation of antibodies if positive ENA

ENAP

71103

Antibodies to extractable nuclear antigens — detection

ENA

71101

Antibodies to nuclear antigens — detection

ANA

71097

Antibodies to nuclear antigens — quantitation and measurement of DNA binding if positive ANA

ANAP

71099

Antibodies to tissue antigens — acetylcholine receptor

ARA

71165

Antibodies to tissue antigens — adrenal cortex

ADR

71165

Antibodies to tissue antigens — ANCA‑ myeloperoxidase

MPO

71153

Antibodies to tissue antigens — ANCA‑PR3

PR3

71153

Antibodies to tissue antigens — anti‑actin

AACT

71119

Antibodies to tissue antigens — anti‑endomysial

EMA

71163

Antibodies to tissue antigens — cardiolipin

ACL

71165

Antibodies to tissue antigens — coeliac disease panel

CLC

71163, 71164

Antibodies to tissue antigens — gastric parietal cell

PCA

71119

Antibodies to tissue antigens — gliadin IgA

GLIA

71163

Antibodies to tissue antigens — gliadin IgG

GLIG

71163

Antibodies to tissue antigens — glomerular basement membrane

GBM

71153

Antibodies to tissue antigens — heart

AHE

71165

Antibodies to tissue antigens — histone

AHI

71165

Antibodies to tissue antigens — insulin receptor antibodies

INSA

71165

Antibodies to tissue antigens — intercellular cement substance of skin

ICCS

71165

Antibodies to tissue antigens — intrinsic factor

AIF

71165

Antibodies to tissue antigens — islet cell

AIC

71165

Antibodies to tissue antigens — Jo‑1

JO1

71119

Antibodies to tissue antigens — keratin

KERA

71119

Antibodies to tissue antigens — liver/kidney microsomes

LKA

71119

Antibodies to tissue antigens — lymphocyte

ALY

71165

Antibodies to tissue antigens — mitochondria

MA

71119

Antibodies to tissue antigens — neuron

ANE

71165

Antibodies to tissue antigens — neutrophil cytoplasm

ANCA

71153

Antibodies to tissue antigens — ovary

AOV

71165

Antibodies to tissue antigens — parathyroid

PTHA

71165

Antibodies to tissue antigens — platelet

APA

71165

Antibodies to tissue antigens — PM‑Sc1

PM1

71119

Antibodies to tissue antigens — reticulin

RCA

71119

Antibodies to tissue antigens — salivary gland

ASG

71165

Antibodies to tissue antigens — Scl‑70

SCL

71119

Antibodies to tissue antigens — skeletal muscle

SLA

71165

Antibodies to tissue antigens — skin basement membrane

SKA

71165

Antibodies to tissue antigens — smooth muscle

SMA

71119

Antibodies to tissue antigens — thyroglobulin

ATG

71165

Antibodies to tissue antigens — thyroid microsome

TMA

71165

Antibodies to tissue antigens — tissue transglutaminase

TTG

71163

Antibodies to tissue antigens — TSH receptor antibody test

TSHA

71165

Antibody testing, microbial (see Microbial)

 

 

Antigen testing, microbial (see Microbial)

 

 

Antithrombin III

ATH

65142, 65171, 65175–65179

Anti‑Xa activity

QAXA

65147

Anus — cytology on specimens from

SMCY

73043

Apolipoprotein B/A1 ratio

APO

66536

Arsenic

AS

66825, 66828

Aspartate aminotransferase

AST

66500

Aspergillus — microbial antibody testing

ASP

69384

Avian precipitins (bird fancier’s disease) — microbial antibody testing

APP

69384

B12 vitamin

B12

66599

Barbiturate

BARB

66800, 66812

Beryllium

BE

66825, 66828

Beta‑2‑microglobulin

BMIC

66629

Beta‑hydroxybutyrate

BHYB

66500

Bicarbonate

HCO3

66500

Bilirubin (all fractions)

BILI

66500

Bilirubin (all fractions) — in urine

UBIL

66500

Bilirubin (all fractions) — neonatal

BILN

66749

Bird fancier’s disease (see avian precipitins)

APP

69384

Blastomyces — microbial antibody testing

BLM

69384

Blood — compatibility testing

XMAT

65099–65108

Blood — culture

BC

69354–69360

Blood — faecal occult

FOB

66764–66770

Blood — film

BF

65066

Blood — full examination

FBE

65070

Blood — gases

GAS

66566

Blood — group and blood group antibodies

BGAB

65096

Blood — group antibodies

BGA

65111

Blood — group systems

BGS

65093

Blood — grouping — ABO and RH (D antigen)

BG

65090

Blood — viscosity

VISC

65060

Body cavities — aspirations of — microscopy and culture of material from

MCPO

69321

Body fluids — cytology

BFCY

73045

Bone — low mineral densities

CBLB

66773

Bone — metabolic bone disease

CBMB

66776

Bone marrow examination — aspirate

BMEA

65087

Bone marrow examination — trephine

BMET

65084

Bordetella pertussis — microbial antibody testing

BOR

69384

Borrelia burgdorferi — microbial antibody testing

BOB

69384

Breath hydrogen test

BHT

66674

Bromide

BRMD

66812

Brucella — microbial antibody testing

BRU

69384

C‑l esterase inhibitor — functional

CEIF

66647

C‑l esterase inhibitor — quantitation

CEIQ

66644

CA‑15.3 antigen

CA15

66650

CA‑19.9 antigen

CA19

66650

CA‑125 antigen

C125

66650

Cadmium

CD

66825, 66828

Caeruloplasmin

CPLS

66632

Calcitonin

CALT

66695

Calcium — ionised

ICA

66584

Calcium (total or corrected for albumin)

CA

66500

Calculus analysis

CALC

66590

Campylobacter jejuni — microbial antibody testing

CAM

69384

Candida — microbial antibody testing

CAN

69384

Carbamazepine (Tegretol)

CARB

66800

Carboxyhaemoglobin

COHB

65117

Carcinoembryonic antigen

CEA

66650

Cardiac enzymes

CE

66506

Cardiolipin — tissue antigens — antibodies

ACL

71165

Catecholamines

CAT

66779

Cell mediated immunity — delayed type — hypersensitivity test

CMI

71137

Cell‑mediated immunity in blood

CMIB

69471

Cervix — cytology — abnormalities

CCRA

73055

Cervix — cytology — routine

CCR

73053

Cervix — microscopy and culture of material from

MCGR

69312

Characterisation of antibodies if positive ENA

ENAP

71103

Chemicals, toxic (ingested or absorbed) — assays

DRGO

66623

Chlamydia — investigation by any method

CHLM

69494

Chlamydia — investigation by any method and N gonorrhoea by NAA methods

CHGO

69494

Chlamydia — microbial antibody testing

CHL

69384

Chlamydia — microbial antigen testing

MCCH

69494

Chloral hydrate

CHHY

66812

Chlorazepate

CHZP

66812

Chloride

CL

66500

Chloroquine

CLOQ

66812

Chlorpromazine

CHLO

66812

Cholesterol

CHOL

66500

Cholesterol — HDL

HDLC

66536

Cholinesterase

CHSE

66758

Chorionic gonadotrophin — quantitation

HCG

66650–66653, 66750, 66751, 73529

Chorionic gonadotrophin — detection for pregnancy diagnosis

HCGP

73527–73529

Chromium

CR

66825, 66828

Chromosome identification and banding

 

73287–73289

Chromosome identification — studies — blood

CSB

73289

Chromosome identification — studies — other than blood

CS

73287

Cimetidine

CMTD

66812

Clobazam

CLOB

66812

Clomipramine

CLOM

66812

Clonazepam (Rivotril)

CLON

66812

Clostridium difficile — microbial antigen testing

CLDT

69363

Coagulation factor inhibitors by Bethesda assay

BETH

65159

Coagulation — factors (see individual factors)

 

 

Coagulation — studies

COAG

65120

Coccidioides — microbial antibody testing

CCC

69384

Coeliac antibodies

CLC

71163, 71164

Cold agglutinins

CAG

65114

Collagen — low bone

CBLB

66773

Collagen — metabolic disease

CBMB

66776

Compatibility testing

XMAT

65099–65108

Complement, total haemolytic

COM

71081

Complement, total haemolytic — components C3

C3

71083

Complement, total haemolytic — components C4

C4

71083

Complement, total haemolytic — other components

COMP

71089

Complement, total haemolytic — properdin factor B

PFB

71083

Copper

CU

66819, 66822

Cortisol

CORT

66695

Cortisol in saliva

CORS

66711, 66712

Coxsackie B1‑6 — microbial antibody testing

COX

69384

C‑Peptide

CPEP

66695

C‑reactive protein

CRP

66500

Creatine kinase

CK

66500

Creatine kinase — isoenzymes

CKI

66518

Creatine kinase — isoenzymes (electrophoresis)

CKIE

66518

Creatinine

C

66500

Cryofibrinogen — detection and quantitation

CFID

71064

Cryoglobulins — characterisation by electrophoresis and immunoelectrophoresis or immunofixation or isoelectric focussing

RYO

71059

Cryoglobulins — detection and quantitation

CGLD

71064

Cryptococcal antigen — microbial antigen testing

CRYN

69494

Cryptococcus — microbial antibody testing

CRY

69384

CSF antigens — group B streptococcus

STB

69494

CSF antigens — Haemophilus influenzae

HI

69494

CSF antigens — Neisseria meningitidis

NMG

69494

CSF antigens — Streptococcus pneumoniae

SPN

69494

CSF — microscopy and culture of material from

MCPO

69321

Cultural examination of faeces

FCS

69345

Cyclic AMP

CAMP

66695

Cyclosporin A

CLSA

66812

Cystine — qualitative

UCYS

66752

Cystine — quantitative

CYST

66752

Cytology — fine needle aspiration of solid tissues

FNCY

73049

Cytology — fine needle aspiration of solid tissues — aspiration or attendance by a pathologist

FNCP

73051

Cytology — from 3 sputum or urine specimens

SPCY

73047

Cytology — from body fluids, sputum (1 specimen), urine, washings or brushings

BFCY

73045

Cytology — from cervix — abnormalities

CCRA

73055

Cytology — from cervix — routine

CCR

73053

Cytology — from skin, nipple discharge, lip, mouth, nose or anus

SMCY

73043

Cytology — from vagina

CVO

73057

Cytomegalovirus — microbial antibody testing

CMV

69384

Cytomegalovirus serology in pregnancy — microbial antibody testing

CMVP

69405–69411

D vitamin

VITD

66608

D‑dimer test

DD

65120

Dehydroepiandrosterone sulphate (DHEAS)

DHEA

66695

Dengue — microbial antibody testing

DEN

69384

11‑Deoxycortisol

DCOR

66695

Desipramine

DESI

66812

Dexamethasone

DXST

66686

Dexamethasone — suppression test

DEXA

66686

DHEAS (Dehydroepiandrosterone sulphate)

DHEA

66695

Diazepam

DIAZ

66812

Differential cell count

DIFF

65070

Digoxin

DIG

66800

Dihydrotestosterone

DHTS

66695

Diphenylhydantoin (Dilantin)

DIL

66812

Diphtheria — microbial antibody testing

DIP

69384

Direct Coombs test

CMBS

65114

Disopyramide (Rythmodan)

DISO

66800

DNA binding — quantitation and measurement if positive ANA

ANAP

71099

DNA (double‑stranded DNA) antibody

DSDNA

71099

Donath Landsteiner antibody test

DLAT

65075

Down’s syndrome and neural tube defects

NTDD

66750, 66751

Doxepin hydrochloride

DOXE

66812

Drugs — abuse treatment programme — assay

DATP

66626

Drugs — inappropriate dosage — assay

DRGO

66623

Drugs — therapeutic — assay (see individual drugs)

 

66800, 66812

Dynamic function tests

GHSE

66686

Ear — microscopy and culture of material from

MCSW

69303

Echinococcus — microbial antibody testing

ECC

69384

Echis test

ECHI

65120

ECHO‑coxsackie group — microbial antibody testing

ECH

69384

Electrolytes

E

66509

Electron microscopy of biopsy material

EM

72851, 72852

Electrophoresis, and immunofixation or immunoelectrophoresis or isoelectric focussing — characterisation of cryoglobulins

RYO

71059

Electrophoresis, and immunofixation or immunoelectrophoresis or isoelectric focussing — characterisation of paraprotein

PRYO

71059

Electrophoresis, to demonstrate — creatine kinase isoenzymes

CKIE

66518

Electrophoresis, to demonstrate — lactate dehydrogenase isoenzymes

LDI

66641

Electrophoresis, to demonstrate — lipoprotein subclasses

LEPG

66539

Electrophoresis, to demonstrate — quantitation of protein classes, or paraprotein

EPPI

71057, 71058

Elements (see individual elements)

 

 

Endomysium antibodies

EMA

71163

Entamoeba histolytica — microbial antibody testing

AMO

69384

Enzyme assays of solid tissue or tissues

ENZS

66683

Enzyme histochemistry of skeletal muscle

EHSK

72844

Eosinophil cationic protein

ECP

71095

Epstein Barr virus — microbial antibody testing

EBV

69472–69474

Erythrocyte — assessment of haemolysis

ERYH

65075

Erythrocyte — assessment of metabolic enzymes

ERYM

65075

Erythrocyte — count

RCC

65070

Erythrocyte — sedimentation rate

ESR

65060

Ethanol (alcohol)

ETOH

66626, 66800

Ethosuximide (Zarontin)

ETHO

66800

Extractable nuclear antigens — detection of antibodies to

ENA

71101

Eye — microscopy and culture of material from

MCSW

69303

Factor II

FII

65150

Factor V

FV

65150

Factor V Leiden mutation

FVLM

73308, 73311

Factor VII

FVII

65150

Factor VIII

VIII

65150

Factor IX

FIX

65150

Factor X

FX

65150

Factor XI

FXI

65150

Factor XII

FXII

65150

Factor XIII

XIII

65150

Factor XIII deficiency test

F13D

65120

Faecal antigen test for Helicobacter pylori

FAHP

69494

Faecal blood

FOB

66764–66770

Faecal fat

FFAT

66674

Faecal fat — haemoglobin

FFH

66764

Faecal fat — reducing substances

FRS

66761

Faeces — culture

FCS

69345

Faeces — microscopy for parasites

OCP

69336–69339

Ferritin (see also Iron studies)

FERR

66593

Fibrin monomer

FM

65120

Fibrinogen

FIB

65120

Fibrinogen — degradation products

FDP

65120

Fitzgerald factor

FGF

65150

Flecainide

FLEC

66812

Fletcher factor

FF

65150

Fluorescent treponemal antibody — absorption test (FTA‑ABS) — microbial antibody testing

FTA

69384

Fluoxetine

FLUX

66812

Foetal red blood cells — Kliehauer

KLEI

65162

Folate — red cell

RCF

66599

Follicle stimulating hormone (FSH)

FSH

66695

Fragile X

FXS

73300, 73305

Frozen section diagnosis of biopsy material

FS

72855, 72856

Fructosamine

FRUC

66557

Full blood examination

FBE

65070

Gamma glutamyl transpeptidase

GGT

66500

Gastric parietal cell — tissue antigens — antibodies

PCA

71119

Gastrin

GAST

66695

Gentamicin

 

66800

Gliadin IgA — tissue antigens — antibodies

GLIA

71163

Globulin

GLOB

66500

Glomerular basement membrane — tissue antigens — antibodies

GBA

71165

Glucagon

GLGO

66695

Glucose

GLUC

66500

Glucose — tolerance test

GTT

66542

Glycosylated haemoglobin (Hb Alc)

GHB

66551

Gold

AU

66825, 66828

Group B streptococcus — CSF antigens

STB

69494

Group B streptococcus — microbial antigen testing

STB

69494

Group P9 — simple basic pathology tests

 

73801–73811

Growth hormone

GH

66695

Growth hormone — stimulation by exercise or L‑dopa

GHSE

66686

Growth hormone — suppression by dexamethasone or glucose

GHSG

66686

Haematocrit

HCT

65070

Haemochromatosis

FEUP

73317

Haemoglobin

HB

65060

Haemoglobinopathy tests

HMGP

65081

Haemophilus influenzae — CSF antigens

HI

69494

Haemophilus influenzae — microbial antibody testing

HUS

69384

Haemophilus influenzae — microbial antigen testing

HI

69494

Haloperidol

HALO

66812

Haptoglobins

HGLB

66632

HDL cholesterol

HDLC

66536

Heart — tissue antigens — antibodies

AHE

71165

Heparin — test

HEPR

65144

Hepatitis B or C confirmatory test

HSVP

69484

Hepatitis C — detection

RNAC

69499

Hepatitis C — genotype

GHCV

69491

Hepatitis C — quantitation

THCV

69488

Hepatitis investigation — 3 markers

HEP3

69481

Hepatitis serology — in pregnancy

HEPP

69405–69413

Hepatitis status or carriage — 1 marker

HEP1

69475

Hepatitis status or carriage — 2 markers

HEP2

69478

Hepatitis status or carriage — 3 markers

HEP3

69481

Herpes simplex virus — direct detection from clinical material

HSV

69494

Herpes simplex virus — investigation by culture

HSVC

69494

Herpes simplex virus — microbial antibody testing

HPA

69384

Herpes simplex virus — microbial antigen testing

HSV

69494

Heterophil antibodies

IM

65114

HIAA (hydroxyindoleacetic acid)

HIAA

66779

Histamine

HIAM

66779

Histone — tissue antigens — antibodies

AHI

71165

Histopathology of biopsy material

HIST

72813–72836

Histoplasma — microbial antibody testing

HIP

69384

HIV — antiretroviral therapy

TVLT

69381

HIV — cerebrospinal fluid

CVLT

69382

HIV — monitoring

MVLT

69378

HLA typing — HLA class 1

HLA1

71149

HLA typing — HLA class 2

HLA2

71151

HLA typing — HLA‑B27

HLAB

71147

HMMA (hydroxy‑3‑methoxymandelic acid, previously known as VMA)

HMMA

66779

HMPG (hydroxy‑methoxy phenylethylene glycol)

HMPG

66779

Homovanillic acid

HVA

66779

Hormone receptor assay — breast

HRA

66662

Hormone receptor assay — ovary

HRO

66662

Hormones — 11 deoxycortisol

DCOR

66695

Hormones — adrenocorticotrophic hormone

ACTH

66695

Hormones — aldosterone

ALDS

66695

Hormones and hormone binding proteins (see individual hormones and proteins)

 

66695

Hormones — androstenedione

ANDR

66695

Hormones — calcitonin

CALT

66695

Hormones — cortisol

CORT

66695

Hormones — C‑Peptide

CPEP

66695

Hormones — cyclic AMP

CAMP

66695

Hormones — dehydroepiandrosterone sulphate (DHEAS)

DHEA

66695

Hormones — dihydrotestosterone

DHTS

66695

Hormones — follicle stimulating hormone

FSH

66695

Hormones — gastrin

GAST

66695

Hormones — glucagon

GLGO

66695

Hormones — growth hormone

GH

66695

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

GHSE

66686

Hormones — growth hormone — suppression by dexamethasone or glucose

GHSG

66686

Hormones — hormone receptor assay — breast

HRA

66662

Hormones — hormone receptor assay — ovary

HRO

66662

Hormones — human chorionic gonadotrophin — detection for pregnancy diagnosis

HCGP

73527, 73529

Hormones — human chorionic gonadotrophin — quantitation

HCG

66650–66653, 66750, 66751, 73529

Hormones — hydroxyprogesterone

OHP

66695

Hormones — insulin

INS

66695

Hormones — luteinizing hormone

LH

66695

Hormones — oestradiol

E2

66695

Hormones — oestriol

E3

66750, 66751

Hormones — oestrone

E1

66695

Hormones — parathyroid hormone

PTH

66695

Hormones — progesterone

PROG

66695

Hormones — prolactin

PROL

66695

Hormones — renin

REN

66695

Hormones — sex hormone binding globulin

SHBG

66695

Hormones — somatomedin

SOMA

66695

Hormones — stimulation by exercise or L‑dopa

GHSE

66686

Hormones — suppression by dexamethasone or glucose

GHSG

66686

Hormones — testosterone

TES

66695

Hormones — urine steroid fraction or fractions

USF

66695

Hormones — vasoactive intestinal peptide

VIP

66695

Hormones — vasopressin

ADH

66695

Huhner’s test

HT

73521

Human chorionic gonadotrophin — detection for pregnancy diagnosis

HCGP

73527, 73529

Human chorionic gonadotrophin — quantitation

HCG

66650–66653, 66750, 66751, 73529

Human papillomaviruses

HPV

69418

HVA (homovanillic acid)

HVA

66779

Hydatid — microbial antibody testing

HYD

69384

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

HMMA

66779

Hydroxychloroquine

HOCQ

66812

Hydroxyindoleacetic acid

HIAA

66779

Hydroxy methoxy phenylethylene glycol

HMPG

66779

Hydroxyprogesterone

OHP

66695

Hydroxyproline

HYDP

66752

Imipramine

IMIP

66812

Immediate frozen section diagnosis of biopsy material

FS

72855–72856

Immunocyto. 1‑3 antibodies

ICC

73059, 73061

Immunocyto. 4+ antibodies

ICC1

73060

Immunoelectrophoresis and electrophoresis —characterisation of cryoglobulins

RYO

71059

Immunoelectrophoresis and electrophoresis —characterisation of paraprotein

PPRO

71059

Immunoglobulins — A

IGA

71066

Immunoglobulins — D

IGD

71074

Immunoglobulins — E (total)

IGE

71075–71079

Immunoglobulins — G

IGG

71068

Immunoglobulins — G, 4 subclasses

SIGG

71073

Immunoglobulins — M

IGM

71072

Immunohistochemical investigation of biopsy material

HIS

72846–72848

Infectious mononucleosis

IM

69384

Influenza A — microbial antibody testing

FLA

69384

Influenza B — microbial antibody testing

FLB

69384

Insulin

INS

66695

Insulin receptor antibodies — tissue antigens — antibodies

INSA

71165

Insulin — tissue antigens — antibodies

AINS

71165

Intercellular cement substance of skin — tissue antigens — antibodies

ICCS

71165

Intestinal disaccharidases

INTD

66680

Intrinsic factor — tissue antigens — antibodies

AIF

71165

Iron studies (iron, transferrin and ferritin)

IS

66596

Islet cell — tissue antigens — antibodies

AIC

71165

Isoelectric focussing and electrophoresis —characterisation of cryoglobulins

RYO

71059

Isoelectric focussing and electrophoresis —characterisation of paraprotein

PPRO

71059

Jo‑1 — tissue antigens — antibodies

JO1

71119

Keratin — tissue antigens — antibodies

KERA

71119

Kleihauer test

KLEI

65162

Lactate

LACT

66500

Lactate — dehydrogenase

LDH

66500

Lactate — dehydrogenase isoenzymes

LDI

66641

Lamellar body phospholipid

LBPH

66749

Lead

PB

66665

Lecithin/sphingomyelin ratio (amniotic fluid)

LS

66749

Legionella pneumophila — serogroup 1 — microbial antibody testing

LP1

69384

Legionella pneumophila — serogroup 2 — microbial antibody testing

LP2

69384

Leishmaniasis — microbial antibody testing

LEI

69384

Leptospira — microbial antibody testing

LEP

69384

Leucocyte count

WCC

65070

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

LMH3

71139

Leucocyte count — 3 surface markers — tissue

LMT3

71141

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

LMHT

71145

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

LM6

71143

Leucocyte count — CD34 surface marker only — blood

LMCD34

71146

Lignocaine

LIGN

66800

Lip — cytology on specimens from

SMCY

73043

Lipase

LIP

66500

Lipid studies

FATS

66500

Lipoprotein subclasses — electrophoresis

LEPG

66539

Listeria — microbial antibody testing

LIS

69384

Lithium

LI

66800

Liver function tests

LFT

66515

Liver/kidney microsomes — tissue antigens — antibodies

LKA

71119

Lupus anticoagulant

LUPA

65137, 65142, 65175–65179

Luteinizing hormone

LH

66695

Lymphocytes — functional tests — 1 test

LF1

71127

Lymphocytes — functional tests — 2 tests

LF2

71129

Lymphocytes — functional tests — 3 tests

LF3

71131

Lymphocyte — tissue antigens — antibodies

ALY

71165

Magnesium

MG

66500

Mammary serum antigen

MSA

66650

Manganese

MN

66819, 66822

Mantoux test

MANT

73811

Measles — microbial antibody testing

MEA

69384

Mercury

HG

66825, 66828

Metabolic bone disease

CBMB

66776

Metanephrines

MNEP

66779

Methadone

MTDN

66812

Methaemalbumin detection (Schumm’s test)

SCHM

65117

Methotrexate

MTTA

66812

Methsuximide

MSUX

66812

Methylphenobarbitone

MPBT

66812

Metronidazole

MRDZ

66812

Mexiletine (Mexitil)

MEX

66812

Mianserin

MIAS

66812

Microalbumin

MALB

66560

Microbial antibody testing — actinomycetes

ACT

69384

Microbial antibody testing — adenovirus

ADE

69384

Microbial antibody testing — aspergillus

ASP

69384

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

APP

69384

Microbial antibody testing — Blastomyces

BLM

69384

Microbial antibody testing — Bordetella pertussis

BOR

69384

Microbial antibody testing — Borrelia burgdorferi

BOB

69384

Microbial antibody testing — Brucella

BRU

69384

Microbial antibody testing — Campylobacter jejuni

CAM

69384

Microbial antibody testing — Candida

CAN

69384

Microbial antibody testing — Chlamydia

CHL

69384

Microbial antibody testing — Coccidioides

CCC

69384

Microbial antibody testing — Coxsackie B1‑6

COX

69384

Microbial antibody testing — Cryptococcus

CRY

69384

Microbial antibody testing — cytomegalovirus

CMV

69384

Microbial antibody testing — cytomegalovirus serology in pregnancy

CMVP

69384

Microbial antibody testing — dengue

DEN

69384

Microbial antibody testing — diphtheria

DIP

69384

Microbial antibody testing — echinococcus

ECC

69384

Microbial antibody testing — echo‑coxsackie group

ECH

69384

Microbial antibody testing — Entamoeba histolytica

AMO

69384

Microbial antibody testing — Epstein Barr virus

EBV

69472–69474

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

FTA

69384

Microbial antibody testing — Haemophilus influenzae

HUS

69384

Microbial antibody testing — herpes simplex virus

HPA

69384

Microbial antibody testing — Histoplasma

HIP

69384

Microbial antibody testing — Human Immunodeficiency Virus

 

69384

Microbial antibody testing — hydatid

HYD

69384

Microbial antibody testing — infectious mononucleosis

IM

69384

Microbial antibody testing — influenza A

FLA

69384

Microbial antibody testing — influenza B

FLB

69384

Microbial antibody testing — Legionella pneumophila — serogroup 1

LP1

69384

Microbial antibody testing — Legionella pneumophila — serogroup 2

LP2

69384

Microbial antibody testing — leishmaniasis

LEI

69384

Microbial antibody testing — Leptospira

LEP

69384

Microbial antibody testing — Listeria

LIS

69384

Microbial antibody testing — measles

MEA

69384

Microbial antibody testing — Micropolyspora faeni

MIC

69384

Microbial antibody testing — mumps

MUM

69384

Microbial antibody testing — Murray Valley encephalitis

MVE

69384

Microbial antibody testing — Mycoplasma pneumoniae

MYC

69384

Microbial antibody testing — Neisseria meningitidis

MEN

69384

Microbial antibody testing — Newcastle disease

NCD

69384

Microbial antibody testing — parainfluenza 1

PF1

69384

Microbial antibody testing — parainfluenza 2

PF2

69384

Microbial antibody testing — parainfluenza 3

PF3

69384

Microbial antibody testing — paratyphi

PTY

69384

Microbial antibody testing — pertussis

PER

69384

Microbial antibody testing — poliomyelitis

PLO

69384

Microbial antibody testing — Proteus OX 19

POX

69384

Microbial antibody testing — Proteus OXK

POK

69384

Microbial antibody testing — Q fever

QFF

69384

Microbial antibody testing — rapid plasma reagin test

RPR

69384

Microbial antibody testing — respiratory syncytial virus

RSV

69384

Microbial antibody testing — Ross River virus

RRV

69384

Microbial antibody testing — rubella

RUB

69384

Microbial antibody testing — Salmonella typhi (H)

SAH

69384

Microbial antibody testing — Salmonella typhi (O)

SAO

69384

Microbial antibody testing — Schistosoma

STO

69384

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

ADNB

69384

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

ASOT

69384

Microbial antibody testing — Streptococcus pneumoniae

PCC

69384

Microbial antibody testing — tetanus

TET

69384

Microbial antibody testing — Thermoactinomyces vulgaris

THE

69384

Microbial antibody testing — thermopolyspora

TPS

69384

Microbial antibody testing — Toxocara

TOC

69384

Microbial antibody testing — Toxoplasma

TOX

69384

Microbial antibody testing — TPHA (Treponema pallidum haemagglutination test)

TPHA

69384

Microbial antibody testing — Treponema pallidum haemagglutination test

TPHA

69384

Microbial antibody testing — trichinosis

TOS

69384

Microbial antibody testing — typhus, Weil‑Felix

TYP

69384

Microbial antibody testing — Varicella zoster

VCZ

69384

Microbial antibody testing — VDRL (Venereal Disease Research Laboratory)

VDRL

69384

Microbial antibody testing — Yersinia enterocolitica

YER

69384

Microbial antigen testing — Chlamydia

MCCH

69494

Microbial antigen testing — Clostridium difficile

CLDT

69363

Microbial antigen testing — group B streptococcus

STB

69494

Microbial antigen testing — Haemophilus influenzae

HI

69494

Microbial antigen testing — herpes simplex virus

HSV

69494

Microbial antigen testing — Neisseria gonorrhoeae

GON

69494

Microbial antigen testing — Neisseria meningitidis

NMG

69494

Microbial antigen testing — respiratory syncytial virus

RSVN

69494

Microbial antigen testing — Streptococcus pneumoniae

SPN

69494

Microbial antigen testing — Varicella zoster

VCZN

69494

Micropolyspora faeni

MIC

69384

Microscopic examination of — faeces for parasites

OCP

69336–36939

Microscopic examination of — wet film material other than blood

MWFM

69300

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

MCSW

69303

Microscopy and culture of — material from skin

MCSK

69309

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

MCPO

69321

Microscopy and culture of — specimens of sputum

MCSP

69318

Microscopy and culture of — specimens of sputum, urine or other body fluids for mycobacteria — 1 specimen

AFB1

69324

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

AFB2

69327

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

AFB3

69330

Microscopy and culture of — superficial sites

MCSS

69306

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

MCGR

69312

Microscopy and culture to detect pathogenic micro‑organisms including Chlamydia

MCCH

69494

Microscopy, culture, identification and sensitivity of urine

UMCS

69333

Mitochondria — tissue antigens — antibodies

MA

71119

Mouth — cytology on specimens from

SMCY

73043

Mumps — microbial antibody testing

MUM

69384

Murray Valley encephalitis — microbial antibody testing

MVE

69384

Mycobacteria microscopy and culture of sputum — 1 specimen

AFB 1

69324

Mycobacteria microscopy and culture of sputum — 2 specimens

AFB 2

69327

Mycobacteria microscopy and culture of sputum — 3 specimens

AFB 3

69333

Mycoplasma pneumoniae — microbial antibody testing

MYC

69384

Myoglobin

MYOG

66518

N‑acetyl procainamide

NAPC

66812

Neisseria gonorrhoeae by NAA techniques and chlamydia by any method

CHGO

69494

Neisseria gonorrhoeae — microbial antigen testing

GON

69494

Neisseria meningitidis — antigens

NMG

69494

Neisseria meningitidis — microbial antibody testing

MEN

69384

Neisseria meningitidis — microbial antigen testing

NMG

69494

Netilmicin

 

66800

Neural tube defects and Down’s syndrome

NTDD

66750, 66751

Neuron — tissue antigens — antibodies

ANE

71165

Neutrophil cytoplasm — tissue antigens — antibodies

ANCA

71165

Neutrophil functions

NFT

71135

Newcastle disease — microbial antibody testing

NCD

69384

Nickel

NI

66825, 66828

Nipple discharge — cytology on specimens from

SMCY

73043

Nitrazepam

NITR

66812

Nordothiepin

NDIP

66812

Norfluoxetine

NFLE

66812

Nortriptyline

NORT

66812

Nose — cytology on specimens from

SMCY

73043

Nose — microscopy and culture of material from

MCSW

69303

Nuclear antigens — detection of antibodies to

ANA

71097

Oestradiol

E2

66695

Oestriol

E3

66750, 66751

Oestrone

E1

66695

Oligoclonal proteins

OGP

71062

Op/biopsy specimens — microscopy and culture of material from

MCPO

69321

Oral glucose challenge test — gestational diabetes

OGCT

66545

Oral glucose tolerance test — gestational diabetes

GTTP

66542

Osmolality, serum or urine

OSML

66563

Ovary — tissue antigens — antibodies

AOV

71165

Oxalate

OXAL

66752

Oxazepam

OXAZ

66812

PAA (phenyl acetic acid)

PAA

66779

Palmitic acid in amniotic fluid

PALM

66749

Pap smear

CCR

73053

Papanicolaou test

CCR

73053

Paracetamol

PARA

66800

Parainfluenza 1 — microbial antibody testing

PF1

69384

Parainfluenza 2 — microbial antibody testing

PF2

69384

Parainfluenza 3 — microbial antibody testing

PF3

69384

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

PPRO

71059

Paraprotein characterisation — on concurrently collected serum or urine

PPSU

71060

Paraprotein quantitation — by electrophoresis

EPPI

71057

Paraquat

PARQ

66812

Parasites — microscopic examination of faeces

OCP

69336–69339

Parathyroid hormone (PTH)

PTH

66695

Parathyroid — tissue antigens — antibodies

PTHA

71165

Paratyphi — microbial antibody testing

PTY

69384

Partial thromboplastin time

PTT

65120

Patient episode initiation fees

PEI

73922–73939

Pentobarbitone

PENT

66812

Perhexiline

PHEX

66812

Pertussis — microbial antibody testing

PER

69384

Phenobarbitone

PHBA

66800

Phensuximide

PHEN

66812

Phenylacetic acid

PAA

66779

Phenytoin

PHEY

66800

Phosphate

PHOS

66500

Phosphatidylglycerol

PTGL

66749

Platelet — aggregation

PLTG

65144

Platelet — count

PLTC

65070

Platelet — tissue antigens — antibodies

APA

71165

PM‑Sc1 — tissue antigens — antibodies

PM1

71119

Poliomyelitis — microbial antibody testing

PLO

69384

Porphobilinogen in urine

UPG

66782

Porphyrins in urine — qualitative test

UPR

66782

Porphyrins — quantitative test, 1 or more fractions

PR

66785

Potassium

K

66500

Prealbumin

PALB

66632

Prednisolone

PRED

66812

Pregnancy serology — 1 test

MSP1

69405

Pregnancy serology — 2 tests

MSP2

69408

Pregnancy serology — 3 tests

MSP3

69411

Pregnancy serology — 4 tests

MSP4

69413

Pregnancy testing

 

73806

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

NTDD

66750, 66751

Pregnancy testing — HCG detection

HCG

73527, 73529

Pregnancy testing — HCG quantitation

HCG

73529

Primidone

PRIM

66800

Procainamide

PCAM

66800

Progesterone

PROG

66695

Prolactin

PROL

66695

Propranolol

PPNO

66812

Prostate specific antigen

PSA

66655–66659

Protein — C

PROC

65142, 65171, 65175–65179

Protein — S

PROS

65142, 65171, 65175–65179

Protein, quantitation of — alpha fetoprotein

AFP

66650–66653, 66743, 66750, 66751

Protein, quantitation of — alpha‑l‑antitrypsin

AAT

66635

Protein, quantitation of — beta‑2‑microglobulin

BMIC

66629

Protein, quantitation of — C‑l esterase inhibitor

CEI

66644

Protein, quantitation of — caeruloplasmin

CPLS

66632

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

EPPI

71057, 71058

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

FERR

66593

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

NTDD

66750, 66751

Protein, quantitation of — haptoglobins

HGLB

66632

Protein, quantitation of — microalbumin

MALB

66560

Protein, total — quantitation of

PROT

66500

Proteus OX 19 — microbial antibody testing

POX

69384

Proteus OXK — microbial antibody testing

POK

69384

Prothrombin gene mutation

PGM

73308, 73311

Prothrombin time

PT

65120

Pyruvate

PVTE

66500

Q fever — microbial antibody testing

QFF

69384

Quinalbarbitone

QUIB

66812

Quinidine

QUIN

66800

Quinine

QNN

66812

Rapid plasma reagin test — microbial antibody testing

RPR

69384

RAST

RAST

71079

Rectum — microscopy and culture of material from

MCGR

69312

Red blood cells — Kleihauer

KLEI

65162

Red cell folate and serum B12

B12F

66602

Red cell folate and serum B12 and serum folate if required

B12F

66602

Red cell folate and serum folate

RCF

66599

Red cell porphyrins — qualitative test

RCP

66782

Referred specimen fee

 

73940

Renin

REN

66695

Reptilase test

REPT

65120

Respiratory syncytial virus — microbial antibody testing

RSV

69384

Respiratory syncytial virus — microbial antigen testing

RSVN

69494

Reticulin — tissue antigens — antibodies

RCA

71119

Reticulocyte count

RETC

65072

Rheumatoid factor

RF

71106

Rheumatoid factor — quantitation

RFQ

71106

Ross River virus — microbial antibody testing

RRV

69384

RSV (respiratory syncytial virus) — microbial antibody testing

RSV

69384

RSV (respiratory syncytial virus) — microbial antigen testing

RSVN

69494

Rubella — serology

RUB

69384

Salicylate (aspirin)

SALI

66800

Salivary gland — tissue antigens — antibodies

ASG

71165

Salmonella typhi (H) — microbial antibody testing

SAH

69384

Salmonella typhi (O) — microbial antibody testing

SAO

69384

Schistosoma — microbial antibody testing

STO

69384

Scl‑70 — tissue antigens — antibodies

SCL

71119

Selenium

SE

66819, 66822

Semen examination

SEE

73523

Semen examination — for spermatozoa (post vasectomy)

SES

73521

Serology — in pregnancy (see Pregnancy serology)

 

 

Serotonin

5HT

66779

Serum — B12

B12

66599

Serum — folate (with B12)

B12

66599

Serum — folate (with B12 red cell folate)

B12F

66602

Sex hormone binding globulin

SHBG

66695

Skeletal muscle — tissue antigens — antibodies

SLA

71165

Skin — cytology

SMCY

73043

Skin — microscopy and culture of material from

MCSS

69306

Skin — microscopy, culture and Chlamydia of material from

MCSK

69309

Skin basement membrane — tissue antigens — antibodies

SKA

71165

Smooth muscle — tissue antigens — antibodies

SMA

71119

Snake venom

HISS

66623

Sodium

NA

66500

Solid tissue or tissues — chemical assays

ENZS

66683

Solid tissue or tissues — cytology of fine needle aspiration

FNCY

73049

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

FNCP

73051

Somatomedin

SOMA

66695

Sotalol

SALL

66812

Specific IgE or IgG antibodies

RAST

71079

Specimen referred fee

 

73940

Sperm antibodies

SAB

73525

Sperm antibodies — penetrating ability

SPA

73525

Sputum — cytology (1 specimen)

BFCY

73045

Sputum — cytology (3 specimens)

SPCY

73047

Sputum — for mycobacteria — 1 specimen

AFB1

69324

Sputum — for mycobacteria — 2 specimens

AFB2

69327

Sputum — for mycobacteria — 3 specimens

AFB3

69330

Sputum — microscopy and culture of specimens

MCSP

69318

Stelazine

STEL

66812

Steroid fraction or fractions in urine

USF

66695

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

ADNB

69384

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

ASOT

69384

Streptococcus — Group B

STB

69494

Streptococcus pneumoniae — CSF antigens

SPN

69494

Streptococcus pneumoniae — microbial antibody testing

PCC

69384

Streptococcus pneumoniae — microbial antigen testing

SPN

69494

Strontium

SR

66825, 66828

Stypven test

STYP

65120

Sugar water test

SWT

65075

Sulthiame (Ospolot)

SUL

66812

Supplementary testing for Hepatitis C antibodies

HCST

69441

Syphilis serology

STS

69387

Testosterone

TES

66695

Tetanus — microbial antibody testing

TET

69384

Thalassaemia studies

TS

65078

Theophylline

THEO

66800

Thermoactinomyces vulgaris — microbial antibody testing

THE

69384

Thermopolyspora — microbial antibody testing

TPS

69384

Thiopentone

TOPO

66812

Thioridazine

THIO

66812

Throat — microscopy and culture of material from

MCSW

69303

Thrombin time

TT

65120

Thrombophilia testing (see individual thrombophilia tests)

 

 

Thyroglobulin

TGL

66650

Thyroglobulin — tissue antigens — antibodies

ATG

71165

Thyroid function tests (including TSH)

TFT

66719

Thyroid microsome — tissue antigens — antibodies

TMA

71165

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

TSH

66716

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

TSH

66722–66734

Tissue transglutaminase antibodies

TTG

71163

Tobramycin

 

66800

Total protein

PROT

66500

Toxocara — microbial antibody testing

TOC

69384

Toxoplasma — microbial antibody testing

TOX

69384

TPHA (Treponema pallidum haemagglutination test) — microbial antibody testing

TPHA

69384

Treponema pallidum haemagglutination test — microbial antibody testing

TPHA

69384

Trichinosis — microbial antibody testing

TOS

69384

Triglycerides

TRIG

66500

Trimipramine

TRIM

66812

Troponin

TROP

66518

Tryptic activity in faeces

TAF

66677

TSH receptor antibody test — tissue antigens — antibodies

TSHA

71165

Tuberculosis

MANT

73811

Tumour markers — CA‑15.3 antigen

CA15

66650

Tumour markers — CA‑19.9 antigen

CA19

66650

Tumour markers — CA‑125 antigen

C125

66650

Tumour markers — carcinoembryonic antigen

CEA

66650

Tumour markers — mammary serum antigen

MSA

66650

Tumour markers — prostate specific antigen

PSA

66656

Tumour markers — prostatic acid phosphatase — 1 or more fractions

ACP

66656

Tumour markers — thyroglobulin

TGL

66650

Typhus, Weil‑Felix — microbial antibody testing

TYP

69384

Urate

URAT

66500

Urea 

U

66500

Urea, electrolytes, creatinine

U&E

66515

Urethra — microscopy and culture of material from

MCGR

69312

Urine — acidification test

UAT

66587

Urine — catalase test

UCAT

73805

Urine — cystine (cysteine)

UCYS

66782

Urine — cytology — on 1 specimen

BFCY

73045

Urine — cytology — on 3 specimens

SPCY

73047

Urine — haemoglobin

UHB

66782

Urine — microscopy, culture, identification and sensitivity

UMCS

69333

Urine — porphobilinogen

UPG

66782

Urine — porphyrins — qualitative test

UPR

66782

Urine — steroid fraction or fractions

USF

66695

Urine — urobilinogen

UUB

66782

Vagina — cytology on specimens from

CVO

73057

Vagina — microscopy and culture of material from

MCGR

69312

Valproate (Epilim)

VALP

66800

Vancomycin

VAN

66800

Varicella zoster — microbial antibody testing

VCZ

69384

Varicella zoster — microbial antigen testing

VCZN

69494

Vasoactive intestinal peptide

VIP

66695

Vasopressin

ADH

66695

VDRL (Venereal Disease Research Laboratory) — microbial antibody testing

VDRL

69384

Viscosity of blood or plasma

VISC

65060

Vitamins — B12

B12

66599

Vitamins — D

VITD

66608

Vitamins — folate

RCF

66599

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

VIT

66605

VMA (see HMMA)

 

 

Von Willebrand’s factor

VWF

65150

Von Willebrand’s factor antigen

VWA

65150

Warfarin

WFR

66812

Yersinia enterocolitica — microbial antibody testing

YER

69384

Zinc

ZN

66667–66670

Part 4          Complexity levels for histopathology items

Specimen type

Complexity level

Adrenal resection, neoplasm

5

Adrenal resection, not neoplasm

4

Anus, all specimens not otherwise specified

3

Anus, neoplasm, biopsy

4

Anus, neoplasm, radical resection

6

Anus, submucosal resection — neoplasm

5

Appendix

3

Artery, all specimens not otherwise specified

3

Artery, biopsy

4

Bartholin’s gland — cyst

3

Bile duct, resection — all specimens

6

Bone — all specimens not otherwise specified

4

Bone, biopsy, curettings or fragments — lesion

5

Bone, biopsy or curettings quantitation — metabolic disease

6

Bone, femoral head

4

Bone, resection, neoplasm — all sites and types

6

Bone marrow, biopsy

4

Brain neoplasm, resection — cerebello‑pontine angle

4

Brain or meninges, biopsy — all lesions

5

Brain or meninges, not neoplasm — temporal lobe

6

Brain or meninges, resection — neoplasm (intracranial)

5

Brain or meninges, resection — not neoplasm

4

Branchial cleft, cyst

4

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

6

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

6

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

4

Breast, microdochectomy

6

Breast, orientated wide local excision for carcinoma with margin assessment

7

Breast tissue — all specimens not otherwise specified

4

Bronchus, biopsy

4

Carotid body — neoplasm

5

Cholesteatoma

3

Digits, amputation — not traumatic

4

Digits, amputation — traumatic

2

Ear, middle and inner — not cholesteatoma

4

Endocrine neoplasm — not otherwise specified

5

Extremity, amputation — not otherwise specified

4

Extremity, amputation or disarticulation — neoplasm

6

Eye, conjunctiva — biopsy or pterygium

3

Eye, cornea

4

Eye, enucleation or exenteration — all lesions

6

Eye — not otherwise specified

4

Fallopian tube, biopsy

4

Fallopian tube, ectopic pregnancy

4

Fallopian tube, sterilization

2

Fetus with dissection

6

Foreskin — new born

2

Foreskin — not new born

3

Gallbladder

3

Gallbladder and porta hepatis‑radical resection

6

Ganglion cyst, all sites

3

Gum or oral mucosa, biopsy

4

Heart — not otherwise specified

5

Heart valve

4

Hernia sac

2

Hydrocele sac

2

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

6

Joint and periarticular tissue, without bone — all specimens

3

Joint tissue, including bone — all specimens

4

Kidney, biopsy including transplant

5

Kidney, nephrectomy transplant

5

Kidney, partial or total nephrectomy — not neoplasm

4

Kidney, partial or total nephrectomy or nephroureterectomy — neoplasm

6

Large bowel, colostomy — stoma

3

Large bowel (including rectum), biopsy — all sites

4

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

5

Large bowel (including rectum), polyp

4

Large bowel (including rectum), segmental resection — neoplasm

6

Large bowel (including rectum), submucosal resection — neoplasm

5

Large bowel, segmental resection — colon, not neoplasm

5

Larynx, biopsy

4

Larynx, partial or total resection

5

Larynx, resection with nodes or pharynx or both

6

Lip biopsy — all specimens not mentioned

3

Lip wedge resection or local excision with orientation

4

Liver — all specimens not otherwise specified

5

Liver, hydatid cyst or resection for trauma

4

Liver, total or subtotal hepatectomy — neoplasm

6

Lung, needle or transbronchial biopsy

4

Lung, resection — neoplasm

6

Lung segment, lobar or total resection

6

Lung, wedge biopsy

5

Lymph node, biopsy — all sites

4

Lymph node, biopsy, for lymphoma or lymphoproliferative disorder

5

Lymph nodes, regional resection — all sites

5

Mediastinum mass

5

Muscle, biopsy

6

Nasopharynx or oropharynx, biopsy

4

Nerve, biopsy neuropathy

5

Nerve, neurectomy or removal of neoplasm

4

Nerve — not otherwise specified

3

Nose, mucosal biopsy

4

Nose or sinuses, polyps

3

Odontogenic neoplasm

5

Odontogenic or dental cyst

4

Oesophagus, biopsy

4

Oesophagus, diverticulum

3

Oesophagus, partial or total resection

6

Oesophagus, submucosal resection — neoplasm

5

Omentum, biopsy

4

Ovary with or without tube — neoplasm

5

Ovary with or without tube — not neoplasm

4

Pancreas, biopsy

5

Pancreas, cyst

4

Pancreas, subtotal or total with or without splenectomy

6

Parathyroid gland(s)

4

Penisectomy — simple

4

Penisectomy with node dissection

5

Peritoneum, biopsy

4

Pituitary neoplasm

4

Placenta — not third trimester

4

Placenta — third trimester, abnormal pregnancy or delivery

4

Pleura or pericardium, biopsy or tissue

4

Products of conception, spontaneous or missed abortion

4

Products of conception, termination of pregnancy

3

Prostate — all types of specimen not otherwise specified

4

Prostate, radical prostatectomy or cystoprostatectomy for carcinoma

7

Prostate, radical resection

6

Retroperitoneum, neoplasm

5

Salivary gland — all specimens not otherwise specified

4

Salivary gland, Mucocele

3

Salivary gland, neoplasm — all sites

5

Sinus, paranasal, biopsy

4

Sinus, paranasal, resection — neoplasm

6

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

3

Skin, biopsy — blistering skin diseases

4

Skin, biopsy — inflammatory dermatosis

4

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

5

Skin, biopsy — investigation of lymphoproliferative disorder

5

Skin, eyelid, wedge resection

4

Skin, local resection — orientation

4

Skin, resection of malignant melanoma or melanoma in situ

5

Small bowel — all specimens not otherwise specified

5

Small bowel — biopsy, all sites

4

Small bowel, diverticulum

3

Small bowel, resection — neoplasm

6

Small bowel, submucosal resection — neoplasm

5

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

6

Soft tissue, lipoma and variants

3

Soft tissue, neoplasm, not lipoma — all specimens

5

Soft tissue — not otherwise specified

4

Spleen

5

Stomach — all specimens not otherwise specified

4

Stomach, endoscopic biopsy or endoscopic polypectomy

4

Stomach, resection, neoplasm — all specimens

6

Stomach, submucosal resection — neoplasm

5

Tendon or tendon sheath, giant cell neoplasm

4

Tendon or tendon sheath — not otherwise specified

3

Testis and adjacent structures, castration

2

Testis and adjacent structures, neoplasm with or without nodes

5

Testis and adjacent structures — not otherwise specified

3

Testis and adjacent structures, vas deferens sterilization

2

Testis, biopsy

5

Thymus — not otherwise specified

5

Thyroglossal duct — all lesions

4

Thyroid — all specimens

5

Tissue or organ — all specimens not otherwise specified

3

Tissue or organ not otherwise specified, abscess

3

Tissue or organ not otherwise specified, haematoma

3

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

6

Tissue or organ not otherwise specified, neoplasm local

4

Tissue or organ not otherwise specified, pilonidal cyst or sinus

3

Tissue or organ not otherwise specified, thrombus or embolus

3

Tissue or organ not otherwise specified, veins varicosity

3

Tongue, biopsy

4

Tongue or tonsil, neoplasm local

5

Tongue or tonsil, neoplasm with nodes

6

Tonsil, biopsy — excluding resection of whole organ

4

Tonsil or adenoids or both

2

Trachea, biopsy

4

Ureter, biopsy

4

Ureter, resection

5

Urethra, biopsy

4

Urethra, resection

5

Urinary bladder — all specimens not otherwise specified

4

Urinary bladder, partial or total with or without prostatectomy

6

Urinary bladder, transurethral resection of neoplasm

5

Uterus and/or cervix — all specimens not otherwise specified

4

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

5

Uterus, cervix, curettings or biopsy

4

Uterus, endocervix, polyp

3

Uterus, endometrium, polyp

3

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

6

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

6

Vagina, biopsy

4

Vaginal mucosa, incidental

3

Vagina, radical resection

6

Vulva or labia, biopsy

4

Vulval, subtotal or total with or without nodes

6


Dictionary

  

abnormal level of TSH for item 66719 — see clause 2.2.5 of Schedule 1.

Act means the Health Insurance Act 1973.

approved collection centre for Group P10 — see clause 2.10.1 of Schedule 1.

ASGC for item 74991 — see clause 2.12.1 of Schedule 1.

biopsy material for Group P5 — see clause 2.5.1 of Schedule 1.

bulk‑billed for items 74990 and 74991 — see clause 2.12.1 of Schedule 1.

Commonwealth concession card holder for items 74990 and 74991 — see clause 2.12.1 of Schedule 1.

compatibility tests by crossmatch for items 65099 and 65102 — see clause 2.1.2 of Schedule 1.

cytology for Group P5 — see clause 2.5.1 of Schedule 1.

designated test — see clause 1.2.4 of Schedule 1.

elevated serum ferritin for items 73317 and 73318 — see clause 2.7.1 of Schedule 1.

general practitioner — see clause 1.2.7 of Schedule 1.

Group, for a Group in the table, means every item in the Group.

Hepatitis C sero‑positive for items 69499 and 69500 — see clause 2.3.5 of Schedule 1.

item means:

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

                          (i)    Schedule 1; or

                         (ii)    Schedule 1 to the diagnostic imaging services table; or

                        (iii)    Schedule 1 to the general medical services table; and

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

institution for Groups P10 — see clause 2.10.1 of Schedule 1.

metal toxicity testing group — see clause 2.2.7 of Schedule 1.

nutritional metals testing group — see clause 2.2.7 of Schedule 1.

patient episode means:

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

                          (i)    on the same day; or

                         (ii)    if more than 1 test is performed on the 1 specimen within 14 days — on the same or different days;

                        whether the services:

                        (iii)    are requested by 1 or more practitioners, participating midwives or participating nurse practitioners; or

                        (iv)    are described in a single item or in more than 1 item; or

                         (v)    are rendered by 1 approved pathology practitioner or more than 1 approved pathology practitioner; or

                        (vi)    are rendered on the same or different days; or

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

practice location for item 74991 — see clause 2.12.1 of Schedule 1.

prescribed laboratory for Groups P10 — see clause 2.10.1 of Schedule 1.

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

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

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

recognised pathologist means:

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

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

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

                (a)    has been requested to render 1 or more designated tests; and

               (b)    is unable, because of the lack of facilities in, or expertise or experience of the staff of, the laboratory of the authority, to render 1 or more of the tests included in the designated test; and

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

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

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

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

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

residential care facility for Groups P10 — see clause 2.10.1 of Schedule 1.

Rural, Remote and Metropolitan Areas Classification for item 74991 — see clause 2.12.1 of Schedule 1.

separately identified specimen for Group P5 — see clause 2.5.1 of Schedule 1.

serial examinations means a series of 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 or cultures were requested on 1 or more request forms by the treating practitioner.

serial examinations or cultures for Group P3 — see clause 2.3.1 of Schedule 1.

serological status is uncertain for items 69499 and 69500 — see clause 2.3.5 of Schedule 1.

set of pathology services — see clause 1.2.7 of Schedule 1.

SLA for item 74991 — see clause 2.12.1 of Part 2 to Schedule 1.

specimen collection centre for Groups P10 — see clause 2.10.1 of Schedule 1.

SSD for item 74991 — see clause 2.12.1 of Schedule 1.

Subgroup, for a Subgroup in the table, means every item in the Subgroup.

treating practitioner for Group P10 — see clause 2.10.1 of Schedule 1.

unreferred service for items 74990 and 74991 — see clause 2.12.1 of Schedule 1.


Notes to the Health Insurance (Pathology Services Table) Regulations 2011

Note 1

The Health Insurance (Pathology Services Table) Regulations 2011 (in force under the Health Insurance Act 1973) as shown in this compilation comprise Select Legislative Instrument 2011 No. 188 amended as indicated in the Tables below.

Table of Instruments

Year and
Number

Date of FRLI registration

Date of
commencement

Application, saving or
transitional provisions

2011 No. 188

26 Oct 2011 (see F2011L02126)

1 Nov 2011

 

2012 No. 58

20 Apr 2012 (see F2012L00907)

1 May 2012

Table of Amendments

ad. = added or inserted      am. = amended      rep. = repealed      rs. = repealed and substituted

Provision affected

How affected

Schedule 1

 

Part 2

 

C. 2.6.1................................

am. 2012 No. 58

C. 2.10.1.............................

am. 2012 No. 58

Note to c. 2.10.1 (7)..........

rep. 2012 No. 58