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Determinations/Health as amended, taking into account amendments up to Health Insurance (Section 3C Pathology Services – Archival Tissue Retrieval) Amendment Determination 2019
Administered by: Health
Registered 05 Nov 2019
Start Date 01 Nov 2019

Commonwealth Coat of Arms of Australia

Health Insurance (Section 3C Pathology Services – Archival Tissue Retrieval) Determination 2019

made under subsection 3C(1) of the

Health Insurance Act 1973

Compilation No. 1

Compilation date:                           1 November 2019

Includes amendments up to:         F2019L01320

Registered:                                      5 November 2019

 

About this compilation

This compilation

This is a compilation of the Health Insurance (Section 3C Pathology Services – Archival Tissue Retrieval) Determination 2019 that shows the text of the law as amended and in force on 1 November 2019 (the compilation date).

The notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.

Uncommenced amendments

The effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Legislation Register (www.legislation.gov.au). The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the series page on the Legislation Register for the compiled law.

Application, saving and transitional provisions for provisions and amendments

If the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.

Editorial changes

For more information about any editorial changes made in this compilation, see the endnotes.

Modifications

If the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the series page on the Legislation Register for the compiled law.

Self-repealing provisions

If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.

  

  

  


Contents

1.      Name  1

3.      Authority  1

4.      Definitions  1

5.      Treatment of relevant services  1

6.      Application of item 72860  2

7.      Limitation of item 72860  2

Schedule 1 – relevant services  3

Endnotes  4

Endnote 1—About the endnotes                     4

Endnote 2—Abbreviation Key                                                                        5

Endnote 3—Legislation history  6

Endnote 4—Amendment history                                                                      7

 


1.      Name

This Determination is the Health Insurance (Section 3C Pathology Services – Archival Tissue Retrieval) Determination 2019.

3.      Authority 

This Determination is made under subsection 3C(1) of the Health Insurance Act 1973.

4.      Definitions

(1)               In this Determination:

Act means the Health Insurance Act 1973.

biopsy material has the meaning given by clause 2.5.1 of the pathology services table.

relevant provisions means all provisions, of the Act and regulations made under the Act, and the National Health Act 1953 and regulations made under the National Health Act 1953, relating to medical services, professional services or items.

relevant service means a health service, as defined in subsection 3C(8) of the Act, that is specified in the Schedule.

Schedule means the Schedule to this Determination.

Note:       The following terms are defined in subsection 3(1) of the Act:

·     accredited pathology laboratory

·     approved pathology authority

·     clinically relevant service

·     item

·     pathology services table

·     professional service

 (2)       Unless the contrary intention appears, a reference in this Determination to a provision of the Act or the National Health Act 1953 or regulations made under the Act or under the National Health Act 1953 as applied, adopted or incorporated in relation to specifying a matter is a reference to those provisions as in force from time to time and any other reference to provisions of an Act or regulations is a reference to those provisions as in force from time to time.

5.      Treatment of relevant services

                   For subsection 3C(1) of the Act a relevant service, provided in accordance with this Determination and as a clinically relevant service, is to be treated, for the relevant provisions, as if:

(a)          it were both a professional service and a pathology service; and

(b)          there were an item the pathology services table that:

(i)           related to the service; and

(ii)          specified for the service a fee in relation to each State, being the fee specified in the Schedule in relation to the service.

6.      Application of item 72860

 

(1)        For any particular patient, item 72860 is applicable if:

(a)          the treating practitioner has requested one or more services in Groups P5 (other than item 72860), P6 or P7 of the pathology services table for a patient; and

(b)          one or more of the services in paragraph (a) are rendered as part of the patient episode (the ‘initial patient episode’); and

(c)          on the basis of information learned from the rendered service, the treating practitioner determines that a genetic test in Group P7 of the pathology services table is clinically necessary for that patient; and

(d)          the treating practitioner requests:

(i)           one or more genetic tests (the ‘subsequent test(s)’) in Group P7 of the pathology services table; and

(ii)          item 72860;

in a patient episode (the ‘subsequent patient episode’).

 

(2)        Item 72860 is applicable if:

(a)          tissue material is collected for the initial patient episode; and

(b)          the material is biopsy material or samples submitted for cytology, from which a tissue block is prepared; and

(c)          the material is archived in formalin fixed paraffin embedded block.

7.      Limitation of item 72860

 

(1)        Item 72860 does not apply if the service is performed in the accredited pathology laboratory in which the subsequent genetic test(s) is performed.

(2)        Item 72860 does not apply if the service is performed in association with:

(a)          a service to which item 72858 or 72859 of the pathology services table applies; or

(b)          a service to which an item in Groups P6, P10 or P11 of the pathology services table applies, as part of the subsequent patient episode.

(3)        For any particular patient, item 72860 is applicable for a maximum of one retrieval per subsequent patient episode.

 


 

Schedule 1 – relevant services

 

Group P5—Tissue pathology

Item

Service

Fee ($)

72860

Retrieval and review of archived formalin fixed paraffin embedded block(s) to determine the appropriate sample(s) for the purpose of conducting genetic testing

85.00

 


Endnotes

Endnote 1—About the endnotes

The endnotes provide information about this compilation and the compiled law.

The following endnotes are included in every compilation:

Endnote 1—About the endnotes

Endnote 2—Abbreviation key

Endnote 3—Legislation history

Endnote 4—Amendment history

Abbreviation key—Endnote 2

The abbreviation key sets out abbreviations that may be used in the endnotes.

Legislation history and amendment history—Endnotes 3 and 4

Amending laws are annotated in the legislation history and amendment history.

The legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.

The amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.

Editorial changes

The Legislation Act 2003 authorises First Parliamentary Counsel to make editorial and presentational changes to a compiled law in preparing a compilation of the law for registration. The changes must not change the effect of the law. Editorial changes take effect from the compilation registration date.

If the compilation includes editorial changes, the endnotes include a brief outline of the changes in general terms. Full details of any changes can be obtained from the Office of Parliamentary Counsel.

Misdescribed amendments

A misdescribed amendment is an amendment that does not accurately describe the amendment to be made. If, despite the misdescription, the amendment can be given effect as intended, the amendment is incorporated into the compiled law and the abbreviation “(md)” added to the details of the amendment included in the amendment history.

If a misdescribed amendment cannot be given effect as intended, the abbreviation “(md not incorp)” is added to the details of the amendment included in the amendment history.

 

Endnote 2—Abbreviation key

 

ad = added or inserted

o = order(s)

am = amended

Ord = Ordinance

amdt = amendment

orig = original

c = clause(s)

par = paragraph(s)/subparagraph(s)

C[x] = Compilation No. x

    /sub‑subparagraph(s)

Ch = Chapter(s)

pres = present

def = definition(s)

prev = previous

Dict = Dictionary

(prev…) = previously

disallowed = disallowed by Parliament

Pt = Part(s)

Div = Division(s)

r = regulation(s)/rule(s)

ed = editorial change

reloc = relocated

exp = expires/expired or ceases/ceased to have

renum = renumbered

    effect

rep = repealed

F = Federal Register of Legislation

rs = repealed and substituted

gaz = gazette

s = section(s)/subsection(s)

LA = Legislation Act 2003

Sch = Schedule(s)

LIA = Legislative Instruments Act 2003

Sdiv = Subdivision(s)

(md) = misdescribed amendment can be given

SLI = Select Legislative Instrument

    effect

SR = Statutory Rules

(md not incorp) = misdescribed amendment

Sub‑Ch = Sub‑Chapter(s)

    cannot be given effect

SubPt = Subpart(s)

mod = modified/modification

underlining = whole or part not

No. = Number(s)

    commenced or to be commenced

 

Endnote 3—Legislation history

 

Name

Registration

Commencement

Application, saving and transitional provisions

Health Insurance (Section 3C Pathology Services – Archival Tissue Retrieval) Determination 2019

10 Apr 2019 (F2019L00600)

1 May 2019 (s 2(1) item 1)

 

Health Insurance (Section 3C Pathology Services – Archival Tissue Retrieval) Amendment Determination 2019

10 Oct 2019 (F2019L01320)

1 Nov 2019 (s 2(1) item 1)

 

Endnote 4—Amendment history

 

Provision affected

How affected

s 2.............................................

rep LA s 48D

s 7.............................................

am F2019L01320