Federal Register of Legislation - Australian Government

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Determinations/Health as made
This instrument amends the Health Insurance (Pathologist-determinable Services) Determination 2015 to include a reference to three pathology items for the detection of Chlamydia trachomatis (69316, 69317, and 69319), two pathology items for viral respiratory pathology tests where the service is referred to a laboratory that did not receive the original request (69497 and 69498), twenty new items for genetic testing of somatic markers for the diagnosis and classification of tumours (73364 to 73383), and one pathology item for archival tissue retrieval and review (72860).
Administered by: Health
Registered 29 Apr 2020
Tabling HistoryDate
Tabled HR12-May-2020
Tabled Senate12-May-2020
Date of repeal 02 Sep 2020
Repealed by Division 1 of Part 3 of Chapter 3 of the Legislation Act 2003
Table of contents.

Commonwealth Coat of Arms of Australia

 

Health Insurance (Pathologist-determinable Services) Amendment Determination (No. 2) 2020

I, RENAYE LUCCHESE, delegate of the Minister for Health, make the following Determination.

Dated   23 April 2020

Renaye Lucchese

Acting Assistant Secretary

Diagnostic Imaging and Pathology Branch

Medical Benefits Division

Health Financing Group

Department of Health

 

 

 


Contents

1  Name........................................................................................................................................ 1

2  Commencement........................................................................................................................ 1

3  Authority.................................................................................................................................. 1

4  Schedules................................................................................................................................. 1

Schedule 1— Amendments................................................................................................... 2

 

 


1  Name

                        This instrument is the Health Insurance (Pathologist-determinable Services) Amendment Determination (No. 2) 2020.

2  Commencement

(1)       Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.

 

Commencement information

Column 1

Column 2

Column 3

Provisions

Commencement

Date/Details

1.  The whole of this instrument

1 May 2020

 

                Note:        This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.

(2)       Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.

3  Authority

                        This instrument is made under subsection 4BA of the Health Insurance Act 1973.

4  Schedules

                        Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.


 

Schedule 1— Amendments

Health Insurance (Pathologist-determinable Services) Determination 2015

 

1.      Subsection 5(b)(iii) (table)

Repeal and replace:

Item

Column 1

Pathology service

Column 2

Originally requested service

1

72846, 72847, 72848, 72849, 72850, 72851, 72852, 73332, 73336, 73337, 73341, 73342, 73344, 73364, 73365, 73366, 73367, 73368, 73369, 73370, 73371, 73372, 73373, 73374, 73375, 73376, 73377, 73378, 73379, 73380, 73381, 73382, 73383

72813, 72816, 72817, 72818, 72823, 72824, 72825, 72826, 72827, 72828, 72830, 72836, 72838

2

73059, 73060, 73061

73045, 73047, 73049, 73051

3

73305

73300

4

73320

71147

5

66839

66838

Note: Items 72860, 73332, 73336, 73337, 73341, 73342 and 73344 are specified in a determination made under subsection 3C(1) of the Act.

 

2.      Paragraph 5(c)

Repeal and replace:

(c)     a pathology service that is mentioned in items 69316, 69317, 69319, 69494, 69495, 69496, 69497 or 69498 of the pathology services table and:

                          (i)    is rendered, by or on behalf of, an approved pathology practitioner who is a recognised pathologist; and

                         (ii)    is a service that the approved pathology practitioner determines to be necessary on the basis of:

(A)   information provided by a treating practitioner in relation to a pathology service mentioned in items 69303, 69306, 69312, 69318, 69321 or 69345 of the pathology services table, that was rendered to the patient by, or on behalf of, the approved pathology practitioner pursuant to a request that complied with paragraph 16A(4)(a) or (b) of the Act; or

(B)   the nature or appearance of the pathology specimen collected for a pathology service mentioned in items 69303, 69306, 69312, 69318, 69321 or 69345 of the pathology services table, that was rendered to the patient by, or on behalf of, the approved pathology practitioner pursuant to a request that complied with paragraph 16A(4)(a) or (b) of the Act; or

(C)   information learned from a pathology service mentioned in items 69303, 69306, 69312, 69318, 69321 or 69345 of the pathology services table, that was rendered to the patient by, or on behalf of, the approved pathology practitioner pursuant to a request that complied with paragraph 16A(4)(a) or (b) of the Act.

 

3.      Section 5 (after paragraph 5(c))

Insert:

(d)     a pathology service that is mentioned in item 72860, which is specified in a determination made under subsection 3C(1) of the Act and:

(i)                 An initial service that is described in an item in Group P5 (other than item 72860), P6 or P7 of the pathology services table was rendered in a patient episode for the patient by, or on behalf of, the approved pathology practitioner pursuant to a request that complied with paragraph 16A(4) (a) or (b) of the Act; and

(ii)               Following the initial service, the treating practitioner determines that a service described in an item in Group P7 (the subsequent P7 service) is clinically necessary; and

(iii)             following a request from the treating practitioner, the pathologist who rendered the initial service, determines they are unable to perform the subsequent P7 service and consequently determines a service described under item 72860 is required to select appropriate tissue samples for referral to a different accredited pathology laboratory for performance of the subsequent P7 service; and

(iv)             the subsequent P7 service and a service under item 72860 are rendered in a different accredited pathology laboratory, by or on behalf of, an approved pathology practitioner who is a recognised pathologist.