Health Insurance Legislation Amendment (2015 Measures No. 1) Regulation 2015

 

Select Legislative Instrument No. 143, 2015

I, General the Honourable Sir Peter Cosgrove AK MC (Ret’d), GovernorGeneral of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following regulation.

Dated 20 August 2015

Peter Cosgrove

GovernorGeneral

By His Excellency’s Command

Sussan Ley

Minister for Health

 

 

 

Contents

1 Name

2 Commencement

3 Authority

4 Schedules

Schedule 1—Amendments

Health Insurance (Diagnostic Imaging Services Table) Regulation 2015

Health Insurance (General Medical Services Table) Regulation 2015

Health Insurance (Pathology Services Table) Regulation 2015

1  Name

  This is the Health Insurance Legislation Amendment (2015 Measures No. 1) Regulation 2015.

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 September 2015.

1 September 2015

Note: This table relates only to the provisions of this instrument as originally made.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 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  Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.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 1Amendments

 

Health Insurance (Diagnostic Imaging Services Table) Regulation 2015

1  Schedule 1 (items 56552 and 56554)

Repeal the items, substitute:

 

56553

Computed tomography—scan of colon for exclusion or diagnosis of colorectal neoplasia in a symptomatic or high risk patient if:

(a) one or more of the following applies:

(i) the patient has had an incomplete colonoscopy in the 3 months before the scan;

(ii) there is a highgrade colonic obstruction;

(iii) the patient is referred by a specialist or consultant physician who performs colonoscopies in the practice of his or her speciality; and

(b) the service is not a service to which item 56301, 56307, 56401, 56407, 56409, 56412, 56501, 56507, 56801, 56807 or 57001 applies; and

(c) the service has not been performed on the patient in the 36 months before the scan (R) (K) (Anaes.)

520.00

56555

Computed tomography—scan of colon for exclusion or diagnosis of colorectal neoplasia in a symptomatic or high risk patient if:

(a) one or more of the following applies:

(i) the patient has had an incomplete colonoscopy in the 3 months before the scan;

(ii) there is a highgrade colonic obstruction;

(iii) the patient is referred by a specialist or consultant physician who performs colonoscopies in the practice of his or her speciality; and

(b) the service is not a service to which item 56301, 56307, 56401, 56407, 56409, 56412, 56501, 56507, 56801, 56807 or 57001 applies; and

(c) the service has not been performed on the patient in the 36 months before the scan (R) (NK) (Anaes.)

260.00

 

Health Insurance (General Medical Services Table) Regulation 2015

2  Clause 1.2.7 of Schedule 1

Omit “10943”, substitute “10948”.

3  Subclause 1.2.8(1) of Schedule 1

After “11721,”, insert “11725, 11726,”.

4  Subclause 2.16.14(4) of Schedule 1

After “Practice nurses”, insert “, Aboriginal health workers”.

5  Clause 2.18A.2 of Schedule 1

Omit “service if”, substitute “facility where”.

6  Subclause 2.28.4(1) of Schedule 1

Omit “the table”, substitute “Subgroup 1 of Group A10”.

7  After clause 2.28.5 of Schedule 1

Insert:

2.28.5A  Limitation of item 10944

  A service mentioned in item 10944 cannot be claimed on the same occasion as a service mentioned in any of items 10905, 10907, 10910, 10911, 10912, 10913, 10914, 10915, 10916 and 10918.

2.28.5B  Application of items 10945 and 10946

  Items 10945 and 10946 do not apply if the patient or specialist travels to a place in order for the patient to satisfy the requirement in subparagraph (c)(i) of the item that, at the time of the attendance, the patient is at least 15 kilometres by road from the specialist.

8  Schedule 1 (before item 10905)

Insert:

 

Subgroup 1—General

 

9  Schedule 1 (items 10931, 10932 and 10933, column headed “Description”)

Before “Group A10”, insert “Subgroup 1 of”.

10  Schedule 1 (after item 10943)

Insert:

 

10944

Cornea, complete removal of embedded foreign body from—not more than once on the same day by the same participating optometrist (excluding aftercare)

Note: If the embedded foreign body is not completely removed, this item does not apply but item 10916 may apply.

72.15

Subgroup 2—Teleheath attendance

10945

A professional attendance of less than 15 minutes (whether or not continuous) by a participating optometrist that requires the provision of clinical support to a patient who:

(a) is participating in a video conferencing consultation with a specialist practising in his or her speciality of ophthalmology; and

(b) is not an admitted patient; and

(c) either:

(i) is located within a telehealth eligible area and, at the time of the attendance, is at least 15 kilometres by road from the specialist mentioned in paragraph (a); or

(ii) is a patient of an Aboriginal Medical Service, or an Aboriginal Community Controlled Health Service, for which a direction under subsection 19(2) of the Act applies

33.45

10946

A professional attendance of at least 15 minutes (whether or not continuous) by a participating optometrist that requires the provision of clinical support to a patient who:

(a) is participating in a video conferencing consultation with a specialist practising in his or her speciality of ophthalmology; and

(b) is not an admitted patient; and

(c) either:

(i) is located within a telehealth eligible area and, at the time of the attendance, is at least 15 kilometres by road from the specialist mentioned in paragraph (a); or

(ii) is a patient of an Aboriginal Medical Service, or an Aboriginal Community Controlled Health Service, for which a direction under subsection 19(2) of the Act applies

66.80

10947

A professional attendance (not being a service to which any other item applies) of less than 15 minutes (whether or not continuous) by a participating optometrist that requires the provision of clinical support to a patient who:

(a) is participating in a video conferencing consultation with a specialist practising in his or her speciality of ophthalmology; and

(b) at the time of the attendance, is located at a residential aged care facility (whether or not at consulting rooms situated within the facility); and

(c) is a care recipient in the facility; and

(d) is not a resident of a selfcontained unit;

for an attendance on one occasion—each patient

33.45

10948

A professional attendance (not being a service to which any other item applies) of at least 15 minutes (whether or not continuous) by a participating optometrist that requires the provision of clinical support to a patient who:

(a) is participating in a video conferencing consultation with a specialist practising in his or her speciality of ophthalmology; and

(b) at the time of the attendance, is located at a residential aged care facility (whether or not at consulting rooms situated within the facility); and

(c) is a care recipient in the facility; and

(d) is not a resident of a selfcontained unit;

for an attendance on one occasion—each patient

66.80

 

11  After clause 2.34.2 of Schedule 1

Insert:

2.34.3  Application of item 11801

  Item 11801 does not apply to a service mentioned in the item if the service is undertaken in association with a service mentioned in item 11800, 11810, 11820, 11823, 11830 or 11833.

12  Schedule 1 (item 11718, column headed “Description”)

Omit “or 11721”, substitute “, 11719, 11720, 11721, 11725 or 11726”.

13  Schedule 1 (after item 11718)

Insert:

 

11719

Implanted pacemaker (including cardiac resynchronisation pacemaker) remote monitoring involving reviews (without patient attendance) of arrhythmias, lead and device parameters, if at least one remote review is provided in a 12 month period

Payable only once in any 12 month period

66.86

11720

Implanted pacemaker testing, with patient attendance, following detection of abnormality by remote monitoring involving electrocardiography, measurement of rate, width and amplitude of stimulus, including reprogramming when required, not being a service associated with a service to which item 11718 or 11721 applies

66.86

 

14  Schedule 1 (item 11721, column headed “Description”)

Omit “or 11718”, substitute “, 11718, 11719, 11720, 11725 or 11726”.

15  Schedule 1 (after item 11724)

Insert:

 

11725

Implanted defibrillator (including cardiac resynchronisation defibrillator) remote monitoring involving reviews (without patient attendance) of arrhythmias, lead and device parameters, if at least 2 remote reviews are provided in a 12 month period

Payable only once in any 12 month period

189.50

11726

Implanted defibrillator testing, with patient attendance, following detection of abnormality by remote monitoring involving electrocardiography, measurement of rate, width and amplitude of stimulus, not being a service associated with a service to which item 11727 applies

94.75

 

16  Schedule 1 (item 11727, column headed “Description”)

Omit “or 11721”, substitute “, 11719, 11720, 11721, 11725 or 11726”.

17  Schedule 1 (after item 11800)

Insert:

 

11801

Clinical assessment of gastrooesophageal reflux disease that involves 48hour catheterfree wireless ambulatory oesophageal pH monitoring, including administration of the device and associated endoscopy procedure for placement, analysis and interpretation of the data and all attendances for providing the service, if:

(a) a catheterbased ambulatory oesophageal pH monitoring:

(i) has been attempted on the patient but failed due to clinical complications; or

(ii) is not clinically appropriate for the patient due to anatomical reasons (nasopharyngeal anatomy) preventing the use of catheterbased pH monitoring; and

(b) the service is performed by a specialist or consultant physician with endoscopic training that is recognised by the Conjoint Committee for the Recognition of Training in Gastrointestinal Endoscopy (Anaes.)

263.00

 

18  Schedule 1 (item 11820, column headed “Description”, paragraph (d))

Omit “The Conjoint Committee for Recognition of Training in Gastrointestinal Endoscopy”, substitute “the Conjoint Committee for the Recognition of Training in Gastrointestinal Endoscopy”.

19  Clause 2.38.3 of Schedule 1

Omit “15600”, substitute “15900”.

20  Schedule 1 (after item 15600)

Insert:

 

Subgroup 7—Intraoperative radiotherapy

15900

Breast, malignant tumour, targeted intraoperative radiotherapy, using an intrabeam device, delivered at the time of breastconserving surgery (partial mastectomy or lumpectomy) for a patient who:

(a) is 45 years of age or over; and

(b) has a T1 or small T2 (less than or equal to 3cm in diameter) primary tumour; and

(c) has a histologic grade 1 or 2 tumour; and

(d) has an oestrogenreceptor positive tumour; and

(e) has a node negative malignancy; and

(f) is suitable for wide local excision of a primary invasive ductal carcinoma that was diagnosed as unifocal on conventional examination and imaging; and

(g) has no contraindications to breast irradiation

250.00

 

21  Schedule 1 (item 18264, column headed “Description”)

Omit “Pudendal nerve,”, substitute “Pudendal nerve or dorsal nerve (or both),”.

22  Schedule 1 (item 30104, column headed “Description”)

After “excision of”, insert “, on a person 10 years of age or over”.

23  Schedule 1 (after item 30104)

Insert:

 

30105

Preauricular sinus, excision of, on a person under 10 years of age (Anaes.)

164.95

 

24  Schedule 1 (item 30286, column headed “Description”)

After “removal of”, insert “, on a person 10 years of age or over”.

25  Schedule 1 (after item 30286)

Insert:

 

30287

Branchial cyst, removal of, on a person under 10 years of age (Anaes.) (Assist.)

517.20

 

26  Schedule 1 (item 30289, column headed “Description”)

After “removal of”, insert “, on a person 10 years of age or over”.

27  Schedule 1 (item 30314, column headed “Description”)

After “bone”, insert “, on a person 10 years of age or over”.

28  Schedule 1 (after item 30324)

Insert:

 

30326

Thyroglossal cyst or fistula or both, radical removal of, including thyroglossal duct and portion of hyoid bone, on a person under 10 years of age (H) (Anaes.) (Assist.)

594.60

 

29  Schedule 1 (item 30375, column headed “Description”)

Omit “(adult) or drainage of pancreas”, substitute “or drainage of pancreas, on a person 10 years of age or over”.

30  Schedule 1 (item 30376, column headed “Description”)

After “performed)”, insert “, on a person 10 years of age or over”.

31  Schedule 1 (item 30378, column headed “Description”)

After “hours”, insert “, on a person 10 years of age or over”.

32  Schedule 1 (item 30390, column headed “Description”)

After “diagnostic,”, insert “on a person 10 years of age or over,”.

33  Schedule 1 (cell at item 30483, column headed “Description”)

Repeal the cell, substitute:

 

Gastrostomy button, caecostomy antegrade enema device (chait etc.) or stomal indwelling device, nonendoscopic insertion of, or nonendoscopic replacement of, on a person 10 years of age or over (Anaes.)

 

34  Schedule 1 (item 30562, column headed “Description”)

Omit “—not involving resection of bowel”, substitute “(not involving resection of bowel), on a person 10 years of age or over”.

35  Schedule 1 (item 30563, column headed “Description”)

After “of”, insert “, on a person 10 years of age or over”.

36  Schedule 1 (item 30566, column headed “Description”)

After “anastomosis”, insert “, on a person 10 years of age or over”.

37  Schedule 1 (item 30571, column headed “Description”)

After “Appendicectomy,”, insert “on a person 10 years of age or over,”.

38  Schedule 1 (item 30572, column headed “Description”)

After “appendicectomy”, insert “, on a person 10 years of age or over”.

39  Schedule 1 (item 30601, column headed “Description”)

After “approach,”, insert “on a person 10 years of age or over,”.

40  Schedule 1 (after item 30606)

Insert:

 

30608

Small intestine, resection of, with anastomosis, on a person under 10 years of age (H) (Anaes.) (Assist.)

1 258.20

 

41  Schedule 1 (item 30609, column headed “Description”)

Omit “30612 or”.

42  Schedule 1 (after item 30609)

Insert:

 

30611

Benign tumour of soft tissue (other than tumours of skin, cartilage and bone, simple lipomas covered by item 31345 and lipomata), removal of, by surgical excision, on a person under 10 years of age, if the specimen excised is sent for histological confirmation of diagnosis, other than a service to which another item in this Group applies (Anaes.) (Assist.)

563.35

 

43  Schedule 1 (item 30612)

Repeal the item.

44  Schedule 1 (item 30614, column headed “Description”)

After “repair of,”, insert “on a person 10 years of age or over,”.

45  Schedule 1 (item 30614, column headed “Description”)

Omit “(S)”.

46  Schedule 1 (item 30615, column headed “Description”)

After “resection”, insert “, on a person 10 years of age or over”.

47  Schedule 1 (items 30616 and 30617)

Repeal the items, substitute:

 

30618

Lymph nodes of neck, selective dissection of one or 2 lymph node levels involving removal of soft tissue and lymph nodes from one side of the neck, on a person under 10 years of age (Anaes.) (Assist.)

522.25

30619

Laparoscopic splenectomy, on a person under 10 years of age (H) (Anaes.) (Assist.)

936.25

 

48  Schedule 1 (after item 30621)

Insert:

 

30622

Caecostomy, enterostomy, colostomy, enterotomy, colotomy, cholecystostomy, gastrostomy, gastrotomy, reduction of intussusception, removal of Meckel’s diverticulum, suture of perforated peptic ulcer, simple repair of ruptured viscus, reduction of volvulus, pyloroplasty or drainage of pancreas, on a person under 10 years of age (H) (Anaes.) (Assist.)

677.65

30623

Laparotomy involving division of peritoneal adhesions (if no other intraabdominal procedure is performed), on a person under 10 years of age (H) (Anaes.) (Assist.)

677.65

30626

Laparotomy involving division of adhesions in association with another intraabdominal procedure if the time taken to divide the adhesions is between 45 minutes and 2 hours, on a person under 10 years of age (H) (Anaes.) (Assist.)

680.80

30627

Laparoscopy, diagnostic, other than a service associated with another laparoscopic procedure, on a person under 10 years of age (H) (Anaes.)

285.95

 

49  Schedule 1 (after item 30635)

Insert:

 

30636

Gastrostomy button, caecostomy antegrade enema device (chait etc.) or stomal indwelling device, nonendoscopic insertion of, or nonendoscopic replacement of, on a person under 10 years of age (Anaes.)

233.15

30637

Enterostomy or colostomy, closure of (not involving resection of bowel), on a person under 10 years of age (H) (Anaes.) (Assist.)

773.50

 

50  Schedule 1 (after item 30638)

Insert:

 

30639

Colostomy or ileostomy, refashioning of, on a person under 10 years of age (Anaes.) (Assist.)

773.50

 

51  Schedule 1 (after item 30641)

Insert:

 

30643

Exploration of spermatic cord, inguinal approach, with or without testicular biopsy and with or without excision of spermatic cord and testis, on a person under 10 years of age (H) (Anaes.) (Assist.)

677.65

 

52  Schedule 1 (item 30644, column headed “Description”)

After “testis”, insert “, on a person 10 years of age or over”.

53  Schedule 1 (after item 30644)

Insert:

 

30645

Appendicectomy, on a person under 10 years of age, other than a service to which item 30574 applies (H) (Anaes.) (Assist.)

579.00

30646

Laparoscopic appendicectomy, on a person under 10 years of age (H) (Anaes.) (Assist.)

579.00

30649

Haemorrhage, arrest of, following circumcision requiring general anaesthesia, on a person under 10 years of age (Anaes.)

187.65

 

54  Schedule 1 (item 30663, column headed “Description”)

After “anaesthesia”, insert “, on a person 10 years of age or over”.

55  Schedule 1 (item 30666, column headed “Description”)

Omit “Paraphimosis,”, substitute “Paraphimosis or phimosis,”.

56  Schedule 1 (item 31350, column headed “Description”)

After “excision,”, insert “on a person 10 years of age or over,”.

57  Schedule 1 (item 31423, column headed “Description”)

After “of the neck”, insert “, on a person 10 years of age or over”.

58  Schedule 1 (item 31470, column headed “Description”)

After “splenectomy”, insert “, on a person 10 years of age or over”.

59  Schedule 1 (after item 31515)

Insert:

 

31516

Breast, malignant tumour, complete local excision of, with or without frozen section histology when targeted intraoperative radiotherapy (using an intrabeam device) is performed concurrently, if the patient satisfies the requirements mentioned in paragraphs (a) to (g) of item 15900 (Anaes.) (Assist.)

867.00

 

60  Schedule 1 (item 34527, column headed “Description”)

Omit “catheterisation (Anaes.)”, substitutecatheterisation, on a person 10 years of age or over (Anaes.)”.

61  Schedule 1 (item 34528, column headed “Description”)

After “device”, insert “, on a person 10 years of age or over”.

62  Schedule 1 (after item 34528)

Insert:

 

34529

Central vein catheterisation by open technique, using subcutaneous tunnel with pump or access port as with central venous line catheter or other chemotherapy delivery device, including any associated percutaneous central vein catheterisation, on a person under 10 years of age (Anaes.)

717.10

 

63  Schedule 1 (item 34530, column headed “Description”)

Omit “catheter”.

64  Schedule 1 (item 34530, column headed “Description”)

After “hospital”, insert “, on a person 10 years of age or over”.

65  Schedule 1 (after item 34533)

Insert:

 

34534

Central vein catheterisation by percutaneous technique, using subcutaneous tunnel with pump or access port as with central venous line catheter or other chemotherapy delivery device, on a person under 10 years of age (Anaes.)

354.10

 

66  Schedule 1 (after item 34539)

Insert:

 

34540

Central venous line, or other chemotherapy device, removal of, by open surgical procedure in the operating theatre of a hospital, on a person under 10 years of age (Anaes.)

265.50

 

67  Schedule 1 (item 37045, column headed “Description”)

Omit “Mitrofanoff continent valve,”, substitute “Continent catheterisation bladder stomas (for example, Mitrofanoff),”.

68  Schedule 1 (item 37800, column headed “Description”)

After “excision of”, insert “, on a person 10 years of age or over”.

69  Schedule 1 (after item 37800)

Insert:

 

37801

Patent urachus, excision of, on a person under 10 years of age (H) (Anaes.) (Assist.)

677.65

 

70  Schedule 1 (item 37803, column headed “Description”)

After “orchidopexy for,”, insert “on a person 10 years of age or over,”.

71  Schedule 1 (after item 37803)

Insert:

 

37804

Undescended testis, orchidopexy for, on a person under 10 years of age, other than a service to which item 37807 applies (H) (Anaes.) (Assist.)

677.65

 

72  Schedule 1 (item 37806, column headed “Description”)

After “orchidopexy for”, insert “, on a person 10 years of age or over”.

73  Schedule 1 (after item 37806)

Insert:

 

37807

Undescended testis in inguinal canal close to deep inguinal ring or within abdominal cavity, orchidopexy for, on a person under 10 years of age (Anaes.) (Assist.)

782.95

 

74  Schedule 1 (item 37809, column headed “Description”)

After “orchidopexy for”, insert “, on a person 10 years of age or over”.

75  Schedule 1 (after item 37809)

Insert:

 

37810

Undescended testis, revision orchidopexy for, on a person under 10 years of age (H) (Anaes.) (Assist.)

782.95

 

76  Schedule 1 (item 37812, column headed “Description”)

After “groin for,”, insert “on a person 10 years of age or over,”.

77  Schedule 1 (item 37812, column headed “Description”)

Omit “items 37803 to 37809”, substitute “any of items 37803, 37806 and 37809”.

78  Schedule 1 (after item 37812)

Insert:

 

37813

Impalpable testis, exploration of groin for, on a person under 10 years of age, other than a service associated with a service to which any of items 37804, 37807 and 37810 apply (H) (Anaes.) (Assist.)

722.80

 

79  Schedule 1 (item 37815, column headed “Description”)

After “test”, insert “, on a person 10 years of age or over”.

80  Schedule 1 (after item 37815)

Insert:

 

37816

Hypospadias, examination under anaesthesia with erection test, on a person under 10 years of age (H) (Anaes.)

120.60

 

81  Schedule 1 (item 37818, column headed “Description”)

After “advancement”, insert “, on a person 10 years of age or over”.

82  Schedule 1 (after item 37818)

Insert:

 

37819

Hypospadias, glanuloplasty incorporating meatal advancement, on a person under 10 years of age (Anaes.) (Assist.)

638.90

 

83  Schedule 1 (item 37821, column headed “Description”)

After “repair”, insert “, on a person 10 years of age or over”.

84  Schedule 1 (after item 37821)

Insert:

 

37822

Hypospadias, distal, one stage repair, on a person under 10 years of age (H) (Anaes.) (Assist.)

1 083.05

 

85  Schedule 1 (item 37824, column headed “Description”)

After “repair”, insert “, on a person 10 years of age or over”.

86  Schedule 1 (after item 37824)

Insert:

 

37825

Hypospadias, proximal, one stage repair, on a person under 10 years of age (H) (Anaes.) (Assist.)

1 505.80

 

87  Schedule 1 (item 37827, column headed “Description”)

After “first stage”, insert “, on a person 10 years of age or over”.

88  Schedule 1 (after item 37827)

Insert:

 

37828

Hypospadias, staged repair, first stage, on a person under 10 years of age (H) (Anaes.) (Assist.)

693.70

 

89  Schedule 1 (item 37833, column headed “Description”)

After “fistula”, insert “, on a person 10 years of age or over”.

90  Schedule 1 (after item 37833)

Insert:

 

37834

Hypospadias, repair of postoperative urethral fistula, on a person under 10 years of age (H) (Anaes.) (Assist.)

428.95

 

91  Schedule 1 (item 42573, column headed “Description”)

After “excision of”, insert “, on a person 10 years of age or over”.

92  Schedule 1 (after item 42575)

Insert:

 

42576

Dermoid, periorbital, excision of, on a person under 10 years of age (Anaes.)

295.70

 

93  Schedule 1 (after item 43804)

Insert:

 

43805

Umbilical, epigastric or linea alba hernia, repair of, on a person under 10 years of age (H) (Anaes.)

356.35

 

94  Schedule 1 (item 43819, column headed “Description”)

Omit “Hirschsprung’s disease,”, substitute “Aganglionosis Coli,”.

 

95  Schedule 1 (after item 43831)

Insert:

 

43832

Branchial fistula, removal of, on a person under 10 years of age (H) (Anaes.) (Assist.)

652.95

 

96  Schedule 1 (after item 43834)

Insert:

 

43835

Strangulated, incarcerated or obstructed hernia, repair of, without bowel resection, on a person under 10 years of age (H) (Anaes.) (Assist.)

677.65

 

97  Schedule 1 (after item 43837)

Insert:

 

43838

Diaphragmatic hernia, congenital, repair of, by thoracic or abdominal approach, on a person under 10 years of age, not being a service to which any of items 31569 to 31581 apply (H) (Anaes.) (Assist.)

1 244.50

 

98  Schedule 1 (after item 43840)

Insert:

 

43841

Femoral or inguinal hernia or infantile hydrocele, repair of, on a person under 10 years of age, other than a service to which item 30403 or 43835 applies (H) (Anaes.) (Assist.)

603.85

 

99  Schedule 1 (items 43852 and 43858, column headed “Description”)

Omit “(Anaes.)”, substitute “(H) (Anaes.)”.

100  Schedule 1 (cell at item 43867, column headed “Description”)

Repeal the cell, substitute:

 

Gastroschisis or exomphalos, secondary operation for, with removal of silo (H) (Anaes.) (Assist.)

 

101  Schedule 1 (items 43915, 43942 and 43948, column headed “Description”)

Omit “(Anaes.)”, substitute “(H) (Anaes.)”.

102  Schedule 1 (item 43990, column headed “Description”)

Omit “Hirschsprung’s disease,”, substitute “Aganglionosis Coli,”.

103  Schedule 1 (item 43993, column headed “Description”)

Omit “Hirschsprung’s disease,”, substitute “Aganglionosis Coli,”.

104  Schedule 1 (item 43993, column headed “Description”)

Omit “(Anaes.)”, substitute “(H) (Anaes.)”.

105  Schedule 1 (item 43996, column headed “Description”)

Omit “Hirschsprung’s disease,”, substitute “Aganglionosis Coli,”.

106  Schedule 1 (item 43996, column headed “Description”)

Omit “(Anaes.)”, substitute “(H) (Anaes.)”.

107  Schedule 1 (item 43999, column headed “Description”)

Omit “Hirschsprung’s disease,”, substitute “Aganglionosis Coli,”.

108  Schedule 1 (after item 43999)

Insert:

 

44101

Rectum, examination of, under general anaesthesia with full thickness biopsy or removal of polyp or similar lesion, on a person under 2 years of age (H) (Anaes.) (Assist.)

334.05

 

109  Schedule 1 (item 44102, column headed “Description”)

After “lesion”, insert “, on a person 2 years of age or over”.

110  Schedule 1 (after item 44102)

Insert:

 

44104

Rectal prolapse, submucosal or perirectal injection for, under general anaesthesia, on a person under 2 years of age (Anaes.)

58.65

 

111  Schedule 1 (item 44105, column headed “Description”)

After “anaesthesia”, insert “, on a person 2 years of age or over”.

112  Schedule 1 (items 44108, 44111 and 44114, column headed “Description”)

Omit “3 months”, substitute “12 months”.

Health Insurance (Pathology Services Table) Regulation 2015

113  Schedule 1 (after item 73337)

Insert:

 

73338

A test of tumour tissue from a patient with metastatic colorectal cancer (stage IV), requested by a specialist or consultant physician, to determine if the requirements relating to rat sarcoma oncogene (RAS) gene mutation status for access to cetuximab or panitumumab under the Pharmaceutical Benefits Scheme are fulfilled, if:

(a) the test is conducted for all clinically relevant mutations on KRAS exons 2, 3 and 4 and NRAS exons 2, 3, and 4; or

(b) a RAS mutation is found

362.59