1

Ultrasound equipment

Equipment primarily used in carrying out a diagnostic imaging procedure used in rendering a service to which an item in Group I1 applies

10

15

2

CT equipment

Equipment primarily used in carrying out a diagnostic imaging procedure used in rendering a service to which an item in Group I2 applies

10

15

3

Mammography equipment

Equipment primarily used in carrying out a diagnostic imaging procedure used in rendering a service to which an item in Subgroup 10 of Group I3 applies

10

15

4

Angiography equipment

Equipment primarily used in carrying out a diagnostic imaging procedure used in rendering a service to which an item in Subgroup 13 of Group I3 applies

10

15

5

Other diagnostic radiology equipment

Equipment primarily used in carrying out a diagnostic imaging procedure used in rendering a service to which an item in Subgroups 1 to 9, 12, 14, 15 or 17 of Group I3 applies

15

20

6

Nuclear medicine imaging equipment (other than for PET)

Equipment primarily used in carrying out a diagnostic imaging procedure used in rendering a service to which an item in Group I4 applies (other than items 61523 to 61647)

10

15

7

MRI equipment

Equipment primarily used in carrying out a diagnostic imaging procedure used in rendering a service to which an item in Group I5 applies

10

20

Subgroup 1—General

55028

Head, ultrasound scan of (R)

110.75

55029

Head, ultrasound scan of (NR)

38.40

55030

Orbital contents, ultrasound scan of (R)

110.75

55031

Orbital contents, ultrasound scan of (NR)

38.40

55032

Neck, one or more structures of, ultrasound scan of (R)

110.75

55033

Neck, one or more structures of, ultrasound scan of (NR)

38.40

55036

Abdomen, ultrasound scan of (including scan of urinary tract when performed), for morphological assessment, if:

(a) the service is not solely a transrectal ultrasonic examination of any of the following:

(i) prostate gland;

(ii) bladder base;

(iii) urethra; and

(b) within 24 hours of the service, a service mentioned in item 55038 is not performed on the same patient by the providing practitioner (R)

112.95

55037

Abdomen, ultrasound scan of (including scan of urinary tract when performed), for morphological assessment, if the service is not solely a transrectal ultrasonic examination of any of the following:

(a) prostate gland;

(b) bladder base;

(c) urethra (NR)

38.40

55038

Urinary tract, ultrasound scan of, if:

(a) the service is not solely a transrectal ultrasonic examination of any of the following:

(i) prostate gland;

(ii) bladder base;

(iii) urethra; and

(b) within 24 hours of the service, a service mentioned in item 55036 or 55065 is not performed on the same patient by the providing practitioner (R)

110.75

55039

Urinary tract, ultrasound scan of, if the service is not solely a transrectal ultrasonic examination of any of the following:

(a) prostate gland;

(b) bladder base;

(c) urethra (NR)

38.40

55048

Scrotum, ultrasound scan of (R)

111.15

55049

Scrotum, ultrasound scan of (NR)

38.40

55054

Ultrasonic cross‑sectional echography, in conjunction with a surgical procedure (other than a procedure to which item 55848 or 55850 applies) using interventional techniques, not being a service associated with a service to which any other item in this Group applies (R)

110.75

55065

Pelvis, ultrasound scan of, by any or all approaches, if:

(a) the service is not solely a service to which an item (other than item 55736 or 55739) in Subgroup 5 of this Group applies or a transrectal ultrasonic examination of any of the following:

(i) prostate gland;

(ii) bladder base;

(iii) urethra; and

(b) within 24 hours of the service, a service mentioned in item 55038 is not performed on the same patient by the providing practitioner (R)

99.70

55066

Breasts, both, ultrasound scan of, in conjunction with a surgical procedure using interventional techniques, if:

(a) the request for the scan indicates that an ultrasound‑guided breast intervention be performed; and

(b) the service is not performed in conjunction with any other item in this Group (R)

221.45

55068

Pelvis, ultrasound scan of, by any or all approaches, if the service is not solely a service to which an item (other than item 55736 or 55739) in Subgroup 5 of this Group applies or a transrectal ultrasonic examination of any of the following:

(a) prostate gland;

(b) bladder base;

(c) urethra (NR)

35.50

55070

Breast, one, ultrasound scan of (R)

99.70

55071

Breast, one, ultrasound scan of, in conjunction with a surgical procedure using interventional techniques, if:

(a) the request for the scan indicates that an ultrasound‑guided breast intervention be performed; and

(b) the service is not performed in conjunction with any other item in this group (R)

210.45

55073

Breast, one, ultrasound scan of (NR)

34.55

55076

Breasts, both, ultrasound scan of (including an ultrasound scan for post mastectomy surveillance) (R)

110.75

55079

Breasts, both, ultrasound scan of (including an ultrasound scan for post mastectomy surveillance) (NR)

38.40

55084

Urinary bladder, ultrasound scan of, by any or all approaches, if within 24 hours of the service, a service mentioned in item 11917, 55036, 55038, 55065, 55600 or 55603 is not performed on the same patient by the providing practitioner (R)

99.70

55085

Urinary bladder, ultrasound scan of, by any or all approaches, if within 24 hours of the service, a service mentioned in item 11917, 55037, 55039, 55068, 55600 or 55603 is not performed on the same patient by the providing practitioner (NR)

34.55

Subgroup 2—Cardiac

55118

Heart, two‑dimensional or three‑dimensional real time transoesophageal examination of, from at least 2 levels, and in more than one plane at each level, if:

(a) the service includes:

(i) real time colour flow mapping and, if indicated, pulsed wave Doppler examination; and

(ii) recordings on digital media; and

(b) the service is not:

(i) an intra‑operative service; or

(ii) a service associated with a service to which an item in Subgroup 3 of this Group applies

(R) (Anaes.)

279.65

55130

Intraoperative two‑dimensional or three‑dimensional real time transoesophageal echocardiography, if the service:

(a) includes Doppler techniques with colour flow mapping and recordings on digital media; and

(b) is performed during cardiac surgery; and

(c) incorporates sequential assessment of cardiac function before and after the surgical procedure; and

(d) is not associated with a service to which item 55135, or an item in Subgroup 3, applies (R) (Anaes.)

172.55

55135

Intraoperative two‑dimensional or three‑dimensional real time transoesophageal echocardiography, if the service:

(a) is provided on the same day as a service to which item 38477, 38484, 38499, 38516 or 38517 applies; and

(b) includes Doppler techniques with colour flow mapping and recordings on digital media; and

(c) is performed during cardiac valve surgery (replacement or repair); and

(d) incorporates sequential assessment of cardiac function and valve competence before and after the surgical procedure; and

(e) is not associated with a service to which item 22054, 55130, or an item in Subgroup 3, applies (R) (Anaes.)

358.90

Subgroup 3—Vascular

55238

Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of arteries or bypass grafts in the lower limb or of arteries and bypass grafts in the lower limb, below the inguinal ligament, not being a service associated with any of the following:

(a) a service to which an item in Subgroup 4 applies;

(b) a service to which item 55880, 55881, 55882, 55883, 55884, 55885, 55886, 55887, 55888, 55889, 55890, 55891, 55892, 55893, 55894 or 55895 applies (R)

172.05

55244

Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of veins in the lower limb, below the inguinal ligament, for acute venous thrombosis, not being a service associated with any of the following:

(a) a service to which item 55246 applies;

(b) a service to which an item in Subgroup 4 applies;

(c) a service to which item 55880, 55881, 55882, 55883, 55884, 55885, 55886, 55887, 55888, 55889, 55890, 55891, 55892, 55893, 55894 or 55895 (R)

172.05

55246

Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of veins in the lower limb, below the inguinal ligament, for chronic venous disease, not being a service associated with any of the following:

(a) a service to which item 55244 applies;

(b) a service to which an item in Subgroup 4 applies;

(c) a service to which item 55880, 55881, 55882, 55883, 55884, 55885, 55886, 55887, 55888, 55889, 55890, 55891, 55892, 55893, 55894 or 55895 (R)

172.05

55248

Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of arteries or bypass grafts in the upper limb or of arteries and bypass grafts in the upper limb, not being a service associated with a service to which an item in Subgroup 4 applies (R)

172.05

55252

Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of veins in the upper limb, not being a service associated with a service to which an item in Subgroup 4 applies (R)

172.05

55274

Duplex scanning, bilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of extra‑cranial bilateral carotid and vertebral vessels, with or without subclavian and innominate vessels, with or without oculoplethysmography or peri‑orbital Doppler examination, not being a service associated with a service to which an item in Subgroup 4 applies (R)

172.05

55276

Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of intra‑abdominal, aorta and iliac arteries or inferior vena cava and iliac veins or of intra‑abdominal, aorta and iliac arteries and inferior vena cava and iliac veins, excluding pregnancy related studies, not being a service associated with a service to which an item in Subgroup 4 applies (R)

172.05

55278

Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of renal or visceral vessels or of renal and visceral vessels, including aorta, inferior vena cava and iliac vessels as required excluding pregnancy related studies, not being a service associated with a service to which an item in Subgroup 4 applies (R)

172.05

55280

Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of intra‑cranial vessels, not being a service associated with a service to which an item in Subgroup 4 applies (R)

172.05

55282

Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements:

(a) by spectral analysis of cavernosal artery of the penis following intracavernosal administration of a vasoactive agent; and

(b) performed during the period of pharmacological activity of the injected agent, to confirm a diagnosis of vascular aetiology for impotence; and

(c) if a specialist in diagnostic radiology, nuclear medicine, urology, general surgery (sub‑specialising in vascular surgery) or a consultant physician in nuclear medicine attends the patient in person at the practice location where the service is performed, immediately before or for a period during the performance of the service; and

(d) if the specialist or consultant physician interprets the results and prepares a report, not being a service associated with a service to which an item in Subgroup 4 applies (R)

172.05

55284

Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements:

(a) by spectral analysis of cavernosal tissue of the penis to confirm a diagnosis; and

(b) if indicated, assess the progress and management of:

(i) priapism; or

(ii) fibrosis of any type; or

(iii) fracture of the tunica; or

(iv) arteriovenous malformations; and

(c) if a specialist in diagnostic radiology, nuclear medicine, urology, general surgery (sub‑specialising in vascular surgery) or a consultant physician in nuclear medicine attends the patient in person at the practice location where the service is performed, immediately before or for a period during the performance of the service; and

(d) if the specialist or consultant physician interprets the results and prepares a report, not being a service associated with a service to which an item in Subgroup 4 applies (R)

172.05

55292

Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of surgically created arteriovenous fistula or surgically created arteriovenous access grafts in the upper or lower limbs, not being a service associated with a service to which an item in Subgroup 4 applies (R)

172.05

55294

Duplex scanning involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of arteries or veins, or both, including any associated skin marking, for mapping of bypass conduit before vascular surgery, not being a service associated with any of the following:

(a) a service to which an item in Subgroup 3 or 4 applies;

(b) a service to which item 55880, 55881, 55882, 55883, 55884, 55885, 55886, 55887, 55888, 55889, 55890, 55891, 55892, 55893, 55894 or 55895 applies (R)

172.05

55296

Duplex scanning, unilateral, involving B mode ultrasound imaging and integrated Doppler flow spectral analysis and marking of veins in the lower limbs below the inguinal ligament before varicose vein surgery, including any associated skin marking, not being a service associated with any of the following:

(a) a service to which an item in Subgroup 3 or 4 applies;

(b) a service to which item 55880, 55881, 55882, 55883, 55884, 55885, 55886, 55887, 55888, 55889, 55890, 55891, 55892, 55893, 55894 or 55895 applies (R)

112.70

Subgroup 4—Urological

55600

Prostate, bladder base and urethra, ultrasound scan of, if performed:

(a) personally by a medical practitioner (not being the medical practitioner who assessed the patient as specified in paragraph (c)) using one or more transducer probes that can obtain both axial and sagittal scans in 2 planes at right angles; and

(b) after a digital rectal examination of the prostate by that medical practitioner; and

(c) on a patient who has been assessed by:

(i) a specialist in urology, radiation oncology or medical oncology; or

(ii) a consultant physician in medical oncology;

 who has:

(iii) examined the patient in the 60 days before the scan; and

(iv) recommended the scan for the management of the patient’s current prostatic disease (R)

110.75

55603

Prostate, bladder base and urethra, ultrasound scan of, if performed:

(a) personally by a medical practitioner who made the assessment mentioned in paragraph (c) using one or more transducer probes that can obtain both axial and sagittal scans in 2 planes at right angles; and

(b) after a digital rectal examination of the prostate by that medical practitioner; and

(c) on a patient who has been assessed by:

(i) a specialist in urology, radiation oncology or medical oncology; or

(ii) a consultant physician in medical oncology;

 who has:

(iii) examined the patient in the 60 days before the scan; and

(iv) recommended the scan for the management of the patient’s current prostatic disease (R)

110.75

Subgroup 5—Obstetric and gynaecological

55700

Pelvis or abdomen, pregnancy‑related or pregnancy complication, ultrasound (the current ultrasound) scan of, by any or all approaches, for determining the gestation, location, viability or number of fetuses, if:

(a) the dating of the pregnancy (as confirmed by the current ultrasound) is less than 12 weeks of gestation; and

(b) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55704, 55705, 55707, 55708, 55740, 55741, 55742 or 55743 (R)

60.90

55703

Pelvis or abdomen, pregnancy‑related or pregnancy complication, ultrasound (the current ultrasound) scan of, by any or all approaches, for determining the gestation, location, viability or number of fetuses, if:

(a) the dating of the pregnancy (as confirmed by the current ultrasound) is less than 12 weeks of gestation; and

(b) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55704, 55705, 55707, 55708, 55740, 55741, 55742 or 55743 (NR)

35.50

55704

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, for determining the structure, gestation, location, viability or number of fetuses, if:

(a) the dating of the pregnancy (as confirmed by the current ultrasound) is 12 to 16 weeks of gestation; and

(b) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in another item in this Subgroup (R)

71.05

55705

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, for determining the structure, gestation, location, viability or number of fetuses, if:

(a) the dating of the pregnancy (as confirmed by the current ultrasound) is 12 to 16 weeks of gestation; and

(b) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in another item in this Subgroup (NR)

35.50

55706

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, with measurement of all parameters for dating purposes, if:

(a) the dating for the pregnancy (as confirmed by the current ultrasound) is 17 to 22 weeks of gestation; and

(b) the current ultrasound:

(i) is not performed in the same pregnancy as item 55709; and

(ii) is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (R)

101.50

55707

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, if:

(a) the pregnancy (as confirmed by the current ultrasound) is dated by a fetal crown rump length of 45 to 84 mm; and

(b) nuchal translucency measurement is performed to assess the risk of fetal abnormality; and

(c) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in another item in this Subgroup (R)

71.05

55708

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, if:

(a) the pregnancy (as confirmed by the current ultrasound) is dated by a crown rump length of 45 to 84 mm; and

(b) nuchal translucency measurement is performed to assess the risk of fetal abnormality; and

(c) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in another item in this Subgroup (NR)

35.50

55709

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, with measurement of all parameters for dating purposes, if:

(a) the dating of the pregnancy (as confirmed by the current ultrasound) is 17 to 22 weeks of gestation; and

(b) the current ultrasound:

(i) is not performed in the same pregnancy as item 55706; and

(ii) is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (NR)

38.55

55712

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, with measurement of all parameters for dating purposes, if:

(a) the current ultrasound is requested by a medical practitioner who:

(i) is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists; or

(ii) has a Diploma of Obstetrics; or

(iii) has a qualification recognised by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as being equivalent to a Diploma of Obstetrics; or

(iv) has obstetric privileges at a non‑metropolitan hospital; and

(b) the dating of the pregnancy (as confirmed by the current ultrasound) is 17 to 22 weeks of gestation; and

(c) further examination is clinically indicated after performance, in the same pregnancy, of a scan mentioned in item 55706 or 55709; and

(d) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (R)

116.70

55715

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, with measurement of all parameters for dating purposes, performed by or on behalf of a medical practitioner who is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, if:

(a) the dating of the pregnancy (as confirmed by the current ultrasound) is 17 to 22 weeks of gestation; and

(b) further examination is clinically indicated after performance, in the same pregnancy, of a scan mentioned in item 55706 or 55709; and

(c) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (NR)

40.60

55718

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, if:

(a) the dating of the pregnancy (as confirmed by the current ultrasound) is after 22 weeks of gestation; and

(b) the current ultrasound:

(i) is not performed in the same pregnancy as item 55723; and

(ii) is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (R)

101.50

55721

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, if:

(a) the current ultrasound is requested by a medical practitioner who:

(i) is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists; or

(ii) has a Diploma of Obstetrics; or

(iii) has a qualification recognised by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as being equivalent to a Diploma of Obstetrics; or

(iv) has obstetric privileges at a non‑metropolitan hospital; and

(b) the dating of the pregnancy (as confirmed by current ultrasound) is after 22 weeks of gestation; and

(c) further examination is clinically indicated in the same pregnancy to which item 55718 or 55723 applies; and

(d) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (R)

116.70

55723

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, if:

(a) the dating of the pregnancy (as confirmed by the current ultrasound) is after 22 weeks of gestation; and

(b) the current ultrasound:

(i) is not performed in the same pregnancy as item 55718; and

(ii) is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (NR)

38.55

55725

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, performed by or on behalf of a medical practitioner who is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, if:

(a) the dating of the pregnancy (as confirmed by the current ultrasound) is after 22 weeks of gestation; and

(b) further examination is clinically indicated in the same pregnancy to which item 55718 or 55723 applies; and

(c) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (NR)

40.60

55729

Duplex scanning, if:

(a) the service involves:

(i) B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of the umbilical artery; and

(ii) measured assessment of amniotic fluid volume after the 24th week of gestation; and

(b) there is reason to suspect intrauterine growth retardation or a significant risk of fetal death;

—examination and report (R)

27.65

55736

Pelvis, ultrasound scan of, in association with saline infusion of the endometrial cavity, by any or all approaches, if a previous transvaginal ultrasound has revealed an abnormality of the uterus or fallopian tube (R)

128.90

55739

Pelvis, ultrasound scan of, in association with saline infusion of the endometrial cavity, by any or all approaches, if a previous transvaginal ultrasound has revealed an abnormality of the uterus or fallopian tube (NR)

57.85

55740

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, for determining the structure, gestation, location, viability or number of fetuses, if:

(a) an ultrasound of the same pregnancy confirms a multiple pregnancy; and

(b) the dating of the pregnancy (as confirmed by the current ultrasound) is 12 to 16 weeks of gestation; and

(c) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in another item in this Subgroup (R)

108.30

55741

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, for determining the structure, gestation, location, viability or number of fetuses, if:

(a) an ultrasound of the same pregnancy confirms a multiple pregnancy; and

(b) the dating of the pregnancy (as confirmed by the current ultrasound) is 12 to 16 weeks of gestation; and

(c) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in another item in this Subgroup (NR)

54.10

55742

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, if:

(a) an ultrasound of the same pregnancy confirms a multiple pregnancy; and

(b) the pregnancy (as confirmed by the current ultrasound) is dated by a fetal crown rump length of 45 to 84 mm; and

(c) nuchal translucency measurement is performed to assess the risk of fetal abnormality; and

(d) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in another item in this Subgroup (R)

108.30

55743

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, if:

(a) an ultrasound of the same pregnancy confirms a multiple pregnancy; and

(b) the pregnancy (as confirmed by the current ultrasound) is dated by a fetal crown rump length of 45 to 84 mm; and

(c) nuchal translucency measurement is performed to assess the risk of fetal abnormality; and

(d) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in another item in this Subgroup (NR)

54.10

55757

Pelvis or abdomen, ultrasound (the current ultrasound) scan of, for cervical length assessment for risk of preterm labour, by any or all approaches, if:

(a) the dating of the pregnancy (as confirmed by the current ultrasound) is between 14 and 30 weeks of gestation; and

(b) any of the following apply:

(i) the patient has a history indicating high risk of preterm labour or birth or second trimester fetal loss;

(ii) the patient has symptoms suggestive of threatened preterm labour or second trimester fetal loss;

(iii) the patient’s cervical length is less than 25 mm on an ultrasound before 28 weeks gestation; and

(c) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in another item in this Subgroup (R)

51.55

55758

Pelvis or abdomen, ultrasound (the current ultrasound) scan of, for cervical length assessment for risk of preterm labour, by any or all approaches, if:

(a) the dating of the pregnancy (as confirmed by the current ultrasound) is between 14 and 30 weeks of gestation; and

(b) any of the following apply:

(i) the patient has a history indicating high risk of preterm labour or birth or second trimester fetal loss;

(ii) the patient has symptoms suggestive of threatened preterm labour or second trimester fetal loss;

(iii) the patient’s cervical length is less than 25 mm on an ultrasound before 28 weeks gestation; and

(c) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in another item in this Subgroup (NR)

19.60

55759

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, with measurement of all parameters for dating purposes, if:

(a) an ultrasound of the same pregnancy confirms a multiple pregnancy; and

(b) the dating of the pregnancy (as confirmed by the current ultrasound) is 17 to 22 weeks gestation; and

(c) the service mentioned in item 55706, 55709, 55712, 55715 or 55762 is not performed in conjunction with the current ultrasound during the same pregnancy; and

(d) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (R)

152.25

55762

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, with measurement of all parameters for dating purposes, if:

(a) an ultrasound of the same pregnancy confirms a multiple pregnancy; and

(b) the dating of the pregnancy (as confirmed by the current ultrasound) is 17 to 22 weeks gestation; and

(c) the service mentioned in item 55706, 55709, 55712, 55715 or 55759 is not performed in conjunction with the current ultrasound during the same pregnancy; and

(d) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (NR)

60.90

55764

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, with measurement of all parameters for dating purposes, if:

(a) the service is requested by a medical practitioner who:

(i) is a Member or Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists; or

(ii) has a Diploma of Obstetrics; or

(iii) has a qualification recognised by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as equivalent to a Diploma of Obstetrics; or

(iv) has obstetric privileges at a non‑metropolitan hospital; and

(b) an ultrasound of the same pregnancy confirms a multiple pregnancy; and

(c) the dating of the pregnancy (as confirmed by the current ultrasound) is 17 to 22 weeks gestation; and

(d) further examination is clinically indicated in the same pregnancy in which item 55759 or 55762 has been performed; and

(e) the service mentioned in item 55706, 55709, 55712 or 55715 is not performed in conjunction with the current ultrasound during the same pregnancy; and

(f) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (R))

162.40

55766

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, with measurement of all parameters for dating purposes, performed by or on behalf of a medical practitioner, who is a Member or Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, if:

(a) an ultrasound of the same pregnancy confirms a multiple pregnancy; and

(b) the dating of the pregnancy (as confirmed by the current ultrasound) is 17 to 22 weeks of gestation; and

(c) further examination is clinically indicated in the same pregnancy in which item 55759 or 55762 has been performed; and

(d) the service mentioned in item 55706, 55709, 55712 or 55715 is not performed in conjunction with the current ultrasound during the same pregnancy; and

(e) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (NR)

65.95

55768

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, if:

(a) dating of the pregnancy (as confirmed by the current ultrasound) is after 22 weeks of gestation; and

(b) an ultrasound confirms a multiple pregnancy; and

(c) the service is not performed in the same pregnancy as item 55770; and

(d) the service mentioned in item 55718, 55721, 55723 or 55725 is not performed in conjunction with the current ultrasound during the same pregnancy; and

(e) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (R)

152.25

55770

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, if:

(a) dating of the pregnancy (as confirmed by the current ultrasound) is after 22 weeks of gestation; and

(b) an ultrasound confirms a multiple pregnancy; and

(c) the service is not performed in the same pregnancy as item 55768; and

(d) the service mentioned in item 55718, 55721, 55723 or 55725 is not performed in conjunction with the current ultrasound during the same pregnancy; and

(e) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (NR)

60.90

55772

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, if:

(a) dating of the pregnancy as confirmed by the current ultrasound is after 22 weeks of gestation; and

(b) the service is requested by a medical practitioner who:

(i) is a Member or Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists; or

(ii) has a Diploma of Obstetrics; or

(iii) has a qualification recognised by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as equivalent to a Diploma of Obstetrics; or

(iv) has obstetric privileges at a non‑metropolitan hospital; and

(c) further examination is clinically indicated in the same pregnancy to which item 55768 or 55770 has been performed; and

(d) the pregnancy as confirmed by an ultrasound is a multiple pregnancy; and

(e) the service mentioned in item 55718, 55721, 55723 or 55725 is not performed in conjunction with the current ultrasound during the same pregnancy; and

(f) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (R)

162.40

55774

Pelvis or abdomen, pregnancy‑related or pregnancy complication, fetal development and anatomy, ultrasound (the current ultrasound) scan of, by any or all approaches, performed by or on behalf of a medical practitioner who is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, if:

(a) dating of the pregnancy as confirmed by the current ultrasound is after 22 weeks of gestation; and

(b) further examination is clinically indicated in the same pregnancy to which item 55768 or 55770 has been performed; and

(c) the pregnancy as confirmed by an ultrasound is a multiple pregnancy; and

(d) the service mentioned in item 55718, 55721, 55723 or 55725 is not performed in conjunction with the current ultrasound during the same pregnancy; and

(e) the current ultrasound is not performed on the same patient within 24 hours of a service mentioned in item 55757 or 55758 (NR)

65.95

1

55856

55858

2

55857

55859

3

55860

55862

4

55861

55863

5

55864

55866

6

55865

55867

7

55868

55870

8

55869

55871

9

55872

55874

10

55873

55875

11

55876

55878

12

55877

55879

13

55880

55882

14

55881

55883

15

55884

55886

16

55885

55887

17

55888

55890

18

55889

55891

19

55892

55894

20

55893

55895

Subgroup 6—Musculoskeletal ultrasound

55812

Chest or abdominal wall, one or more areas, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55070, 55073, 55076 or 55079 (R)

110.75

55814

Chest or abdominal wall, one or more areas, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55070, 55073, 55076 or 55079 (NR)

38.40

55844

Assessment of a mass associated with the skin or subcutaneous structures, not being a part of the musculoskeletal system, one or more areas, ultrasound scan of (R)

88.65

55846

Assessment of a mass associated with the skin or subcutaneous structures, not being a part of the musculoskeletal system, one or more areas, ultrasound scan of (NR)

38.40

55848

Musculoskeletal ultrasound, in conjunction with a surgical procedure using interventional techniques, not being a service associated with a service to which any other item in this group applies, and not performed in conjunction with a service mentioned in item 55054 (R)

138.65

55850

Musculoskeletal ultrasound, in conjunction with a surgical procedure using interventional techniques, inclusive of a diagnostic musculoskeletal ultrasound service, if:

(a) a medical practitioner or nurse practitioner has indicated on a referral for a musculoskeletal ultrasound that an ultrasound guided intervention be performed if clinically indicated; and

(b) the service is not performed in conjunction with a service mentioned in item 55054 or any other item in this Subgroup (R)

183.05

55852

Paediatric spine, spinal cord and overlying subcutaneous tissues, ultrasound scan of (R)

110.75

55854

Paediatric spine, spinal cord and overlying subcutaneous tissues, ultrasound scan of (NR)

38.40

55856

Hand or wrist, or both, left or right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55858 (R)

110.75

55857

Hand or wrist, or both, left or right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55859 (NR)

38.40

55858

Hand or wrist, or both, left and right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55856 (R)

122.90

55859

Hand or wrist, or both, left and right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55857 (NR)

42.65

55860

Forearm or elbow, or both, left or right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55862 (R)

110.75

55861

Forearm or elbow, or both, left or right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55863 (NR)

38.40

55862

Forearm or elbow, or both, left and right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55860 (R)

122.90

55863

Forearm or elbow, or both, left and right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55861 (NR)

42.65

55864

Shoulder or upper arm, or both, left or right, ultrasound scan of, if

(a) the service is used for the assessment of one or more of the following suspected or known conditions:

(i) an injury to a muscle, tendon or muscle/tendon junction;

(ii) rotator cuff tear, calcification or tendinosis (biceps, subscapular, supraspinatus or infraspinatus);

(iii) biceps subluxation;

(iv) capsulitis and bursitis;

(v) a mass, including a ganglion;

(vi) an occult fracture;

(vii) acromioclavicular joint pathology; and

(b) the service is not performed in conjunction with a service mentioned in item 55866 (R)

110.75

55865

Shoulder or upper arm, or both, left or right, ultrasound scan of, if:

(a) the service is used for the assessment of one or more of the following suspected or known conditions:

(i) an injury to a muscle, tendon or muscle/tendon junction;

(ii) rotator cuff tear, calcification or tendinosis (biceps, subscapular, supraspinatus or infraspinatus);

(iii) biceps subluxation;

(iv) capsulitis and bursitis;

(v) a mass, including a ganglion;

(vi) an occult fracture;

(vii) acromioclavicular joint pathology; and

(b) the service is not performed in conjunction with a service mentioned in item 55867 (NR)

38.40

55866

Shoulder or upper arm, or both, left and right, ultrasound scan of, if:

(a) the service is used for the assessment of one or more of the following suspected or known conditions:

(i) an injury to a muscle, tendon or muscle/tendon junction;

(ii) rotator cuff tear, calcification or tendinosis (biceps, subscapular, supraspinatus or infraspinatus);

(iii) biceps subluxation;

(iv) capsulitis and bursitis;

(v) a mass, including a ganglion;

(vi) an occult fracture;

(vii) acromioclavicular joint pathology; and

(b) the service is not performed in conjunction with a service mentioned in item 55864 (R)

122.90

55867

Shoulder or upper arm, or both, left and right, ultrasound scan of, if:

(a) the service is used for the assessment of one or more of the following suspected or known conditions:

(i) an injury to a muscle, tendon or muscle/tendon junction;

(ii) rotator cuff tear, calcification or tendinosis (biceps, subscapular, supraspinatus or infraspinatus);

(iii) biceps subluxation;

(iv) capsulitis and bursitis;

(v) a mass, including a ganglion;

(vi) an occult fracture;

(vii) acromioclavicular joint pathology; and

(c) the service is not performed in conjunction with a service mentioned in item 55865 (NR)

42.65

55868

Hip or groin, or both, left or right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55870 (R)

110.75

55869

Hip or groin, or both, left or right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55871 (NR)

38.40

55870

Hip or groin, or both, left and right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55868 (R)

122.90

55871

Hip or groin, or both, left and right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55869 (NR)

42.65

55872

Paediatric hip examination for dysplasia, left or right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55874 (R)

110.75

55873

Paediatric hip examination for dysplasia, left or right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55875 (NR)

38.40

55874

Paediatric hip examination for dysplasia, left and right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55872 (R)

122.90

55875

Paediatric hip examination for dysplasia, left and right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55873 (NR)

42.65

55876

Buttock or thigh, or both, left or right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55878 (R)

110.75

55877

Buttock or thigh or both, left or right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55879 (NR)

38.40

55878

Buttock or thigh, or both, left and right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55876 (R)

122.90

55879

Buttock or thigh, or both, left and right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55877 (NR)

42.65

55880

Knee, left or right, ultrasound scan of, if:

(a) the service is used for the assessment of one or more of the following suspected or known conditions:

(i) abnormality of tendons or bursae about the knee;

(ii) a meniscal cyst, popliteal fossa cyst, mass or pseudomass;

(iii) a nerve entrapment or a nerve or nerve sheath tumour;

(iv) an injury of collateral ligaments; and

(b) the service is not performed in conjunction with a service mentioned in item 55882 (R)

110.75

55881

Knee, left or right, ultrasound scan of, if:

(a) the service is used for the assessment of one or more of the following suspected or known conditions:

(i) abnormality of tendons or bursae about the knee;

(ii) a meniscal cyst, popliteal fossa cyst, mass or pseudomass;

(iii) a nerve entrapment or a nerve or nerve sheath tumour;

(iv) an injury of collateral ligaments; and

(b) the service is not performed in conjunction with a service mentioned in item 55883 (NR)

38.40

55882

Knee, left and right, ultrasound scan of, if:

(a) the service is used for the assessment of one or more of the following suspected or known conditions:

(i) abnormality of tendons or bursae about the knee;

(ii) a meniscal cyst, popliteal fossa cyst, mass or pseudomass;

(iii) a nerve entrapment or a nerve or nerve sheath tumour;

(iv) an injury of collateral ligaments; and

(b) the service is not performed in conjunction with a service mentioned in item 55880 (R)

122.90

55883

Knee, left and right, ultrasound scan of, if:

(a) the service is used for the assessment of one or more of the following suspected or known conditions:

(i) abnormality of tendons or bursae about the knee;

(ii) a meniscal cyst, popliteal fossa cyst, mass or pseudomass;

(iii) a nerve entrapment or a nerve or nerve sheath tumour;

(iv) an injury of collateral ligaments; and

(b) the service is not performed in conjunction with a service mentioned in item 55881 (NR)

42.65

55884

Lower leg, left or right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55886 (R)

110.75

55885

Lower leg, left or right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55887 (NR)

38.40

55886

Lower leg, left and right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55884 (R)

122.90

55887

Lower leg, left and right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55885 (NR)

42.65

55888

Ankle or hind foot, or both, left or right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55890 (R)

110.75

55889

Ankle or hind foot, or both, left or right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55891 (NR)

38.40

55890

Ankle or hind foot, or both, left and right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55888 (R)

122.90

55891

Ankle or hind foot, or both, left and right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55889 (NR)

42.65

55892

Mid foot or fore foot, or both, left or right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55894 (R)

110.75

55893

Mid foot or fore foot, or both, left or right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55895 (NR)

38.40

55894

Mid foot or fore foot, or both, left and right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55892 (R)

122.90

55895

Mid foot or fore foot, or both, left and right, ultrasound scan of, if the service is not performed in conjunction with a service mentioned in item 55893 (NR)

42.65

Subgroup 7—Transthoracic and stress echocardiograms

55126

Initial real time transthoracic echocardiographic examination of the heart with real time colour flow mapping from at least 3 acoustic windows, with recordings on digital media, if the service:

(a) is for the investigation of any of the following:

(i) symptoms or signs of cardiac failure;

(ii) suspected or known ventricular hypertrophy or dysfunction;

(iii) pulmonary hypertension;

(iv) valvular, aortic, pericardial, thrombotic or embolic disease;

(v) heart tumour;

(vi) symptoms or signs of congenital heart disease;

(vii) other rare indications; and

(b) is not associated with a service to which:

(i) another item in this Subgroup applies (except items 55137, 55141, 55143, 55145 and 55146); or

(ii) an item in Subgroup 2 applies (except items 55118 and 55130); or

(iii) an item in Subgroup 3 applies

Applicable not more than once in a 24 month period (R)

234.15

55127

Repeat serial real time transthoracic echocardiographic examination of the heart with real time colour flow mapping from at least 3 acoustic windows, with recordings on digital media, if the service:

(a) is for the investigation of known valvular dysfunction; and

(b) is requested by a specialist or consultant physician; and

(c) is not associated with a service to which:

(i) another item in this Subgroup applies (except items 55137, 55141, 55143, 55145 and 55146); or

(ii) an item in Subgroup 2 applies (except items 55118 and 55130); or

(iii) an item in Subgroup 3 applies (R)

234.15

55128

Repeat serial real time transthoracic echocardiographic examination of the heart with real time colour flow mapping from at least 3 acoustic windows, with recordings on digital media, if the service:

(a) is for the investigation of known valvular dysfunction; and

(b) is requested by a medical practitioner (other than a specialist or consultant physician) at, or from, a practice located in a Modified Monash 3, 4, 5, 6 or 7 area; and

(c) is not associated with a service to which:

(i) another item in this Subgroup applies (except items 55137, 55141, 55143, 55145 and 55146); or

(ii) an item in Subgroup 2 applies (except items 55118 and 55130); or

(iii) an item in Subgroup 3 applies (R)

234.15

55129

Repeat serial real time transthoracic echocardiographic examination of the heart with real time colour flow mapping from at least 3 acoustic windows, with recordings on digital media, if:

(a) valvular dysfunction is not the primary issue for the patient (although it may be a secondary issue); and

(b) the service is for the investigation of any of the following:

(i) symptoms or signs of cardiac failure;

(ii) suspected or known ventricular hypertrophy or dysfunction;

(iii) pulmonary hypertension;

(iv) aortic, thrombotic, embolic disease or pericardial disease (excluding isolated pericardial effusion or pericarditis);

(v) heart tumour;

(vi) structural heart disease;

(vii) other rare indications; and

(c) the service is requested by a specialist or consultant physician; and

(d) the service is not associated with a service to which:

(i) another item in this Subgroup applies (except items 55137, 55141, 55143, 55145 and 55146); or

(ii) an item in Subgroup 2 applies (except items 55118 and 55130); or

(iii) an item in Subgroup 3 applies (R)

234.15

55132

Serial real time transthoracic echocardiographic examination of the heart with real time colour flow mapping from at least 4 acoustic windows, with recordings on digital media, if the service:

(a) is for the investigation of a patient who:

(i) is under 17 years of age; or

(ii) has complex congenital heart disease; and

(b) is performed by a specialist or consultant physician practising in the speciality of cardiology; and

(c) is not associated with a service to which:

(i) another item in this Subgroup applies (except items 55137, 55141, 55143, 55145 and 55146); or

(ii) an item in Subgroup 2 applies (except items 55118 and 55130); or

(iii) an item in Subgroup 3 applies (R)

234.15

55133

Frequent repetition serial real time transthoracic echocardiographic examination of the heart with real time colour flow mapping from at least 3 acoustic windows, with recordings on digital media, if the service:

(a) is for the investigation of a patient who:

(i) has an isolated pericardial effusion or pericarditis; or

(ii) has a normal baseline study, and has commenced medication for non‑cardiac purposes that has cardiotoxic side effects and is a pharmaceutical benefit (within the meaning of Part VII of the National Health Act 1953) for the writing of a prescription for the supply of which under that Part an echocardiogram is required; and

(b) is not associated with a service to which:

(i) another item in this Subgroup applies (except items 55137, 55141, 55143, 55145 and 55146); or

(ii) an item in Subgroup 2 applies (except items 55118 and 55130); or

(iii) an item in Subgroup 3 applies (R)

210.75

55134

Repeat real time transthoracic echocardiographic examination of the heart with real time colour flow mapping from at least 3 acoustic windows, with recordings on digital media, for the investigation of rare cardiac pathologies, if the service:

(a) is requested by a specialist or consultant physician; and

(b) is not associated with a service to which:

(i) another item in this Subgroup applies (except items 55137, 55141, 55143, 55145 and 55146); or

(ii) an item in Subgroup 2 applies (except items 55118 and 55130); or

(iii) an item in Subgroup 3 applies (R)

234.15

55137

Serial real time transthoracic echocardiographic examination of the heart with real time colour flow mapping from at least 4 acoustic windows, with recordings on digital media, if the service:

(a) is for the investigation of a fetus with suspected or confirmed:

(i) complex congenital heart disease; or

(ii) functional heart disease; or

(iii) fetal cardiac arrhythmia; or

(iv) cardiac structural abnormality requiring confirmation; and

(b) is performed by a specialist or consultant physician practising in the speciality of cardiology with advanced training and expertise in fetal cardiac imaging; and

(c) is not associated with a service to which:

(i) an item in Subgroup 2 applies (except items 55118 and 55130); or

(ii) an item in Subgroup 3 applies (R)

234.15

55141

Exercise stress echocardiography focused study, other than a service associated with a service to which:

(a) item 11704, 11705, 11707, 11714, 11729 or 11730 applies; or

(b) an item in Subgroup 3 applies

Applicable not more than once in a 24 month period (R)

417.45

55143

Repeat pharmacological or exercise stress echocardiography if:

(a) a service to which item 55141, 55145 or 55146, or this item, applies has been performed on the patient in the previous 24 months; and

(b) the patient has symptoms of ischaemia that have evolved and are not adequately controlled with optimal medical therapy; and

(c) the service is requested by a specialist or a consultant physician; and

(d) the service is not associated with a service to which:

(i) item 11704, 11705, 11707, 11714, 11729 or 11730 applies; or

(ii) an item in Subgroup 3 applies

Applicable not more than once in a 12 month period (R)

417.45

55145

Pharmacological stress echocardiography, other than a service associated with a service to which:

(a) item 11704, 11705, 11707, 11714, 11729 or 11730 applies; or

(b) an item in Subgroup 3 applies

Applicable not more than once in a 24 month period (R)

483.85

55146

Pharmacological stress echocardiography if:

(a) a service to which item 55141 applies has been performed on the patient in the previous 4 weeks, and the test has failed due to an inadequate heart rate response; and

(b) the service is not associated with a service to which:

(i) item 11704, 11705, 11707, 11714, 11729 or 11730 applies; or

(ii) an item in Subgroup 3 applies

Applicable not more than once in a 24 month period (R)

483.85

Subgroup 1—Head

56001

Computed tomography—scan of brain without intravenous contrast medium, not being a service to which item 57001 applies (R) (Anaes.)

198.00

56007

Computed tomography—scan of brain with intravenous contrast medium and with any scans of the brain before intravenous contrast injection, when performed, not being a service to which item 57007 applies (R) (Anaes.)

253.75

56010

Computed tomography—scan of pituitary fossa with or without intravenous contrast medium and with or without brain scan when performed (R) (Anaes.)

255.90

56013

Computed tomography—scan of orbits with or without intravenous contrast medium and with or without brain scan when performed (R) (Anaes.)

253.75

56016

Computed tomography—scan of petrous bones in axial and coronal planes in 1 mm or 2 mm sections, with or without intravenous contrast medium, with or without scan of brain (R) (Anaes.)

294.35

56022

Computed tomography—scan of facial bones, para nasal sinuses or both without intravenous contrast medium (R) (Anaes.)

228.35

56028

Computed tomography—scan of facial bones, para nasal sinuses or both with intravenous contrast medium and with any scans of the facial bones, para nasal sinuses or both before intravenous contrast injection, when performed (R) (Anaes.)

341.85

56030

Computed tomography—scan of facial bones, para nasal sinuses or both, with scan of brain, without intravenous contrast medium (R) (Anaes.)

228.35

56036

Computed tomography—scan of facial bones, para nasal sinuses or both, with scan of brain, with intravenous contrast medium, if:

(a) a scan without intravenous contrast medium has been performed; and

(b) the service is required because the result of the scan mentioned in paragraph (a) is abnormal (R) (Anaes.)

341.85

Subgroup 2—Neck

56101

Computed tomography—scan of soft tissues of neck, including larynx, pharynx, upper oesophagus and salivary glands (not associated with cervical spine) without intravenous contrast medium, not being a service to which item 56801 applies (R) (Anaes.)

233.45

56107

Computed tomography—scan of soft tissues of neck, including larynx, pharynx, upper oesophagus and salivary glands (not associated with cervical spine)—with intravenous contrast medium and with any scans of soft tissues of neck, including larynx, pharynx, upper oesophagus and salivary glands (not associated with cervical spine) before intravenous contrast injection, when undertaken, not being a service associated with a service to which item 56807 applies (R) (Anaes.)

345.10

Subgroup 3—Spine

56219

Computed tomography—scan of spine, one or more regions with intrathecal contrast medium, including the preparation for intrathecal injection of contrast medium and any associated plain X‑rays, not being a service to which item 59724 applies (R) (Anaes.)

331.10

56220

Computed tomography—scan of spine, cervical region, without intravenous contrast medium (R) (Anaes.)

243.60

56221

Computed tomography—scan of spine, thoracic region, without intravenous contrast medium (R) (Anaes.)

243.60

56223

Computed tomography—scan of spine, lumbosacral region, without intravenous contrast medium (R) (Anaes.)

243.60

56224

Computed tomography—scan of spine, cervical region, with intravenous contrast medium and with any scans of the cervical region of the spine before intravenous contrast injection when undertaken (R) (Anaes.)

356.65

56225

Computed tomography—scan of spine, thoracic region, with intravenous contrast medium and with any scans of the thoracic region of the spine before intravenous contrast injection when undertaken (R) (Anaes.)

356.65

56226

Computed tomography—scan of spine, lumbosacral region, with intravenous contrast medium and with any scans of the lumbosacral region of the spine prior to intravenous contrast injection when undertaken (R) (Anaes.)

356.65

56233

Computed tomography—scan of spine, 2 examinations of the kind referred to in items 56220, 56221 and 56223, without intravenous contrast medium (R) (Anaes.)

243.60

56234

Computed tomography—scan of spine, 2 examinations of the kind referred to in items 56224, 56225 and 56226, with intravenous contrast medium and with any scans of these regions of the spine before intravenous contrast injection when undertaken (R) (Anaes.)

356.65

56237

Computed tomography—scan of spine, 3 regions cervical, thoracic and lumbosacral, without intravenous contrast medium (R) (Anaes.)

243.60

56238

Computed tomography—scan of spine, 3 regions, cervical, thoracic and lumbosacral, with intravenous contrast medium and with any scans of these regions of the spine before intravenous contrast injection when undertaken (R) (Anaes.)

356.65

Subgroup 4—Chest and upper abdomen

56301

Computed tomography—scan of chest, including lungs, mediastinum, chest wall and pleura, with or without scans of the upper abdomen, without intravenous contrast medium, not being a service to which item 56801 or 57001 applies and not including a study performed to exclude coronary artery calcification or image the coronary arteries (R) (Anaes.)

299.40

56307

Computed tomography—scan of chest, including lungs, mediastinum, chest wall and pleura, with or without scans of the upper abdomen, with intravenous contrast medium and with any scans of the chest, including lungs, mediastinum, chest wall or pleura and upper abdomen before intravenous contrast injection, when undertaken, not being a service to which item 56807 or 57007 applies and not including a study performed to exclude coronary artery calcification or image the coronary arteries (R) (Anaes.)

406.00

Subgroup 5—Upper abdomen only

56401

Computed tomography—scan of upper abdomen only (diaphragm to iliac crest) without intravenous contrast medium, not being a service to which item 56301, 56501, 56801 or 57001 applies (R) (Anaes.)

253.75

56407

Computed tomography—scan of upper abdomen only (diaphragm to iliac crest), with intravenous contrast medium, and with any scans of upper abdomen (diaphragm to iliac crest) before intravenous contrast injection, when undertaken, not being a service to which item 56307, 56507, 56807 or 57007 applies (R) (Anaes.)

365.40

56409

Computed tomography—scan of pelvis only (iliac crest to pubic symphysis) without intravenous contrast medium not being a service associated with a service to which item 56401 applies (R) (Anaes.)

253.75

56412

Computed tomography—scan of pelvis only (iliac crest to pubic symphysis), with intravenous contrast medium and with any scans of pelvis (iliac crest to pubic symphysis) before intravenous contrast injection, when undertaken, not being a service to which item 56407 applies (R) (Anaes.)

365.40

Subgroup 6—Upper abdomen and pelvis

56501

Computed tomography—scan of upper abdomen and pelvis without intravenous contrast medium, not for the purposes of virtual colonoscopy and not being a service to which item 56801 or 57001 applies(R) (Anaes.)

390.75

56507

Computed tomography—scan of upper abdomen and pelvis with intravenous contrast medium and with any scans of upper abdomen and pelvis before intravenous contrast injection, when performed, not for the purposes of virtual colonoscopy and not being a service to which item 56807 or 57007 applies (R) (Anaes.)

487.25

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 high‑grade colonic obstruction;

(iii) the service is requested by a specialist or consultant physician who performs colonoscopies in the practice of the specialist’s or consultant physician’s 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 (R) (Anaes.)

527.80

Subgroup 7—Extremities

56620

Computed tomography—scan of knee, without intravenous contrast medium, not being a service to which item 56622 or 56629 applies (R) (Anaes.)

223.30

56622

Computed tomography—scan of lower limb, left or right or both, one region (other than knee), or more than one region (which may include knee), without intravenous contrast medium, not being a service to which item 56620 applies (R) (Anaes.)

223.30

56623

Computed tomography—scan of lower limb, left or right or both, one region (other than knee), or more than one region (which may include knee), with intravenous contrast medium and with any scans of the lower limb before intravenous contrast injection, when performed, not being a service to which item 56626 applies (R) (Anaes.)

339.65

56626

Computed tomography—scan of knee, with intravenous contrast medium and with any scans of the knee before intravenous contrast injection, when performed, not being a service to which to which item 56623 or 56630 applies (R) (Anaes.)

339.65

56627

Computed tomography—scan of upper limb, left or right or both, any one region, or more than one region, without intravenous contrast medium (R) (Anaes.)

223.30

56628

Computed tomography—scan of upper limb, left or right or both, any one region, or more than one region, with intravenous contrast medium and with any scans of the upper limb before intravenous contrast injection, when performed (R) (Anaes.)

339.65

56629

Computed tomography—scan of upper limb and lower limb, left or right or both, any one region (other than knee), or more than one region (which may include knee) without intravenous contrast medium not being a service to which item 56620 applies (R) (Anaes.)

223.30

56630

Computed tomography—scan of upper limb and lower limb, left or right or both, any one region (other than knee), or more than one region (which may include knee) with intravenous contrast medium with any scans of the limbs before intravenous contrast injection, when performed, not being a service to which item 56626 applies (R) (Anaes.)

339.65

Subgroup 8—Chest, abdomen, pelvis and neck

56801

Computed tomography—scan of chest, abdomen and pelvis with or without scans of soft tissues of neck without intravenous contrast medium, not including a study performed to exclude coronary artery calcification or image the coronary arteries (R) (Anaes.)

473.55

56807

Computed tomography—scan of chest, abdomen and pelvis with or without scans of soft tissues of neck with intravenous contrast medium and with any scans of chest, abdomen and pelvis with or without scans of soft tissue of neck before intravenous contrast injection, when performed, not including a study performed to exclude coronary artery calcification or image the coronary arteries (R) (Anaes.)

568.40

Subgroup 9—Brain, chest and upper abdomen

57001

Computed tomography—scan of brain and chest with or without scans of upper abdomen without intravenous contrast medium, not including a study performed to exclude coronary artery calcification or image the coronary arteries (R) (Anaes.)

473.65

57007

Computed tomography—scan of brain and chest with or without scans of upper abdomen with intravenous contrast medium and with any scans of brain and chest and upper abdomen before intravenous contrast injection, when performed, not including a study performed to exclude coronary artery calcification or image the coronary arteries (R) (Anaes.)

576.25

Subgroup 10—Pelvimetry

57201

Computed tomography—pelvimetry (R) (Anaes.)

157.55

Subgroup 11—Interventional techniques

57341

Computed tomography, in conjunction with a surgical procedure using interventional techniques (R) (Anaes.)

477.05

Subgroup 12—Angiography

57352

Computed tomography—angiography with intravenous contrast medium of any or all, or any part, of:

(a) the arch of the aorta; or

(b) the carotid arteries; or

(c) the vertebral arteries and their branches (head and neck);

including any scans performed before intravenous contrast injection—one or more data acquisitions, including image editing, and maximum intensity projections or 3 dimensional surface shaded display, with hardcopy or digital recording of multiple projections, if:

(d) either:

(i) the service is requested by a specialist or consultant physician; or

(ii) the service is requested by a medical practitioner (other than a specialist or consultant physician) and the request indicates that the patient’s case has been discussed with a specialist or consultant physician; and

(e) the service is not a service to which another item in this group applies; and

(f) the service is performed for the exclusion of arterial stenosis, occlusion, aneurysm or embolism; and

(g) the service is not a study performed to image the coronary arteries (R) (Anaes.)

517.65

57353

Computed tomography—angiography with intravenous contrast medium of any or all, or any part, of:

(a) the ascending and descending aorta; or

(b) the common iliac and abdominal branches including upper limbs (chest, abdomen and upper limbs);

including any scans performed before intravenous contrast injection—one or more data acquisitions, including image editing, and maximum intensity projections or 3 dimensional surface shaded display, with hardcopy or digital recording of multiple projections, if:

(c) either:

(i) the service is requested by a specialist or consultant physician; or

(ii) the service is requested by a medical practitioner (other than a specialist or consultant physician) and the request indicates that the patient’s case has been discussed with a specialist or consultant physician; and

(d) the service is not a service to which another item in this group applies; and

(e) the service is performed for the exclusion of arterial stenosis, occlusion, aneurysm or embolism; and

(f) the service is not a study performed to image the coronary arteries (R) (Anaes.)

517.65

57354

Computed tomography—angiography with intravenous contrast medium of any or all, or any part, of:

(a) the descending aorta; or

(b) the pelvic vessels (aorto‑iliac segment) and lower limbs;

including any scans performed before intravenous contrast injection—one or more data acquisitions, including image editing, and maximum intensity projections or 3 dimensional surface shaded display, with hardcopy or digital recording of multiple projections, if:

(c) either:

(i) the service is requested by a specialist or consultant physician; or

(ii) the service is requested by a medical practitioner (other than a specialist or consultant physician) and the request indicates that the patient’s case has been discussed with a specialist or consultant physician; and

(d) the service is not a service to which another item in this group applies; and

(e) the service is performed for the exclusion of arterial stenosis, occlusion, aneurysm or embolism; and

(f) the service is not a study performed to image the coronary arteries (R) (Anaes.)

517.65

57357

Computed tomography—angiography with intravenous contrast medium of any or all, or any part, of the pulmonary arteries and their branches, including any scans performed before intravenous contrast injection—one or more data acquisitions, including image editing, and maximum intensity projections or 3 dimensional surface shaded display, with hardcopy or digital recording of multiple projections, if:

(a) the service is:

(i) performed for the exclusion of pulmonary arterial stenosis, occlusion, aneurysm or embolism and is requested by a specialist or consultant physician; or

(ii) performed for the exclusion of pulmonary arterial stenosis, occlusion or aneurysm, is requested by a medical practitioner (other than a specialist or consultant physician) and the request indicates that the patient’s case has been discussed with a specialist or consultant physician; or

(iii) performed for the exclusion of pulmonary embolism and is requested by a medical practitioner (other than a specialist or consultant physician); and

(b) the service is not:

(i) a service to which another item in this group applies; or

(ii) a study performed to image the coronary arteries (R) (Anaes)

517.65

57360

Computed tomography of the coronary arteries performed on a minimum of a 64 slice (or equivalent) scanner if:

(a) the request is made by a specialist or consultant physician; and

(b) the patient has stable or acute symptoms consistent with coronary ischaemia; and

(c) the patient is at low to intermediate risk of an acute coronary event, including having no significant cardiac biomarker elevation and no electrocardiogram changes indicating acute ischaemia (R) (Anaes.)

710.50

57364

Computed tomography of the coronary arteries performed on a minimum of a 64 slice (or equivalent) scanner, if:

(a) the service is requested by a specialist or consultant physician; and

(b) at least one of the following apply to the patient:

(i) the patient has stable symptoms and newly recognised left ventricular systolic dysfunction of unknown aetiology;

(ii) the patient requires exclusion of coronary artery anomaly or fistula;

(iii) the patient will be undergoing non‑coronary cardiac surgery;

(iv) the patient meets the criteria to be eligible for a service to which item 38247, 38249 or 38252 applies, but as an alternative to selective coronary angiography will require an assessment of the patency of one or more bypass grafts

(R) (Anaes)

710.50

Subgroup 13—Cone beam computed tomography

57362

Cone beam computed tomography—dental and temporo‑mandibular joint imaging (without contrast medium) for diagnosis and management of any of the following:

(a) mandibular and dento‑alveolar fractures;

(b) dental implant planning;

(c) orthodontics;

(d) endodontic conditions;

(e) periodontal conditions;

(f) temporo‑mandibular joint conditions

Applicable once per patient per day, not being for a service to which any of items 57960 to 57969 apply, and not being a service associated with another service in Group I2 (R) (Anaes.)

114.85

Subgroup 1—Radiographic examination of extremities

57506

Hand, wrist, forearm, elbow or humerus (NR)

30.20

57509

Hand, wrist, forearm, elbow or humerus (R)

40.35

57512

Hand and wrist, or hand, wrist and forearm, or forearm and elbow, or elbow and humerus (NR)

41.10

57515

Hand and wrist, or hand, wrist and forearm, or forearm and elbow, or elbow and humerus (R)

54.80

57518

Foot, ankle, leg or femur (NR)

33.00

57521

Foot, ankle, leg or femur (R)

44.05

57522

Knee (NR)

33.00

57523

Knee (R)

44.05

57524

Foot and ankle, or ankle and leg, or leg and knee, or knee and femur (NR)

50.15

57527

Foot and ankle, or ankle and leg, or leg and knee, or knee and femur (R)

66.75

Subgroup 2—Radiographic examination of shoulder or pelvis

57700

Shoulder or scapula (NR)

41.10

57703

Shoulder or scapula (R)

54.80

57706

Clavicle (NR)

33.00

57709

Clavicle (R)

44.05

57712

Hip joint (R)

47.85

57715

Pelvic girdle (R)

61.80

57721

Femur, internal fixation of neck or intertrochanteric (pertrochanteric) fracture (R)

100.75

Subgroup 3—Radiographic examination of head

57901

Skull, not in association with item 57902 (R)

65.45

57902

Cephalometry, not in association with item 57901 (R)

65.45

57905

Mastoids or petrous temporal bones (R)

65.45

57907

Sinuses, or facial bones—orbit, maxilla or malar, any or all (R)

48.00

57915

Mandible, not by orthopantomography technique (R)

47.85

57918

Salivary calculus (R)

47.85

57921

Nose (R)

47.85

57924

Eye (R)

47.85

57927

Temporo‑mandibular joints (R)

50.40

57930

Teeth—single area (R)

33.40

57933

Teeth—full mouth (R)

79.40

57939

Palato‑pharyngeal studies with fluoroscopic screening (R)

65.45

57942

Palato‑pharyngeal studies without fluoroscopic screening (R)

50.40

57945

Larynx, lateral airways and soft tissues of the neck, not being a service associated with a service to which item 57939 or 57942 applies (R)

44.05

57960

Orthopantomography for diagnosis or management (or both) of trauma, infection, tumour or a congenital or surgical condition of the teeth or maxillofacial region (R)

48.10

57963

Orthopantomography for diagnosis or management (or both) of any of the following conditions, if the signs and symptoms of the condition is present:

(a) impacted teeth;

(b) caries;

(c) periodontal pathology;

(d) periapical pathology (R)

48.10

57966

Orthopantomography for diagnosis or management (or both) of missing or crowded teeth, or developmental anomalies of the teeth or jaws (R)

48.10

57969

Orthopantomography for diagnosis or management (or both) of temporo‑mandibular joint arthroses or dysfunction (R)

48.10

Subgroup 4—Radiographic examination of spine

58100

Spine—cervical (R)

68.15

58103

Spine—thoracic (R)

55.95

58106

Spine—lumbosacral (R)

78.15

58108

Spine—4 regions, cervical, thoracic, lumbosacral and sacrococcygeal (R)

111.65

58109

Spine—sacrococcygeal (R)

47.70

58112

Spine—2 examinations of the kind mentioned in items 58100, 58103, 58106 and 58109 (R)

98.70

58115

Spine—3 examinations of the kind mentioned in items 58100, 58103, 58106 and 58109 (R)

111.65

58120

Spine—4 regions, cervical, thoracic, lumbosacral and sacrococcygeal, if the service to which item 58120 or 58121 applies has not been performed on the same patient within the same calendar year (R)

111.65

58121

Spine—3 examinations of the kind mentioned in items 58100, 58103, 58106 and 58109, if the service to which item 58120 or 58121 applies has not been performed on the same patient within the same calendar year (R)

111.65

Subgroup 5—Bone age study and skeletal survey

58300

Bone age study (R)

40.70

58306

Skeletal survey (R)

90.75

Subgroup 6—Radiographic examination of thoracic region

58500

Chest (lung fields) by direct radiography (NR)

35.90

58503

Chest (lung fields) by direct radiography (R)

47.85

58506

Chest (lung fields) by direct radiography with fluoroscopic screening (R)

61.65

58509

Thoracic inlet or trachea (R)

40.35

58521

Left ribs, right ribs or sternum (R)

44.05

58524

Left and right ribs, left ribs and sternum, or right ribs and sternum (R)

57.35

58527

Left ribs, right ribs and sternum (R)

70.45

Subgroup 7—Radiographic examination of urinary tract

58700

Plain renal only (R)

46.75

58706

Intravenous pyelography, with or without preliminary plain films and with or without tomography (R)

160.25

58715

Antegrade or retrograde pyelography with or without preliminary plain films and with preparation and contrast injection, one side (R)

153.80

58718

Retrograde cystography or retrograde urethrography with or without preliminary plain films and with preparation and contrast injection (R) (Anaes.)

128.00

58721

Retrograde micturating cysto‑urethrography, with preparation and contrast injection (R) (Anaes.)

140.30

Subgroup 8—Radiographic examination of alimentary tract and biliary system

58900

Plain abdominal only, not being a service associated with a service to which item 58909, 58912 or 58915 applies (NR)

36.25

58903

Plain abdominal only, not being a service associated with a service to which item 58909, 58912 or 58915 applies (R)

48.30

58909

Barium or other opaque meal of one or more of pharynx, oesophagus, stomach or duodenum, with or without preliminary plain films of pharynx, chest or duodenum, not being a service associated with a service to which item 57939, 57942 or 57945 applies (R)

91.30

58912

Barium or other opaque meal of oesophagus, stomach, duodenum and follow through to colon, with or without screening of chest and with or without preliminary plain film (R)

111.90

58915

Barium or other opaque meal, small bowel series only, with or without preliminary plain film (R)

80.15

58916

Small bowel enema, barium or other opaque study of the small bowel, including duodenal intubation, with or without preliminary plain films, not being a service associated with a service to which item 30488 applies (R) (Anaes.)

140.60

58921

Opaque enema, with or without air contrast study and with or without preliminary plain films (R)

137.30

58927

Cholegraphy direct, with or without preliminary plain films and with preparation and contrast injection, not being a service associated with a service to which item 30439 applies (R)

77.60

58933

Cholegraphy, percutaneous transhepatic, with or without preliminary plain films and with preparation and contrast injection (R)

208.70

58936

Cholegraphy, drip infusion, with or without preliminary plain films, with preparation and contrast injection and with or without tomography (R)

198.90

58939

Defaecogram (R)

141.40

Subgroup 9—Radiographic examination for localisation of foreign bodies

59103

Localisation of foreign body, if provided in conjunction with a service mentioned in Subgroups 1 to 12 of Group I3 (R)

21.60

Subgroup 10—Radiographic examination of breasts

59300

Mammography of both breasts if there is reason to suspect the presence of malignancy because of:

(a) the past occurrence of breast malignancy in the patient; or

(b) significant history of breast or ovarian malignancy in the patient’s family; or

(c) symptoms or indications of breast disease found on examination of the patient by a medical practitioner (R)

90.85

59302

Three dimensional tomosynthesis of both breasts, if there is reason to suspect the presence of malignancy because of:

(a) the past occurrence of breast malignancy in the patient; or

(b) significant history of breast or ovarian malignancy in the patient’s family; or