View Associated Notes
Category 6 - PATHOLOGY SERVICES
65096 - Additional Information
Blood grouping (including back-grouping if performed), and examination of serum for Rh and other blood group antibodies, including:
(a) identification and quantitation of any antibodies detected; and
(b) (if performed) any test described in item 65060 or 65070
Fee: $41.00 Benefit: 75% = $30.75 85% = $34.85
(See para PN.1.1 of explanatory notes to this Category)
Category 6 - PATHOLOGY SERVICES
Pathology Services in Relation to Medicare Benefits - Outline of Arrangements
Determination of Necessity of Service
The treating practitioner must determine that the pathology service is necessary.
Request for Service
The service may only be provided:
(i) in response to a request from the treating practitioner, including a participating midwife or a participating nurse practitioner, or from another Approved Pathology Practitioner and the request must be in writing (or, if oral, confirmed in writing within fourteen days); or
(ii) if determined to be necessary by an Approved Pathology Practitioner who is treating the patient.
Services requested by participating midwives and participating nurse practitioners:
(i) A participating midwife can request the following services:
Items 65060, 65070, 65090 to 65099 (inclusive), 65114, 66500 to 66512 (inclusive), 66545, 66548, 66566, 66743, 66750, 66751, 69303 to 69317 (inclusive), 69324, 69384 to 69415 (inclusive), 73070, 73071, 73075, 73076 and 73529.
(ii) A participating nurse practitioner can request items in the range 65060 to 73529 (inclusive).
Provision of Service
The following conditions relate to provision of services:
(i) the service has to be provided by or on behalf of an Approved Pathology Practitioner;
(ii) the service has to be provided in a pathology laboratory accredited for that kind of service;
(iii) the proprietor of the laboratory where the service is performed must be an Approved Pathology Authority;
(iv) the Approved Pathology Practitioner providing the service must either be the proprietor of the laboratory or party to an agreement, either by way of contract of employment or otherwise, with the proprietor of the laboratory in which the service is provided; and
(v) no benefit will be payable for services provided by an Approved Pathology Practitioner on behalf of an Approved Pathology Authority if they are not performed in the laboratories of that particular Approved Pathology Authority.
Therapeutic Goods Act 1989
For any service listed in the MBS to be eligible for a Medicare rebate, the service must be rendered in accordance with the provisions of the relevant Commonwealth and State and Territory laws. Approved Pathology Practitioners have the responsibility to ensure that the supply of medicines or medical devices used in the provision of pathology services is strictly in accordance with the provisions of the Therapeutic Goods Act 1989.
- Assist - Addition/Deletion of (Assist.)
- Amend - Amended Description
- Anaes - Anaesthetic Values Amended
- Emsn - EMSN Change
- Fee - Fee Amended
- Renum - Item Number Change (renumbered)
- New - New Item
- NewMin - New Item (previous Ministerial Determination)
- Qfe - QFE Change