Medicare Benefits Schedule - Note DN.1.14

Search Results for Note DN.1.14

View Related Items

Category 2 - DIAGNOSTIC PROCEDURES AND INVESTIGATIONS

DN.1.14

Respiratory Function Tests - (Item 11503)

Specialists and consultant physicians providing services under item 11503 should successfully complete a substantial course of study and training in the relevant test, which has been endorsed by a professional medical organisation. Specialists and consultant physicians should keep appropriate records of this training. Tests should be performed in a respiratory laboratory capable of performing all of, or the majority of the tests listed. 

Fractional exhaled nitric oxide (FeNO) testing cannot be claimed under item 11503.

When laboratory based spirometry (item 11512) is performed on the same day as a test approved under item 11503, then only 11503 must be claimed. When spirometry is the only laboratory test performed then 11512 must be claimed.

Maximum inspiratory and expiratory flow-volume loop testing for the purpose of diagnosing central airways obstruction is to be performed under item 11512 not 11503. Item 11503 is not for the purpose of investigation of sleep disorders. Polygraphic data obtained as part of a sleep study item in the range 12203 to 12250 cannot be used for the purpose of claiming item 11503.

For the purposes of item 11503, (c) (iii) measurement of airway or pulmonary resistance by any method includes measurement of nasal resistance by rhinomanometry when performed in a respiratory laboratory.

Related Items: 11503


Related Items

Category 2 - DIAGNOSTIC PROCEDURES AND INVESTIGATIONS

11503

11503 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Nov-2021
Schedule Fee Updated:
01-Nov-2023

Complex measurement of properties of the respiratory system, including the lungs and respiratory muscles, that is performed:

(a) in a respiratory laboratory; and

(b) under the supervision of a specialist or consultant physician who is responsible for staff training, supervision, quality assurance and the issuing of written reports on tests performed; and

(c) using any of the following tests:

(i) measurement of absolute lung volumes by any method;

(ii) measurement of carbon monoxide diffusing capacity by any method;

(iii) measurement of airway or pulmonary resistance by any method;

(iv) inhalation provocation testing, including pre‑provocation spirometry and the construction of a dose response curve, using a recognised direct or indirect bronchoprovocation agent and post‑bronchodilator spirometry;

(v) provocation testing involving sequential measurement of lung function at baseline and after exposure to specific sensitising agents, including drugs, or occupational asthma triggers;

(vi) spirometry performed before and after simple exercise testing undertaken as a provocation test for the investigation of asthma, in premises equipped with resuscitation equipment and personnel trained in Advanced Life Support;

(vii) measurement of the strength of inspiratory and expiratory muscles at multiple lung volumes;

(viii) simulated altitude test involving exposure to hypoxic gas mixtures and oxygen saturation at rest and/or during exercise with or without an observation of the effect of supplemental oxygen;

(ix) calculation of pulmonary or cardiac shunt by measurement of arterial oxygen partial pressure and haemoglobin concentration following the breathing of an inspired oxygen concentration of 100% for a duration of 15 minutes or greater;

(x) if the measurement is for the purpose of determining eligibility for pulmonary arterial hypertension medications subsidised under the Pharmaceutical Benefits Scheme or eligibility for the provision of portable oxygen—functional exercise test by any method (including 6 minute walk test and shuttle walk test);

each occasion at which one or more tests are performed

Not applicable to a service performed in association with a spirometry or sleep study service to which item 11505, 11506, 11507, 11508, 11512, 12203, 12204, 12205, 12207, 12208, 12210, 12213, 12215, 12217 or 12250 applies

Not applicable to a service to which item 11507 applies

Fee: $152.60 Benefit: 75% = $114.45 85% = $129.75

(See para DN.1.14 of explanatory notes to this Category)


Legend

  • 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