Medicare Benefits Schedule - Note IN.0.19

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Category 5 - DIAGNOSTIC IMAGING SERVICES

IN.0.19

Bulk Billing Incentive

To provide an incentive to bulk-bill, for out of hospital services that are bulk billed the schedule fee is reduced by 5% and rebates paid at 100% of this revised fee (except for item 61369, and all items in Group I5 - Magnetic Resonance Imaging).  For items in Group I5 - Magnetic Resonance Imaging, the bulk billing incentive for out of hospital services is 100% of the Schedule Fee listed in the table.

Related Items: 55005 55007 55008 55010 55011 55013 55014 55016 55017 55019 55023 55026 55028 55029 55030 55031 55032 55033 55036 55037 55038 55039 55048 55049 55054 55059 55060 55061 55062 55063 55064 55065 55067 55068 55069 55070 55073 55076 55079 55084 55085 55113 55114 55115 55116 55117 55118 55119 55120 55121 55122 55123 55125 55130 55131 55135 55136 55220 55221 55222 55223 55224 55226 55227 55228 55229 55230 55232 55233 55235 55236 55238 55244 55246 55248 55252 55274 55276 55278 55280 55282 55284 55292 55294 55296 55600 55601 55603 55604 55700 55701 55702 55703 55704 55705 55706 55707 55708 55709 55710 55711 55712 55713 55714 55715 55716 55717 55718 55719 55720 55721 55722 55723 55724 55725 55726 55727 55729 55730 55735 55736 55737 55739 55759 55760 55762 55763 55764 55765 55766 55767 55768 55769 55770 55771 55772 55773 55774 55775 55800 55801 55802 55803 55804 55805 55806 55807 55808 55809 55810 55811 55812 55813 55814 55815 55816 55817 55818 55819 55820 55821 55822 55823 55824 55825 55826 55828 55829 55830 55831 55832 55833 55834 55835 55836 55837 55838 55839 55840 55841 55842 55843 55844 55845 55846 55847 55848 55849 55850 55851 55852 55853 55854 55855 56001 56007 56010 56013 56016 56022 56028 56030 56036 56041 56047 56050 56053 56056 56062 56068 56070 56076 56101 56107 56141 56147 56219 56220 56221 56223 56224 56225 56226 56227 56228 56229 56230 56231 56232 56233 56234 56235 56236 56237 56238 56239 56240 56259 56301 56307 56341 56347 56401 56407 56409 56412 56441 56447 56449 56452 56501 56507 56541 56547 56619 56625 56659 56665 56801 56807 56841 56847 57001 57007 57041 57047 57201 57247 57341 57345 57350 57351 57355 57356 57360 57361 57506 57509 57512 57515 57518 57521 57524 57527 57529 57530 57532 57533 57535 57536 57538 57539 57700 57702 57703 57705 57706 57708 57709 57711 57712 57714 57715 57717 57721 57723 57901 57902 57903 57906 57909 57911 57912 57914 57915 57917 57918 57920 57921 57923 57924 57926 57927 57929 57930 57932 57933 57935 57938 57939 57941 57942 57944 57945 57947 57950 57953 57956 57959 57960 57962 57963 57965 57966 57968 57969 58100 58102 58103 58105 58106 58108 58109 58111 58112 58114 58115 58117 58123 58124 58126 58127 58300 58302 58306 58308 58500 58502 58503 58505 58506 58508 58509 58511 58521 58523 58524 58526 58527 58529 58700 58702 58706 58708 58715 58717 58718 58720 58721 58723 58900 58902 58903 58905 58909 58911 58912 58914 58915 58916 58917 58920 58921 58923 58927 58929 58933 58935 58936 58938 58939 58941 59103 59104 59300 59301 59303 59304 59306 59307 59309 59310 59312 59313 59314 59315 59318 59319 59700 59701 59703 59704 59712 59713 59715 59716 59718 59719 59724 59725 59733 59734 59739 59740 59751 59752 59754 59755 59763 59764 59903 59912 59925 59970 59971 59972 59973 59974 60000 60001 60003 60004 60006 60007 60009 60010 60012 60013 60015 60016 60018 60019 60021 60022 60024 60025 60027 60028 60030 60031 60033 60034 60036 60037 60039 60040 60042 60043 60045 60046 60048 60049 60051 60052 60054 60055 60057 60058 60060 60061 60063 60064 60066 60067 60069 60070 60072 60073 60075 60076 60078 60079 60100 60101 60500 60501 60503 60506 60509 60510 60918 60927 61109 61110 61302 61303 61306 61307 61310 61313 61314 61316 61317 61320 61328 61340 61348 61352 61353 61356 61360 61361 61364 61368 61372 61373 61376 61381 61383 61384 61386 61387 61389 61390 61393 61397 61401 61402 61405 61409 61413 61417 61421 61425 61426 61429 61430 61433 61434 61437 61438 61441 61442 61445 61446 61449 61450 61453 61454 61457 61458 61461 61462 61469 61473 61480 61484 61485 61495 61499 61505 61523 61529 61541 61553 61559 61565 61650 61651 61652 61653 61654 61655 61656 61657 61658 61659 61660 61661 61662 61663 61664 61665 61666 61667 61668 61669 61670 61671 61672 61673 61674 61675 61676 61677 61678 61679 61680 61681 61682 61683 61684 61685 61686 61687 61688 61689 61690 61691 61692 61693 61694 61695 61696 61697 61698 61699 61700 61701 61702 61703 61704 61705 61706 61707 61708 61709 61710 61712 61713 61714 61715 61716 61717 61718 61719 61729 63001 63004 63007 63010 63013 63014 63016 63017 63040 63043 63046 63049 63052 63055 63058 63061 63064 63067 63070 63073 63074 63075 63076 63077 63078 63079 63080 63081 63082 63083 63084 63085 63101 63104 63111 63114 63117 63119 63125 63128 63131 63134 63135 63136 63151 63154 63157 63158 63161 63164 63167 63170 63173 63176 63179 63182 63185 63186 63187 63188 63189 63190 63191 63192 63193 63194 63201 63204 63207 63208 63219 63222 63225 63228 63231 63234 63237 63240 63243 63257 63258 63259 63260 63261 63262 63263 63264 63265 63271 63274 63277 63280 63282 63283 63284 63285 63301 63304 63307 63310 63311 63313 63322 63325 63328 63331 63334 63337 63340 63341 63342 63343 63345 63346 63347 63348 63361 63364 63385 63388 63391 63392 63393 63394 63401 63404 63407 63408 63416 63419 63425 63428 63432 63433 63440 63443 63446 63447 63448 63449 63455 63457 63458 63461 63464 63467 63470 63473 63476 63479 63481 63482 63484 63486 63491 63494 63497 63498 63499 63501 63502 63504 63505 64990 64991


Related Items

Category 5 - DIAGNOSTIC IMAGING SERVICES

60500

60500 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
19-Feb-1997
Schedule Fee Start Date:
01-Nov-2004

FLUOROSCOPY, with general anaesthesia (not being a service associated with a radiographic examination) (R)

(Anaes.)

Fee: $43.40 Benefit: 75% = $32.55 85% = $36.90

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

60501

60501 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

FLUOROSCOPY, with general anaesthesia (not being a service associated with a radiographic examination) (R) (NK)

(Anaes.)

Fee: $21.70 Benefit: 75% = $16.30 85% = $18.45

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

60503

60503 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
19-Feb-1997
Schedule Fee Start Date:
01-Nov-2004

FLUOROSCOPY, without general anaesthesia (not being a service associated with a radiographic examination) (R)

Fee: $29.75 Benefit: 75% = $22.35 85% = $25.30

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

60506

60506 - Additional Information

Item Start Date:
31-Oct-1992
Description Start Date:
01-Nov-1997
Schedule Fee Start Date:
01-Nov-2004

FLUOROSCOPY using a mobile image intensifier, in conjunction with a surgical procedure lasting less than 1 hour, not being a service associated with a service to which another item in this Table applies (R)

Fee: $63.75 Benefit: 75% = $47.85 85% = $54.20

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

60509

60509 - Additional Information

Item Start Date:
31-Oct-1992
Description Start Date:
01-Nov-1997
Schedule Fee Start Date:
01-Nov-2004

FLUOROSCOPY using a mobile image intensifier, in conjunction with a surgical procedure lasting 1 hour or more, not being a service associated with a service to which another item in this Table applies (R)

Fee: $98.90 Benefit: 75% = $74.20 85% = $84.10

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

60510

60510 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

FLUOROSCOPY using a mobile image intensifier, in conjunction with a surgical procedure lasting 1 hour or more, not being a service associated with a service to which another item in this Table applies (R) (NK)

Fee: $49.45 Benefit: 75% = $37.10 85% = $42.05

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63385

63385 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

NOTE: Benefits are payable for each service included by Subgroup 14 on two occasions only in any 12 month period


MAGNETIC RESONANCE IMAGING (including Magnetic Resonance Angiography if performed), performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of cardiovascular system for:


- congenital disease of the heart or a great vessel (R) (Contrast)

(Anaes.)

Fee: $448.00 Benefit: 75% = $336.00 85% = $380.80

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63388

63388 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- tumour of the heart or a great vessel (R) (Contrast)

(Anaes.)

Fee: $448.00 Benefit: 75% = $336.00 85% = $380.80

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63391

63391 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- abnormality of thoracic aorta (R) (Contrast)

(Anaes.)

Fee: $403.20 Benefit: 75% = $302.40 85% = $342.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63392

63392 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

NOTE: Benefits are payable for each service included by Subgroup 14 on two occasions only in any 12 month period


MAGNETIC RESONANCE IMAGING (including Magnetic Resonance Angiography if performed), performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of cardiovascular system for:


- congenital disease of the heart or a great vessel (R) (NK) (Contrast)

(Anaes.)

Fee: $224.00 Benefit: 75% = $168.00 85% = $190.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63393

63393 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- tumour of the heart or a great vessel (R) (NK) (Contrast)

(Anaes.)

Fee: $224.00 Benefit: 75% = $168.00 85% = $190.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63394

63394 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- abnormality of thoracic aorta (R) (NK) (Contrast)

(Anaes.)

Fee: $201.60 Benefit: 75% = $151.20 85% = $171.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63455

63455 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

NOTE: Benefits are payable for each service included by Subgroup 19 on one occasion only in any 12 month period


MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of body for:


- adrenal mass in a patient with malignancy which is otherwise resectable (R) (NK)

(Anaes.)

Fee: $179.20 Benefit: 75% = $134.40 85% = $152.35

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63457

63457 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jan-2014
Schedule Fee Start Date:
01-Jul-2011

MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician and where:  

(a)     a dedicated breast coil is used; and

(b)     the request for scan identifies that the person is asymptomatic and is less than 50 years of age; and

(c)     the request for scan identifies either:

    (i)     that the patient is at high risk of developing breast cancer, due to 1 of the following:

    (A) 3 or more first or second degree relatives on the same side of the family diagnosed with breast or ovarian cancer;

    (B) 2 or more first or second degree relatives on the same side of the family diagnosed with breast or ovarian cancer,  if any of the following applies to at least 1 of the relatives:                                                              

        - has been diagnosed with bilateral breast cancer;

        - had onset of breast cancer before the age of 40 years;

        - had onset of ovarian cancer before the age of 50 years;

        - has been diagnosed with breast and ovarian cancer, at the same time or at different times;

        - has Ashkenazi Jewish ancestry;

        - is a male relative who has been diagnosed with breast cancer;


    (C) 1 first or second degree relative diagnosed with breast cancer at age 45 years or younger, plus another first or second degree relative on the same side of the family with bone or soft tissue sarcoma at age 45 years or younger; or


    (ii)    that genetic testing has identified the presence of a high risk breast cancer gene mutation.


Scan of both breasts for:


- detection of cancer (R)


NOTE: Benefits are payable on one occasion only in any 12 month period

(NK)

(Anaes.)

Fee: $345.00 Benefit: 75% = $258.75 85% = $293.25

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63458

63458 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jan-2014
Schedule Fee Start Date:
01-Jul-2011

MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician and where:

(a)     a dedicated breast coil is used; and

(b)   the person has had an abnormality detected as a result of a service described in item 63464 or 63457 performed in the previous 12 months


Scan of both breasts for:


- detection of cancer (R)

NOTE 1:    Benefits are payable on one occasion only in any 12 month period


NOTE 2:    This item is intended for follow-up imaging of abnormalities diagnosed on a scan described by item 63464 or 63457


(NK)

(Anaes.)

Fee: $345.00 Benefit: 75% = $258.75 85% = $293.25

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63461

63461 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

NOTE: Benefits are payable for each service included by Subgroup 19 on one occasion only in any 12 month period


MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of body for:


- adrenal mass in a patient with malignancy which is otherwise resecetable (R)

(Anaes.)

Fee: $358.40 Benefit: 75% = $268.80 85% = $304.65

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63464

63464 - Additional Information

Item Start Date:
01-Feb-2009
Description Start Date:
01-Jan-2014
Schedule Fee Start Date:
01-Feb-2009

MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician and where:  

(a)     a dedicated breast coil is used; and

(b)     the request for scan identifies that the person is asymptomatic and is less than 50 years of age; and

(c)     the request for scan identifies either:

    (i)     that the patient is at high risk of developing breast cancer, due to 1 of the following:

    (A) 3 or more first or second degree relatives on the same side of the family diagnosed with breast or ovarian cancer;

    (B) 2 or more first or second degree relatives on the same side of the family diagnosed with breast or ovarian cancer,  if any of the following applies to at least 1 of the relatives:                                                              

        - has been diagnosed with bilateral breast cancer;

        - had onset of breast cancer before the age of 40 years;

        - had onset of ovarian cancer before the age of 50 years;

        - has been diagnosed with breast and ovarian cancer, at the same time or at different times;

        - has Ashkenazi Jewish ancestry;

        - is a male relative who has been diagnosed with breast cancer;


    (C) 1 first or second degree relative diagnosed with breast cancer at age 45 years or younger, plus another first or second degree relative on the same side of the family with bone or soft tissue sarcoma at age 45 years or younger; or


    (ii)    that genetic testing has identified the presence of a high risk breast cancer gene mutation.


Scan of both breasts for:


- detection of cancer (R)


NOTE: Benefits are payable on one occasion only in any 12 month period

(Anaes.)

Fee: $690.00 Benefit: 75% = $517.50 85% = $609.80

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63467

63467 - Additional Information

Item Start Date:
01-Feb-2009
Description Start Date:
01-Jan-2014
Schedule Fee Start Date:
01-Feb-2009

MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician and where:

(a)     a dedicated breast coil is used; and

(b)   the person has had an abnormality detected as a result of a service described in item 63464 performed in the previous 12 months


Scan of both breasts for:


- detection of cancer (R)


NOTE 1:    Benefits are payable on one occasion only in any 12 month period


NOTE 2:    This item is intended for follow-up imaging of abnormalities diagnosed on a scan described by item     63464

(Anaes.)

Fee: $690.00 Benefit: 75% = $517.50 85% = $609.80

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55113

55113 - Additional Information

Item Start Date:
01-Jul-2001
Description Start Date:
01-May-2002
Schedule Fee Start Date:
01-Nov-2007

M-MODE and 2 DIMENSIONAL REAL TIME ECHOCARDIOGRAPHIC EXAMINATION of the heart from at least 2 acoustic windows, with measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave Doppler techniques, and real time colour flow mapping from at least 2 acoustic windows, with recordings on video tape or digital medium, not being a service associated with a service to which an item in Subgroups 1 (with the exception of item 55054) or 3, or another item in this Subgroup (with the exception of items 55118 and 55130), applies, for the investigation of symptoms or signs of cardiac failure, or suspected or known ventricular hypertrophy or dysfunction, or chest pain (R)

Fee: $230.65 Benefit: 75% = $173.00 85% = $196.10

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55114

55114 - Additional Information

Item Start Date:
01-Jul-2001
Description Start Date:
01-May-2002
Schedule Fee Start Date:
01-Nov-2007

M-MODE and 2 DIMENSIONAL REAL TIME ECHOCARDIOGRAPHIC EXAMINATION of the heart from at least 2 acoustic windows, with measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave Doppler techniques, and real time colour flow mapping from at least 2 acoustic windows, with recordings on video tape or digital medium, not being a service associated with a service to which an item in Subgroups 1 (with the exception of item 55054) or 3, or another item in this Subgroup (with the exception of items 55118 and 55130), applies, for the investigation of suspected or known acquired valvular, aortic, pericardial, thrombotic, or embolic disease, or heart tumour (R)

Fee: $230.65 Benefit: 75% = $173.00 85% = $196.10

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55115

55115 - Additional Information

Item Start Date:
01-Jul-2001
Description Start Date:
01-May-2002
Schedule Fee Start Date:
01-Nov-2007

M-MODE and 2 DIMENSIONAL REAL TIME ECHOCARDIOGRAPHIC EXAMINATION of the heart from at least 2 acoustic windows, with measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave Doppler techniques, and real time colour flow mapping from at least 2 acoustic windows, with recordings on video tape or digital medium, not being a service associated with a service to which an item in Subgroups 1 (with the exception of item 55054) or 3, or another item in this Subgroup (with the exception of items 55118 and 55130), applies, for the investigation of symptoms or signs of congenital heart disease (R)

Fee: $230.65 Benefit: 75% = $173.00 85% = $196.10

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55116

55116 - Additional Information

Item Start Date:
01-Nov-2000
Description Start Date:
01-May-2002
Schedule Fee Start Date:
01-Nov-2007

EXERCISE STRESS ECHOCARDIOGRAPHY performed in conjunction with item 11712, with two-dimensional recordings before exercise (baseline) from at least three acoustic windows and matching recordings from the same windows at, or immediately after, peak exercise, not being a service associated with a service to which an item in Subgroups 1 (with the exception of item 55054) or 3, or another item in this Subgroup applies (with the exception of items 55118 and 55130). Recordings must be made on digital media with equipment permitting display of baseline and matching peak images on the same screen (R)

Fee: $261.65 Benefit: 75% = $196.25 85% = $222.45

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55117

55117 - Additional Information

Item Start Date:
01-Nov-2000
Description Start Date:
01-May-2002
Schedule Fee Start Date:
01-Nov-2007

PHARMACOLOGICAL STRESS ECHOCARDIOGRAPHY performed in conjunction with item 11712, with two-dimensional recordings before drug infusion (baseline) from at least three acoustic windows and matching recordings from the same windows at least twice during drug infusion, including a recording at the peak drug dose not being a service associated with a service to which an item in Subgroups 1 (with the exception of item 55054) or 3, or another item in this Subgroup, applies (with the exception of items 55118 and 55130). Recordings must be made on digital media with equipment permitting display of baseline and matching peak images on the same screen (R)

Fee: $261.65 Benefit: 75% = $196.25 85% = $222.45

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55118

55118 - Additional Information

Item Start Date:
31-Oct-1992
Description Start Date:
01-May-2004
Schedule Fee Start Date:
01-Jun-2003

HEART, 2 DIMENSIONAL REAL TIME TRANSOESOPHAGEAL EXAMINATION of, from at least two levels, and in more than one plane at each level:

(a)    with:

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

    (ii)    recordings on video tape or digital medium; and

(b)    not being an intra-operative service or a service associated with a service to which an item

in Subgroups 1 (with the exception of item 55054) or 3, applies (R)

(Anaes.)

Fee: $275.50 Benefit: 75% = $206.65 85% = $234.20

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55119

55119 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

M-MODE and 2 DIMENSIONAL REAL TIME ECHOCARDIOGRAPHIC EXAMINATION of the heart from at least 2 acoustic windows, with measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave Doppler techniques, and real time colour flow mapping from at least 2 acoustic windows, with recordings on video tape or digital medium, not being a service associated with a service to which an item in Subgroups 1 (with the exception of items 55026 and 55054) or 3, or another item in this Subgroup (with the exception of items 55118, 55125, 55130 and 55131), applies, for the investigation of symptoms or signs of cardiac failure, or suspected or known ventricular hypertrophy or dysfunction, or chest pain (R) (NK)

Fee: $115.35 Benefit: 75% = $86.55 85% = $98.05

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55120

55120 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

M-MODE and 2 DIMENSIONAL REAL TIME ECHOCARDIOGRAPHIC EXAMINATION of the heart from at least 2 acoustic windows, with measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave Doppler techniques, and real time colour flow mapping from at least 2 acoustic windows, with recordings on video tape or digital medium, not being a service associated with a service to which an item in Subgroups 1 (with the exception of items 55026 and 55054) or 3, or another item in this Subgroup (with the exception of items 55118, 55125, 55130 and 55131), applies, for the investigation of suspected or known acquired valvular, aortic, pericardial, thrombotic, or embolic disease, or heart tumour (R) (NK)

Fee: $115.35 Benefit: 75% = $86.55 85% = $98.05

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55121

55121 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

M-MODE and 2 DIMENSIONAL REAL TIME ECHOCARDIOGRAPHIC EXAMINATION of the heart from at least 2 acoustic windows, with measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave Doppler techniques, and real time colour flow mapping from at least 2 acoustic windows, with recordings on video tape or digital medium, not being a service associated with a service to which an item in Subgroups 1 (with the exception of items 55026 and 55054) or 3, or another item in this Subgroup (with the exception of items 55118, 55125, 55130 and 55131), applies, for the investigation of symptoms or signs of congenital heart disease (R) (NK)

Fee: $115.35 Benefit: 75% = $86.55 85% = $98.05

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55122

55122 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

EXERCISE STRESS ECHOCARDIOGRAPHY performed in conjunction with item 11712, with two-dimensional recordings before exercise (baseline) from at least three acoustic windows and matching recordings from the same windows at, or immediately after, peak exercise, not being a service associated with a service to which an item in Subgroups 1 (with the exception of items 55026 and 55054) or 3, or another item in this Subgroup applies (with the exception of items 55118, 55125, 55130 and 55131). Recordings must be made on digital media with equipment permitting display of baseline and matching peak images on the same screen (R) (NK)

Fee: $130.85 Benefit: 75% = $98.15 85% = $111.25

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55123

55123 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

PHARMACOLOGICAL STRESS ECHOCARDIOGRAPHY performed in conjunction with item 11712, with two-dimensional recordings before drug infusion (baseline) from at least three acoustic windows and matching recordings from the same windows at least twice during drug infusion, including a recording at the peak drug dose not being a service associated with a service to which an item in Subgroups 1 (with the exception of items 55026 and 55054) or 3, or another item in this Subgroup, applies (with the exception of items 55118, 55125, 55130 and 55131). Recordings must be made on digital media with equipment permitting display of baseline and matching peak images on the same screen (R) (NK)

Fee: $130.85 Benefit: 75% = $98.15 85% = $111.25

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55125

55125 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

HEART, 2 DIMENSIONAL REAL TIME TRANSOESOPHAGEAL EXAMINATION of, from at least two levels, and in more than one plane at each level:

(a)    with:

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

    (ii)    recordings on video tape or digital medium; and

(b)    not being an intra-operative service or a service associated with a service to which an item

in Subgroups 1 (with the exception of items 55026 and 55054) or 3, applies (R) (NK)

(Anaes.)

Fee: $137.75 Benefit: 75% = $103.35 85% = $117.10

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55130

55130 - Additional Information

Item Start Date:
31-Oct-1992
Description Start Date:
01-May-2004
Schedule Fee Start Date:
01-May-2004

INTRA-OPERATIVE 2 DIMENSIONAL REAL TIME TRANSOESOPHAGEAL ECHOCARDIOGRAPHY incorporating Doppler techniques with colour flow mapping and recording onto video tape or digital medium, performed during cardiac surgery incorporating sequential assessment of cardiac function before and after the surgical procedure - not associated with item 55135 (R)

(Anaes.)

Fee: $170.00 Benefit: 75% = $127.50 85% = $144.50

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55131

55131 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

INTRA-OPERATIVE 2 DIMENSIONAL REAL TIME TRANSOESOPHAGEAL ECHOCARDIOGRAPHY incorporating Doppler techniques with colour flow mapping and recording onto video tape or digital medium, performed during cardiac surgery incorporating sequential assessment of cardiac function before and after the surgical procedure - not associated with items 55135 and 55136 (R) (NK)

(Anaes.)

Fee: $85.00 Benefit: 75% = $63.75 85% = $72.25

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55135

55135 - Additional Information

Item Start Date:
01-May-2004
Description Start Date:
01-May-2004
Schedule Fee Start Date:
01-May-2004

INTRA-OPERATIVE 2 DIMENSIONAL REAL TIME TRANSOESOPHAGEAL ECHOCARDIOGRAPHY incorporating Doppler techniques with colour flow mapping and recording onto video tape or digital medium, performed during cardiac valve surgery (repair or replacement) incorporating sequential assessment of cardiac function and valve competence before and after the surgical procedure - not associated with item 55130 (R)

(Anaes.)

Fee: $353.60 Benefit: 75% = $265.20 85% = $300.60

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55136

55136 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

INTRA-OPERATIVE 2 DIMENSIONAL REAL TIME TRANSOESOPHAGEAL ECHOCARDIOGRAPHY incorporating Doppler techniques with colour flow mapping and recording onto video tape or digital medium, performed during cardiac valve surgery (repair or replacement) incorporating sequential assessment of cardiac function and valve competence before and after the surgical procedure - not associated with items 55130 and 55131 (R) (NK)

(Anaes.)

Fee: $176.80 Benefit: 75% = $132.60 85% = $150.30

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57506

57506 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-1997
Schedule Fee Start Date:
01-Nov-2004

HAND, WRIST, FOREARM, ELBOW OR HUMERUS (NR)

Fee: $29.75 Benefit: 75% = $22.35 85% = $25.30

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57509

57509 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-1997
Schedule Fee Start Date:
01-Nov-2004

HAND, WRIST, FOREARM, ELBOW OR HUMERUS (R)

Fee: $39.75 Benefit: 75% = $29.85 85% = $33.80

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57512

57512 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-May-2005
Schedule Fee Start Date:
01-Nov-2004

HAND AND WRIST OR HAND, WRIST AND FOREARM OR FOREARM AND ELBOW OR ELBOW AND HUMERUS (NR)

Fee: $40.50 Benefit: 75% = $30.40 85% = $34.45

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57515

57515 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-May-2005
Schedule Fee Start Date:
01-Nov-2004

HAND AND WRIST OR HAND, WRIST AND FOREARM OR FOREARM AND ELBOW OR ELBOW AND HUMERUS (R)

Fee: $54.00 Benefit: 75% = $40.50 85% = $45.90

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57518

57518 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-1997
Schedule Fee Start Date:
01-Nov-2004

FOOT, ANKLE, LEG, KNEE OR FEMUR (NR)

Fee: $32.50 Benefit: 75% = $24.40 85% = $27.65

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57521

57521 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-1997
Schedule Fee Start Date:
01-Nov-2004

FOOT, ANKLE, LEG, KNEE OR FEMUR (R)

Fee: $43.40 Benefit: 75% = $32.55 85% = $36.90

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57524

57524 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-1997
Schedule Fee Start Date:
01-Nov-2004

FOOT AND ANKLE, OR ANKLE AND LEG, OR LEG AND KNEE, OR KNEE AND FEMUR (NR)

Fee: $49.40 Benefit: 75% = $37.05 85% = $42.00

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57527

57527 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-1997
Schedule Fee Start Date:
01-Nov-2004

FOOT AND ANKLE, OR ANKLE AND LEG, OR LEG AND KNEE, OR KNEE AND FEMUR (R)

Fee: $65.75 Benefit: 75% = $49.35 85% = $55.90

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57529

57529 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

HAND, WRIST, FOREARM, ELBOW OR HUMERUS (NR) (NK)

Fee: $14.90 Benefit: 75% = $11.20 85% = $12.70

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57530

57530 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

HAND, WRIST, FOREARM, ELBOW OR HUMERUS (R) (NK)

Fee: $19.90 Benefit: 75% = $14.95 85% = $16.95

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57532

57532 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

HAND AND WRIST OR HAND, WRIST AND FOREARM OR FOREARM AND ELBOW OR ELBOW AND HUMERUS (NR) (NK)

Fee: $20.25 Benefit: 75% = $15.20 85% = $17.25

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57533

57533 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

HAND AND WRIST OR HAND, WRIST AND FOREARM OR FOREARM AND ELBOW OR ELBOW AND HUMERUS (R) (NK)

Fee: $27.00 Benefit: 75% = $20.25 85% = $22.95

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57535

57535 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

FOOT, ANKLE, LEG, KNEE OR FEMUR (NR) (NK)

Fee: $16.25 Benefit: 75% = $12.20 85% = $13.85

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57536

57536 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

FOOT, ANKLE, LEG, KNEE OR FEMUR (R) (NK)

Fee: $21.70 Benefit: 75% = $16.30 85% = $18.45

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57538

57538 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

FOOT AND ANKLE, OR ANKLE AND LEG, OR LEG AND KNEE, OR KNEE AND FEMUR (NR) (NK)

Fee: $24.70 Benefit: 75% = $18.55 85% = $21.00

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57539

57539 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

FOOT AND ANKLE, OR ANKLE AND LEG, OR LEG AND KNEE, OR KNEE AND FEMUR (R) (NK)

Fee: $32.90 Benefit: 75% = $24.70 85% = $28.00

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63425

63425 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

NOTE: Benefits are payable for each service included by Subgroup 17 on two occasions only in any 12 month period, for previously diagnosed conditions


MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of person under the age of 16 for:


- post-inflammatory or post-traumatic physeal fusion (R)

(Anaes.)

Fee: $403.20 Benefit: 75% = $302.40 85% = $342.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63428

63428 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- Gaucher disease (R)

(Anaes.)

Fee: $403.20 Benefit: 75% = $302.40 85% = $342.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63432

63432 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

NOTE: Benefits are payable for each service included by Subgroup 17 on two occasions only in any 12 month period, for previously diagnosed conditions


MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of person under the age of 16 for:


- post-inflammatory or post-traumatic physeal fusion (R) (NK)

(Anaes.)

Fee: $201.60 Benefit: 75% = $151.20 85% = $171.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63433

63433 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- Gaucher disease (R) (NK)

(Anaes.)

Fee: $201.60 Benefit: 75% = $151.20 85% = $171.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63219

63219 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

NOTE: Benefits are payable for each service included by Subgroup 9 on three occasions only in any 12 month period


MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of three contiguous regions or two non  contiguous regions of the spine for:


- demyelinating disease (R) (Contrast)

(Anaes.)

Fee: $448.00 Benefit: 75% = $336.00 85% = $380.80

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63222

63222 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- congenital malformation of the spinal cord or the cauda equina or the meninges (R) (Contrast)

(Anaes.)

Fee: $448.00 Benefit: 75% = $336.00 85% = $380.80

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63225

63225 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- myelopathy (R) (Contrast)

(Anaes.)

Fee: $448.00 Benefit: 75% = $336.00 85% = $380.80

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63228

63228 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- syrinx (congenital or acquired ) (R) (Contrast)

(Anaes.)

Fee: $448.00 Benefit: 75% = $336.00 85% = $380.80

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63231

63231 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- cervical radiculopathy (R) (Contrast)

(Anaes.)

Fee: $448.00 Benefit: 75% = $336.00 85% = $380.80

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63234

63234 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- sciatica (R) (Contrast)

(Anaes.)

Fee: $448.00 Benefit: 75% = $336.00 85% = $380.80

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63237

63237 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- spinal canal stenosis (R) (Contrast)

(Anaes.)

Fee: $448.00 Benefit: 75% = $336.00 85% = $380.80

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63240

63240 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- previous spinal surgery (R) (Contrast)

(Anaes.)

Fee: $448.00 Benefit: 75% = $336.00 85% = $380.80

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63243

63243 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- trauma (R)

(Anaes.)

Fee: $448.00 Benefit: 75% = $336.00 85% = $380.80

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63257

63257 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

NOTE: Benefits are payable for each service included by Subgroup 9 on three occasions only in any 12 month period


MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of three contiguous regions or two non  contiguous regions of the spine for:


- demyelinating disease (R) (NK) (Contrast)

(Anaes.)

Fee: $224.00 Benefit: 75% = $168.00 85% = $190.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63258

63258 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- congenital malformation of the spinal cord or the cauda equina or the meninges (R) (NK) (Contrast)

(Anaes.)

Fee: $224.00 Benefit: 75% = $168.00 85% = $190.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63259

63259 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- myelopathy (R) (NK) (Contrast)

(Anaes.)

Fee: $224.00 Benefit: 75% = $168.00 85% = $190.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63260

63260 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- syrinx (congenital or acquired ) (R) (NK) (Contrast)

(Anaes.)

Fee: $224.00 Benefit: 75% = $168.00 85% = $190.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63261

63261 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- cervical radiculopathy (R) (NK) (Contrast)

(Anaes.)

Fee: $224.00 Benefit: 75% = $168.00 85% = $190.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63262

63262 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- sciatica (R) (NK) (Contrast)

(Anaes.)

Fee: $224.00 Benefit: 75% = $168.00 85% = $190.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63263

63263 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- spinal canal stenosis (R) (NK) (Contrast)

(Anaes.)

Fee: $224.00 Benefit: 75% = $168.00 85% = $190.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63264

63264 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- previous spinal surgery (R) (NK) (Contrast)

(Anaes.)

Fee: $224.00 Benefit: 75% = $168.00 85% = $190.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63265

63265 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- trauma (R) (NK)

(Anaes.)

Fee: $224.00 Benefit: 75% = $168.00 85% = $190.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

61109

61109 - Additional Information

Item Start Date:
31-Oct-1992
Description Start Date:
01-Nov-1997
Schedule Fee Start Date:
01-Nov-2004

FLUOROSCOPY in an ANGIOGRAPHY SUITE with image intensification, in conjunction with a surgical procedure, using interventional techniques, not being a service associated with a service to which another item in this Table applies (R)

Fee: $258.90 Benefit: 75% = $194.20 85% = $220.10

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

61110

61110 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

FLUOROSCOPY in an ANGIOGRAPHY SUITE with image intensification, in conjunction with a surgical procedure, using interventional techniques, not being a service associated with a service to which another item in this Table applies (R) (NK)

Fee: $129.45 Benefit: 75% = $97.10 85% = $110.05

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57901

57901 - Additional Information

Item Start Date:
01-Nov-1998
Description Start Date:
01-Nov-1998
Schedule Fee Start Date:
01-Nov-2004

SKULL, not in association with item 57902 (R)

Fee: $64.50 Benefit: 75% = $48.40 85% = $54.85

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57902

57902 - Additional Information

Item Start Date:
01-Nov-1998
Description Start Date:
01-Nov-1998
Schedule Fee Start Date:
01-Nov-2004

CEPHALOMETRY, not in association with item 57901 (R)

Fee: $64.50 Benefit: 75% = $48.40 85% = $54.85

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57903

57903 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Dec-1991
Schedule Fee Start Date:
01-Nov-2004

SINUSES (R)

Fee: $47.30 Benefit: 75% = $35.50 85% = $40.25

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57906

57906 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Dec-1991
Schedule Fee Start Date:
01-Nov-2004

MASTOIDS (R)

Fee: $64.50 Benefit: 75% = $48.40 85% = $54.85

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57909

57909 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Dec-1991
Schedule Fee Start Date:
01-Nov-2004

PETROUS TEMPORAL BONES (R)

Fee: $64.50 Benefit: 75% = $48.40 85% = $54.85

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57911

57911 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

SKULL, not in association with item 57902 or 57914 (R) (NK)

Fee: $32.25 Benefit: 75% = $24.20 85% = $27.45

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57912

57912 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Dec-1991
Schedule Fee Start Date:
01-Nov-2004

FACIAL BONES  orbit, maxilla or malar, any or all (R)

Fee: $47.15 Benefit: 75% = $35.40 85% = $40.10

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57914

57914 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

CEPHALOMETRY, not in association with item 57901 or 57911 (R) (NK)

Fee: $32.25 Benefit: 75% = $24.20 85% = $27.45

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57915

57915 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-1996
Schedule Fee Start Date:
01-Nov-2004

MANDIBLE, not by orthopantomography technique (R)

Fee: $47.15 Benefit: 75% = $35.40 85% = $40.10

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57917

57917 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

SINUSES (R) (NK)

Fee: $23.65 Benefit: 75% = $17.75 85% = $20.15

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57918

57918 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-1996
Schedule Fee Start Date:
01-Nov-2004

SALIVARY CALCULUS (R)

Fee: $47.15 Benefit: 75% = $35.40 85% = $40.10

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57920

57920 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

MASTOIDS (R) (NK)

Fee: $32.25 Benefit: 75% = $24.20 85% = $27.45

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57921

57921 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Dec-1991
Schedule Fee Start Date:
01-Nov-2004

NOSE (R)

Fee: $47.15 Benefit: 75% = $35.40 85% = $40.10

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57923

57923 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

PETROUS TEMPORAL BONES (R) (NK)

Fee: $32.25 Benefit: 75% = $24.20 85% = $27.45

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57924

57924 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Dec-1991
Schedule Fee Start Date:
01-Nov-2004

EYE (R)

Fee: $47.15 Benefit: 75% = $35.40 85% = $40.10

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57926

57926 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

FACIAL BONES  orbit, maxilla or malar, any or all (R) (NK)

Fee: $23.60 Benefit: 75% = $17.70 85% = $20.10

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57927

57927 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Dec-1991
Schedule Fee Start Date:
01-Nov-2004

TEMPOROMANDIBULAR JOINTS (R)

Fee: $49.65 Benefit: 75% = $37.25 85% = $42.25

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57929

57929 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

MANDIBLE, not by orthopantomography technique (R) (NK)

Fee: $23.60 Benefit: 75% = $17.70 85% = $20.10

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57930

57930 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Dec-1991
Schedule Fee Start Date:
01-Nov-2004

TEETH  SINGLE AREA (R)

Fee: $32.90 Benefit: 75% = $24.70 85% = $28.00

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57932

57932 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

SALIVARY CALCULUS (R) (NK)

Fee: $23.60 Benefit: 75% = $17.70 85% = $20.10

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57933

57933 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Dec-1991
Schedule Fee Start Date:
01-Nov-2004

TEETH  FULL MOUTH (R)

Fee: $78.25 Benefit: 75% = $58.70 85% = $66.55

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57935

57935 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

NOSE (R) (NK)

Fee: $23.60 Benefit: 75% = $17.70 85% = $20.10

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57938

57938 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

EYE (R) (NK)

Fee: $23.60 Benefit: 75% = $17.70 85% = $20.10

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57939

57939 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Dec-1991
Schedule Fee Start Date:
01-Nov-2004

PALATOPHARYNGEAL STUDIES with fluoroscopic screening (R)

Fee: $64.50 Benefit: 75% = $48.40 85% = $54.85

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57941

57941 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

TEMPOROMANDIBULAR JOINTS (R) (NK)

Fee: $24.85 Benefit: 75% = $18.65 85% = $21.15

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57942

57942 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Dec-1991
Schedule Fee Start Date:
01-Nov-2004

PALATOPHARYNGEAL STUDIES without fluoroscopic screening (R)

Fee: $49.65 Benefit: 75% = $37.25 85% = $42.25

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57944

57944 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

TEETH  SINGLE AREA (R) (NK)

Fee: $16.45 Benefit: 75% = $12.35 85% = $14.00

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57945

57945 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-1996
Schedule Fee Start Date:
01-Nov-2004

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)

Fee: $43.40 Benefit: 75% = $32.55 85% = $36.90

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57947

57947 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

TEETH  FULL MOUTH (R) (NK)

Fee: $39.15 Benefit: 75% = $29.40 85% = $33.30

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57950

57950 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

PALATOPHARYNGEAL STUDIES with fluoroscopic screening (R) (NK)

Fee: $32.25 Benefit: 75% = $24.20 85% = $27.45

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57953

57953 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

PALATOPHARYNGEAL STUDIES without fluoroscopic screening (R) (NK)

Fee: $24.85 Benefit: 75% = $18.65 85% = $21.15

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57956

57956 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

LARYNX, LATERAL AIRWAYS AND SOFT TISSUES OF THE NECK, not being a service associated with a service to which item 57939, 57942, 57950 or 57953 applies (R) (NK)

Fee: $21.70 Benefit: 75% = $16.30 85% = $18.45

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57959

57959 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

Orthopantomography, for diagnosis and/or management of trauma, infection, tumours, congenital conditions or surgical conditions of the teeth or maxillofacial region (R) (NK)

Fee: $23.70 Benefit: 75% = $17.80 85% = $20.15

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57960

57960 - Additional Information

Item Start Date:
01-Nov-2002
Description Start Date:
01-Nov-2002
Schedule Fee Start Date:
01-Nov-2004

Orthopantomography, for diagnosis and/or management of trauma, infection, tumours, congenital conditions or surgical conditions of the teeth or maxillofacial region (R)

Fee: $47.40 Benefit: 75% = $35.55 85% = $40.30

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57962

57962 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

Orthopantomography, for diagnosis and/or management of impacted teeth, caries, periodontal or peripical pathology where signs or symptoms of those conditions are evident (R) (NK)

Fee: $23.70 Benefit: 75% = $17.80 85% = $20.15

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57963

57963 - Additional Information

Item Start Date:
01-Nov-2002
Description Start Date:
01-Nov-2002
Schedule Fee Start Date:
01-Nov-2004

Orthopantomography, for diagnosis and/or management of impacted teeth, caries, periodontal or peripical pathology where signs or symptoms of those conditions are evident (R)

Fee: $47.40 Benefit: 75% = $35.55 85% = $40.30

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57965

57965 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

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

Fee: $23.70 Benefit: 75% = $17.80 85% = $20.15

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57966

57966 - Additional Information

Item Start Date:
01-Nov-2002
Description Start Date:
01-Nov-2002
Schedule Fee Start Date:
01-Nov-2004

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

Fee: $47.40 Benefit: 75% = $35.55 85% = $40.30

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57968

57968 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

Orthopantomography, for diagnosis and/or management of temporomandibular joint arthroses or dysfunction (R) (NK)

Fee: $23.70 Benefit: 75% = $17.80 85% = $20.15

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57969

57969 - Additional Information

Item Start Date:
01-Nov-2002
Description Start Date:
01-Nov-2002
Schedule Fee Start Date:
01-Nov-2004

Orthopantomography, for diagnosis and/or management of temporomandibular joint arthroses or dysfunction (R)

Fee: $47.40 Benefit: 75% = $35.55 85% = $40.30

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58300

58300 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
20-Jan-1997
Schedule Fee Start Date:
01-Nov-2004

BONE AGE STUDY (R)

Fee: $40.10 Benefit: 75% = $30.10 85% = $34.10

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58302

58302 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

BONE AGE STUDY (R) (NK)

Fee: $20.05 Benefit: 75% = $15.05 85% = $17.05

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58306

58306 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-1996
Schedule Fee Start Date:
01-Nov-2004

SKELETAL SURVEY (R)

Fee: $89.40 Benefit: 75% = $67.05 85% = $76.00

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58308

58308 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

SKELETAL SURVEY (R) (NK)

Fee: $44.70 Benefit: 75% = $33.55 85% = $38.00

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58500

58500 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Dec-1991
Schedule Fee Start Date:
01-Nov-2004

CHEST (lung fields) by direct radiography (NR)

Fee: $35.35 Benefit: 75% = $26.55 85% = $30.05

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58502

58502 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

CHEST (lung fields) by direct radiography (NR) (NK)

Fee: $17.70 Benefit: 75% = $13.30 85% = $15.05

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58503

58503 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Dec-1991
Schedule Fee Start Date:
01-Nov-2004

CHEST (lung fields) by direct radiography (R)

Fee: $47.15 Benefit: 75% = $35.40 85% = $40.10

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58505

58505 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

CHEST (lung fields) by direct radiography (R) (NK)

Fee: $23.60 Benefit: 75% = $17.70 85% = $20.10

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58506

58506 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Dec-1991
Schedule Fee Start Date:
01-Nov-2004

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

Fee: $60.75 Benefit: 75% = $45.60 85% = $51.65

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58508

58508 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

CHEST (lung fields) by direct radiography with fluoroscopic screening (R) (NK)

Fee: $30.40 Benefit: 75% = $22.80 85% = $25.85

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58509

58509 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Dec-1991
Schedule Fee Start Date:
01-Nov-2004

THORACIC INLET OR TRACHEA (R)

Fee: $39.75 Benefit: 75% = $29.85 85% = $33.80

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58511

58511 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

THORACIC INLET OR TRACHEA (R) (NK)

Fee: $19.90 Benefit: 75% = $14.95 85% = $16.95

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58521

58521 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-1996
Schedule Fee Start Date:
01-Nov-2004

LEFT RIBS, RIGHT RIBS OR STERNUM (R)

Fee: $43.40 Benefit: 75% = $32.55 85% = $36.90

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58523

58523 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

LEFT RIBS, RIGHT RIBS OR STERNUM (R) (NK)

Fee: $21.70 Benefit: 75% = $16.30 85% = $18.45

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58524

58524 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-1996
Schedule Fee Start Date:
01-Nov-2004

LEFT AND RIGHT RIBS, LEFT RIBS AND STERNUM, OR RIGHT RIBS AND STERNUM (R)

Fee: $56.50 Benefit: 75% = $42.40 85% = $48.05

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58526

58526 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

LEFT AND RIGHT RIBS, LEFT RIBS AND STERNUM, OR RIGHT RIBS AND STERNUM (R) (NK)

Fee: $28.25 Benefit: 75% = $21.20 85% = $24.05

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58527

58527 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-1996
Schedule Fee Start Date:
01-Nov-2004

LEFT RIBS, RIGHT RIBS AND STERNUM (R)

Fee: $69.40 Benefit: 75% = $52.05 85% = $59.00

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58529

58529 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

LEFT RIBS, RIGHT RIBS AND STERNUM (R) (NK)

Fee: $34.70 Benefit: 75% = $26.05 85% = $29.50

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

59103

59103 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-2009
Schedule Fee Start Date:
01-Nov-2009

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

Fee: $21.30 Benefit: 75% = $16.00 85% = $18.15

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

59104

59104 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

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

Fee: $10.65 Benefit: 75% = $8.00 85% = $9.10

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63401

63401 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

NOTE: Benefits are payable for each service included by Subgroup 15 on three occasions only in any 12 month period


MAGNETIC RESONANCE ANGIOGRAPHY performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician and where the request for the scan specifically identifies the clinical indication for the scan - scan of cardiovascular system for:


- vascular abnormality in a patient with a previous anaphylactic reaction to an iodinated contrast medium (R) (Contrast)

(Anaes.)

Fee: $403.20 Benefit: 75% = $302.40 85% = $342.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63404

63404 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- obstruction of the superior vena cava, inferior vena cava or a major pelvic vein (R) (Contrast)

(Anaes.)

Fee: $403.20 Benefit: 75% = $302.40 85% = $342.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63407

63407 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

NOTE: Benefits are payable for each service included by Subgroup 15 on three occasions only in any 12 month period


MAGNETIC RESONANCE ANGIOGRAPHY performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician and where the request for the scan specifically identifies the clinical indication for the scan - scan of cardiovascular system for:


- vascular abnormality in a patient with a previous anaphylactic reaction to an iodinated contrast medium (R) (NK) (Contrast)

(Anaes.)

Fee: $201.60 Benefit: 75% = $151.20 85% = $171.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63408

63408 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- obstruction of the superior vena cava, inferior vena cava or a major pelvic vein (R) (NK) (Contrast)

(Anaes.)

Fee: $201.60 Benefit: 75% = $151.20 85% = $171.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63040

63040 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

NOTE: Benefits are payable for each service included by Subgroup 2 on three occasions only in any 12 month period


MAGNETIC RESONANCE IMAGING (including Magnetic Resonance Angiography if performed), performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of head for:


- acoustic neuroma (R) (Contrast)

(Anaes.)

Fee: $336.00 Benefit: 75% = $252.00 85% = $285.60

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63043

63043 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- pituitary tumour (R) (Contrast)

(Anaes.)

Fee: $358.40 Benefit: 75% = $268.80 85% = $304.65

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63046

63046 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- toxic or metabolic or ischaemic encephalopathy (R) (Contrast)

(Anaes.)

Fee: $403.20 Benefit: 75% = $302.40 85% = $342.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63049

63049 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- demyelinating disease of the brain (R) (Contrast)

(Anaes.)

Fee: $403.20 Benefit: 75% = $302.40 85% = $342.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63052

63052 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- congenital malformation of the brain or meninges (R) (Contrast)

(Anaes.)

Fee: $403.20 Benefit: 75% = $302.40 85% = $342.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63055

63055 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- venous sinus thrombosis (R) (Contrast)

(Anaes.)

Fee: $403.20 Benefit: 75% = $302.40 85% = $342.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63058

63058 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- head trauma (R) (Contrast)

(Anaes.)

Fee: $403.20 Benefit: 75% = $302.40 85% = $342.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63061

63061 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- epilepsy (R) (Contrast)

(Anaes.)

Fee: $403.20 Benefit: 75% = $302.40 85% = $342.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63064

63064 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- stroke (R) (Contrast)

(Anaes.)

Fee: $403.20 Benefit: 75% = $302.40 85% = $342.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63067

63067 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- carotid or vertebral artery desection (R) (Contrast)

(Anaes.)

Fee: $403.20 Benefit: 75% = $302.40 85% = $342.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63070

63070 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- intracranial aneurysm (R) (Contrast)

(Anaes.)

Fee: $403.20 Benefit: 75% = $302.40 85% = $342.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63073

63073 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- intracranial arteriovenous malformation (R) (Contrast)

(Anaes.)

Fee: $403.20 Benefit: 75% = $302.40 85% = $342.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63074

63074 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

NOTE: Benefits are payable for each service included by Subgroup 2 on three occasions only in any 12 month period


MAGNETIC RESONANCE IMAGING (including Magnetic Resonance Angiography if performed), performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of head for:


- acoustic neuroma (R) (NK) (Contrast)

(Anaes.)

Fee: $168.00 Benefit: 75% = $126.00 85% = $142.80

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63075

63075 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- pituitary tumour (R) (NK) (Contrast)

(Anaes.)

Fee: $179.20 Benefit: 75% = $134.40 85% = $152.35

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63076

63076 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- toxic or metabolic or ischaemic encephalopathy (R) (NK) (Contrast)

(Anaes.)

Fee: $201.60 Benefit: 75% = $151.20 85% = $171.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63077

63077 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- demyelinating disease of the brain (R) (NK) (Contrast)

(Anaes.)

Fee: $201.60 Benefit: 75% = $151.20 85% = $171.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63078

63078 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- congenital malformation of the brain or meninges (R) (NK) (Contrast)

(Anaes.)

Fee: $201.60 Benefit: 75% = $151.20 85% = $171.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63079

63079 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- venous sinus thrombosis (R) (NK) (Contrast)

(Anaes.)

Fee: $201.60 Benefit: 75% = $151.20 85% = $171.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63080

63080 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- head trauma (R) (NK) (Contrast)

(Anaes.)

Fee: $201.60 Benefit: 75% = $151.20 85% = $171.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63081

63081 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- epilepsy (R) (NK) (Contrast)

(Anaes.)

Fee: $201.60 Benefit: 75% = $151.20 85% = $171.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63082

63082 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- stroke (R) (NK) (Contrast)

(Anaes.)

Fee: $201.60 Benefit: 75% = $151.20 85% = $171.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63083

63083 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- carotid or vertebral artery desection (R) (NK) (Contrast)

(Anaes.)

Fee: $201.60 Benefit: 75% = $151.20 85% = $171.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63084

63084 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- intracranial aneurysm (R) (NK) (Contrast)

(Anaes.)

Fee: $201.60 Benefit: 75% = $151.20 85% = $171.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63085

63085 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- intracranial arteriovenous malformation (R) (NK) (Contrast)

(Anaes.)

Fee: $201.60 Benefit: 75% = $151.20 85% = $171.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

64990

64990 - Additional Information

Item Start Date:
01-Feb-2004
Description Start Date:
01-Feb-2004
Schedule Fee Start Date:
01-Nov-2012

A diagnostic imaging service to which an item in this table (other than this item or item 64991) applies if:

(a)    the service is an unreferred service; and

(b)    the service is provided to a person who is under the age of 16 or is a Commonwealth concession card holder;         and

(c)    the person is not an admitted patient of a hospital; and

(d)    the service is bulk-billed in respect of the fees for:

    (i)    this item; and

    (ii)    the other item in this table applying to the service

Fee: $7.05 Benefit: 85% = $6.00

(See para IN.0.14, IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

64991

64991 - Additional Information

Item Start Date:
01-May-2004
Description Start Date:
01-Sep-2004
Schedule Fee Start Date:
01-Nov-2012

A diagnostic imaging service to which an item in this table (other than this item or item 64990) applies if:

(a)    the service is an unreferred service; and

(b)    the service is provided to a person who is under the age of 16 or is a Commonwealth concession card holder;         and

(c)    the person is not an admitted patient of a hospital; and

(d)    the service is bulk-billed in respect of the fees for:

    (i)    this item; and

    (ii)    the other item in this table applying to the service; and

(e)    the service is provided at, or from, a practice location in:

    (i)    a regional, rural or remote area; or

    (ii)    Tasmania; or

    (iii)    A geographical area included in any of the following SSD spatial units:

    (A)    Beaudesert Shire Part A

    (B)    Belconnen

    (C)    Darwin City

    (D)    Eastern Outer Melbourne

    (E)    East Metropolitan, Perth

    (F)    Frankston City

    (G)    Gosford-Wyong

    (H)    Greater Geelong City Part A

    (I)    Gungahlin-Hall

    (J)    Ipswich City (part in BSD)

    (K)    Litchfield Shire

    (L)    Melton-Wyndham

    (M)    Mornington Peninsula Shire

    (N)    Newcastle

    (O)    North Canberra

    (P)    Palmerston-East Arm

    (Q)    Pine Rivers Shire

    (R)    Queanbeyan

    (S)    South Canberra

    (T)    South Eastern Outer Melbourne

    (U)    Southern Adelaide

    (V)    South West Metropolitan, Perth

    (W)    Thuringowa City Part A

    (X)    Townsville City Part A

    (Y)    Tuggeranong

    (Z)    Weston Creek-Stromlo

    (ZA)    Woden Valley

    (ZB)    Yarra Ranges Shire Part A; or

    (iv)    the geographical area included in the SLA spatial unit of Palm Island (AC)

Fee: $10.65 Benefit: 85% = $9.10

(See para IN.0.14, IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56001

56001 - Additional Information

Item Start Date:
01-Nov-1996
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

HEAD


COMPUTED TOMOGRAPHY - scan of brain without intravenous contrast medium, not being a service to which item 57001 applies (R) (K) (Anaes.)

Fee: $195.05 Benefit: 75% = $146.30 85% = $165.80

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56007

56007 - Additional Information

Item Start Date:
01-Nov-1996
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of brain with intravenous contrast medium and with any scans of the brain prior to intravenous contrast injection, when undertaken, not being a service to which item 57007 applies (R) (K) (Anaes.)

Fee: $250.00 Benefit: 75% = $187.50 85% = $212.50

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56010

56010 - Additional Information

Item Start Date:
01-Nov-1996
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of pituitary fossa with or without intravenous contrast medium and with or without brain scan when undertaken (R) (K) (Anaes.)

Fee: $252.10 Benefit: 75% = $189.10 85% = $214.30

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56013

56013 - Additional Information

Item Start Date:
01-Nov-1996
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of orbits with or without intravenous contrast medium and with or without brain scan when undertaken (R) (K) (Anaes.)

Fee: $250.00 Benefit: 75% = $187.50 85% = $212.50

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56016

56016 - Additional Information

Item Start Date:
01-Nov-1996
Description Start Date:
01-Feb-2000
Schedule Fee Start Date:
01-Nov-2004

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) (K) (Anaes.)

Fee: $290.00 Benefit: 75% = $217.50 85% = $246.50

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56022

56022 - Additional Information

Item Start Date:
01-Nov-1996
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of facial bones, para nasal sinuses or both without intravenous contrast medium (R) (K) (Anaes.)

Fee: $225.00 Benefit: 75% = $168.75 85% = $191.25

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56028

56028 - Additional Information

Item Start Date:
01-Nov-1996
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

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 prior to intravenous contrast injection, when undertaken (R) (K) (Anaes.)

Fee: $336.80 Benefit: 75% = $252.60 85% = $286.30

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56030

56030 - Additional Information

Item Start Date:
01-Feb-2000
Description Start Date:
01-Feb-2000
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of facial bones, paranasal sinuses or both, with scan of brain, without intravenous contrast medium (R) (K) (Anaes.)

Fee: $225.00 Benefit: 75% = $168.75 85% = $191.25

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56036

56036 - Additional Information

Item Start Date:
01-Feb-2000
Description Start Date:
01-Feb-2000
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of facial bones, paranasal sinuses or both, with scan of brain, with intravenous contrast medium, where:

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

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

Fee: $336.80 Benefit: 75% = $252.60 85% = $286.30

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56041

56041 - Additional Information

Item Start Date:
01-Mar-1999
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of brain without intravenous contrast medium, not being a service to which item 57041 applies (R) (NK) (Anaes.)

Fee: $98.75 Benefit: 75% = $74.10 85% = $83.95

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56047

56047 - Additional Information

Item Start Date:
01-Mar-1999
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of brain with intravenous contrast medium and with any scans of the brain prior to intravenous contrast injection, when undertaken, not being a service to which item 57047 applies (R) (NK) (Anaes.)

Fee: $126.10 Benefit: 75% = $94.60 85% = $107.20

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56050

56050 - Additional Information

Item Start Date:
01-Mar-1999
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of pituitary fossa with or without intravenous contrast medium and with or without brain scan when undertaken (R) (NK) (Anaes.)

Fee: $128.20 Benefit: 75% = $96.15 85% = $109.00

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56053

56053 - Additional Information

Item Start Date:
01-Mar-1999
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of orbits with or without intravenous contrast medium and with or without brain scan when undertaken (R) (NK) (Anaes.)

Fee: $128.20 Benefit: 75% = $96.15 85% = $109.00

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56056

56056 - Additional Information

Item Start Date:
01-Mar-1999
Description Start Date:
01-Feb-2000
Schedule Fee Start Date:
01-Nov-2004

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) (NK) (Anaes.)

Fee: $155.45 Benefit: 75% = $116.60 85% = $132.15

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56062

56062 - Additional Information

Item Start Date:
01-Mar-1999
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of facial bones, para nasal sinuses or both without intravenous contrast medium (R) (NK) (Anaes.)

Fee: $113.15 Benefit: 75% = $84.90 85% = $96.20

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56068

56068 - Additional Information

Item Start Date:
01-Mar-1999
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

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 prior to intravenous contrast injection, when undertaken (R) (NK) (Anaes.)

Fee: $168.40 Benefit: 75% = $126.30 85% = $143.15

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56070

56070 - Additional Information

Item Start Date:
01-May-2000
Description Start Date:
01-May-2000
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of facial bones, paranasal sinuses or both, with scan of brain, without intravenous contrast medium (R) (NK) (Anaes.)

Fee: $113.15 Benefit: 75% = $84.90 85% = $96.20

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56076

56076 - Additional Information

Item Start Date:
01-May-2000
Description Start Date:
01-May-2000
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of facial bones, paranasal sinuses or both, with scan of brain, with intravenous contrast medium, where:

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

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

Fee: $168.40 Benefit: 75% = $126.30 85% = $143.15

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56101

56101 - Additional Information

Item Start Date:
01-Nov-1996
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

NECK


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) (K) (Anaes.)

Fee: $230.00 Benefit: 75% = $172.50 85% = $195.50

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56107

56107 - Additional Information

Item Start Date:
01-Nov-1996
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

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) prior to intravenous contrast injection, when undertaken, not being a service associated with a service to which item 56807 applies (R) (K) (Anaes.)

Fee: $340.00 Benefit: 75% = $255.00 85% = $289.00

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56141

56141 - Additional Information

Item Start Date:
01-Mar-1999
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

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 56841 applies (R) (NK) (Anaes.)

Fee: $116.45 Benefit: 75% = $87.35 85% = $99.00

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56147

56147 - Additional Information

Item Start Date:
01-Mar-1999
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

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) prior to intravenous contrast injection, when undertaken, not being a service associated with a service to which item 56847 applies (R) (NK) (Anaes.)

Fee: $171.60 Benefit: 75% = $128.70 85% = $145.90

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56219

56219 - Additional Information

Item Start Date:
01-Nov-1996
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

SPINE


COMPUTED TOMOGRAPHY - scan of spine, 1 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) (K) (Anaes.)

Fee: $326.20 Benefit: 75% = $244.65 85% = $277.30

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56220

56220 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of spine, cervical region, without intravenous contrast medium, payable once only, whether 1 or more attendances are required to complete the service (R) (K) (Anaes.)

Fee: $240.00 Benefit: 75% = $180.00 85% = $204.00

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56221

56221 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of spine, thoracic region, without intravenous contrast medium payable once only, whether 1 or more attendances are required to complete the service (R) (K) (Anaes.)

Fee: $240.00 Benefit: 75% = $180.00 85% = $204.00

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56223

56223 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of spine, lumbosacral region, without intravenous contrast medium, payable once only, whether 1 or more attendances are required to complete the service (R) (K) (Anaes.)

Fee: $240.00 Benefit: 75% = $180.00 85% = $204.00

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56224

56224 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of spine, cervical region, with intravenous contrast medium and with any scans of the cervical region of the spine prior to intravenous contrast injection when undertaken; only 1 benefit payable whether 1 or more attendances are required to complete the service (R) (K) (Anaes.)

Fee: $351.40 Benefit: 75% = $263.55 85% = $298.70

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56225

56225 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of spine, thoracic region, with intravenous contrast medium and with any scans of the thoracic region of the spine prior to intravenous contrast injection when undertaken, only 1 benefit payable whether 1 or more attendances are required to complete the service (R) (K) (Anaes.)

Fee: $351.40 Benefit: 75% = $263.55 85% = $298.70

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56226

56226 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

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; only 1 benefit payable whether 1 or more attendances are required to complete the service (R) (K) (Anaes.)

Fee: $351.40 Benefit: 75% = $263.55 85% = $298.70

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56227

56227 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of spine, cervical region, without intravenous contrast medium, payable once only, whether 1 or more attendances are required to complete the service (R) (NK) (Anaes.)

Fee: $122.50 Benefit: 75% = $91.90 85% = $104.15

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56228

56228 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of spine, thoracic region, without intravenous contrast medium, payable once only, whether 1 or more attendances are required to complete the service (R) (NK) (Anaes.)

Fee: $122.50 Benefit: 75% = $91.90 85% = $104.15

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56229

56229 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of spine, lumbosacral region, without intravenous contrast medium, payable once only, whether 1 or more attendances are required to complete the service (R) (NK) (Anaes.)

Fee: $122.50 Benefit: 75% = $91.90 85% = $104.15

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56230

56230 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of spine, cervical region, with intravenous contrast medium, and with any scans to the cerival region of the spine prior to intravenous contrast injection when undertaken; only 1 benefit payable whether 1 or more attendances are required to complete the service (R) (NK) (Anaes.)

Fee: $177.45 Benefit: 75% = $133.10 85% = $150.85

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56231

56231 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of spine, thoracic region, with intravenous contrast medium and with any scans of the thoracic region of the spine prior to intravenous contrast injection when undertaken; only 1 benefit payable whether 1 or more attendances are required to complete the service (R) (NK) (Anaes.)

Fee: $177.45 Benefit: 75% = $133.10 85% = $150.85

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56232

56232 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

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; only 1 benefit payable whether 1 or more attendances are required to complete the service (R) (NK) (Anaes.)

Fee: $177.45 Benefit: 75% = $133.10 85% = $150.85

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56233

56233 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

NOTE:  An account issued or a patient assignment form must show the item numbers of the examinations performed under this item


COMPUTED TOMOGRAPHY - scan of spine, two examinations of the kind referred to in items 56220, 56221 and 56223 without intravenous contrast medium payable once only, whether 1 or more attendances are required to complete the service (R) (K) (Anaes.)

Fee: $240.00 Benefit: 75% = $180.00 85% = $204.00

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56234

56234 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

NOTE:  An account issued or a patient assignment form must show the item numbers of the examinations performed under this item


COMPUTED TOMOGRAPHY - scan of spine, two 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 prior to intravenous contrast injection when undertaken; only 1 benefit payable whether 1 or more attendances are required to complete the service (R) (K) (Anaes.)

Fee: $351.40 Benefit: 75% = $263.55 85% = $298.70

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56235

56235 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

NOTE:  An account issued or a patient assignment form must show the item numbers of the examinations performed under this item


COMPUTED TOMOGRAPHY - scan of spine, two examinations of the kind referred to in items 56227, 56228 and 56229 without intravenous contrast medium payable once only, whether 1 or more attendances are required to complete the service (R) (NK) (Anaes.)

Fee: $122.45 Benefit: 75% = $91.85 85% = $104.10

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56236

56236 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

NOTE:  An account issued or a patient assignment form must show the item numbers of the examinations performed under this item


COMPUTED TOMOGRAPHY - scan of spine, two examinations of the kind referred to in items 56230, 56231 and 56232 with intravenous contrast medium and with any scans of these regions of the spine prior to intravenous contrast injection when undertaken; only 1 benefit payable whether 1 or more attendances are required to complete the service (R) (NK) (Anaes.)

Fee: $177.45 Benefit: 75% = $133.10 85% = $150.85

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56237

56237 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of spine, three regions cervical, thoracic and lumbosacral, without intravenous contrast medium, payable once only, whether 1 or more attendances are required to complete the service (R) (K) (Anaes.)

Fee: $240.00 Benefit: 75% = $180.00 85% = $204.00

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56238

56238 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of spine, three regions cervical, thoracic and lumbosacral, with intravenous contrast medium and with any scans of these regions of the spine prior to intravenous contrast injection when undertaken; only 1 benefit, payable whether 1 or more attendances are required to complete the service (R) (K) (Anaes.)

Fee: $351.40 Benefit: 75% = $263.55 85% = $298.70

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56239

56239 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of spine, three regions cervical, thoracic and lumbosacral, without intravenous contrast medium, payable once only, whether 1 or more attendances are required to complete the service (R) (NK) (Anaes.)

Fee: $122.45 Benefit: 75% = $91.85 85% = $104.10

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56240

56240 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of spine, three regions cervical, thoracic and lumbosacral, with intravenous contrast medium and with any scans of these regions of the spine prior to intravenous contrast injection when undertaken; only 1 benefit, payable whether 1 or more attendances are required to complete the service (R) (NK) (Anaes.)

Fee: $177.45 Benefit: 75% = $133.10 85% = $150.85

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56259

56259 - Additional Information

Item Start Date:
01-Mar-1999
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of spine, 1 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) (NK) (Anaes.)

Fee: $164.80 Benefit: 75% = $123.60 85% = $140.10

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56301

56301 - Additional Information

Item Start Date:
01-Nov-1996
Description Start Date:
01-May-2006
Schedule Fee Start Date:
01-Nov-2004

CHEST AND UPPER ABDOMEN


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) (K) (Anaes.)

Fee: $295.00 Benefit: 75% = $221.25 85% = $250.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56307

56307 - Additional Information

Item Start Date:
01-Nov-1996
Description Start Date:
01-May-2006
Schedule Fee Start Date:
01-Nov-2004

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 prior to 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) (K) (Anaes.)

Fee: $400.00 Benefit: 75% = $300.00 85% = $340.00

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56341

56341 - Additional Information

Item Start Date:
01-Mar-1999
Description Start Date:
01-May-2006
Schedule Fee Start Date:
01-Nov-2004

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 56841 or 57041 applies and not including a study performed to exclude coronary artery calcification or image the coronary arteries (R) (NK) (Anaes.)

Fee: $149.45 Benefit: 75% = $112.10 85% = $127.05

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56347

56347 - Additional Information

Item Start Date:
01-Mar-1999
Description Start Date:
01-May-2006
Schedule Fee Start Date:
01-Nov-2004

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 prior to intravenous contrast injection, when undertaken, not being a service to which item 56847 or 57047 applies and not including a study performed to exclude coronary artery calcification or image the coronary arteries (R) (NK) (Anaes.)

Fee: $202.00 Benefit: 75% = $151.50 85% = $171.70

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56401

56401 - Additional Information

Item Start Date:
01-Nov-1996
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

UPPER ABDOMEN


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) (K) (Anaes.)

Fee: $250.00 Benefit: 75% = $187.50 85% = $212.50

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56407

56407 - Additional Information

Item Start Date:
01-Nov-1996
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

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) prior to intravenous contrast injection, when undertaken, not being a service to which item 56307, 56507, 56807 or 57007 applies (R) (K) (Anaes.)

Fee: $360.00 Benefit: 75% = $270.00 85% = $306.00

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56409

56409 - Additional Information

Item Start Date:
01-Nov-1996
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

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) (K) (Anaes.)

Fee: $250.00 Benefit: 75% = $187.50 85% = $212.50

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56412

56412 - Additional Information

Item Start Date:
01-Nov-1996
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

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) prior to intravenous contrast injection, when undertaken, not being a service to which item 56407 applies (R) (K) (Anaes.)

Fee: $360.00 Benefit: 75% = $270.00 85% = $306.00

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56441

56441 - Additional Information

Item Start Date:
01-Mar-1999
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of upper abdomen only (diaphragm to iliac crest), without intravenous contrast medium, not being a service to which item 56341, 56541, 56841 or 57041 applies (R) (NK) (Anaes.)

Fee: $126.80 Benefit: 75% = $95.10 85% = $107.80

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56447

56447 - Additional Information

Item Start Date:
01-Mar-1999
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

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) prior to intravenous contrast injection, when undertaken, not being a service to which item 56347, 56547, 56847 or 57047 applies (R) (NK) (Anaes.)

Fee: $181.50 Benefit: 75% = $136.15 85% = $154.30

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56449

56449 - Additional Information

Item Start Date:
01-Mar-1999
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of pelvis only (iliac crest to pubic symphysis) without intravenous contrast medium, not being a service to which item 56441 applies (R) (NK) (Anaes.)

Fee: $126.80 Benefit: 75% = $95.10 85% = $107.80

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56452

56452 - Additional Information

Item Start Date:
01-Mar-1999
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

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) prior to intravenous contrast injection, when undertaken, not being a service to which item 56447 applies (R) (NK) (Anaes.)

Fee: $181.50 Benefit: 75% = $136.15 85% = $154.30

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56501

56501 - Additional Information

Item Start Date:
01-Nov-1996
Description Start Date:
01-May-2004
Schedule Fee Start Date:
01-Nov-2004

UPPER ABDOMEN AND PELVIS


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

Fee: $385.00 Benefit: 75% = $288.75 85% = $327.25

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56507

56507 - Additional Information

Item Start Date:
01-Nov-1996
Description Start Date:
01-May-2004
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of upper abdomen and pelvis with intravenous contrast medium and with any scans of upper abdomen and pelvis prior to intravenous contrast injection, when undertaken, not for the purposes of virtual colonoscopy, not being a service to which item 56807 or 57007 applies (R) (K) (Anaes.)

Fee: $480.05 Benefit: 75% = $360.05 85% = $408.05

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56541

56541 - Additional Information

Item Start Date:
01-Mar-1999
Description Start Date:
01-May-2004
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of upper abdomen and pelvis without intravenous contrast medium, not for the purposes of virtual colonoscopy, not being a service to which item 56841 or 57041 applies (R) (NK) (Anaes.)

Fee: $193.15 Benefit: 75% = $144.90 85% = $164.20

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56547

56547 - Additional Information

Item Start Date:
01-Mar-1999
Description Start Date:
01-May-2004
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of upper abdomen and pelvis with intravenous contrast medium, and with any scans of upper abdomen and pelvis prior to intravenous contrast injection, when undertaken, not for the purposes of virtual colonoscopy, not being a service to which item 56847 or 57047 applies (R) (NK) (Anaes.)

Fee: $243.75 Benefit: 75% = $182.85 85% = $207.20

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56619

56619 - Additional Information

Item Start Date:
01-Nov-1996
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

EXTREMITIES


COMPUTED TOMOGRAPHY - scan of extremities, 1 or more regions without intravenous contrast medium, payable once only whether 1 or more attendances are required to complete the service (R) (K) (Anaes.)

Fee: $220.00 Benefit: 75% = $165.00 85% = $187.00

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56625

56625 - Additional Information

Item Start Date:
01-Nov-1996
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of extremities, 1 or more regions with intravenous contrast medium and with any scans of extremities prior to intravenous contrast injection, when undertaken; only 1 benefit is payable whether 1 or more attendances are required to complete the service (R) (K) (Anaes.)

Fee: $334.65 Benefit: 75% = $251.00 85% = $284.50

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56659

56659 - Additional Information

Item Start Date:
01-Mar-1999
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of extremities, 1 or more regions without intravenous contrast medium, payable once only whether 1 or more attendances are required to complete (R) (NK) (Anaes.)

Fee: $112.10 Benefit: 75% = $84.10 85% = $95.30

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56665

56665 - Additional Information

Item Start Date:
01-Mar-1999
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - scan of extremities, 1 or more regions with intravenous contrast medium, and with any scans of extremities prior to intravenous contrast injection, when undertaken; only 1 benefit is payable whether 1 or more attendances are required to complete the service (R) (NK) (Anaes.)

Fee: $167.40 Benefit: 75% = $125.55 85% = $142.30

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56801

56801 - Additional Information

Item Start Date:
01-Nov-1996
Description Start Date:
01-May-2006
Schedule Fee Start Date:
01-Nov-2004

CHEST, ABDOMEN, PELVIS AND NECK


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) (K) (Anaes.)

Fee: $466.55 Benefit: 75% = $349.95 85% = $396.60

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56807

56807 - Additional Information

Item Start Date:
01-Nov-1996
Description Start Date:
01-May-2006
Schedule Fee Start Date:
01-Nov-2004

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 prior to intravenous contrast injection, when undertaken, not including a study performed to exclude coronary artery calcification or image the coronary arteries (R) (K) (Anaes.)

Fee: $560.00 Benefit: 75% = $420.00 85% = $479.80

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56841

56841 - Additional Information

Item Start Date:
01-Mar-1999
Description Start Date:
01-May-2006
Schedule Fee Start Date:
01-Nov-2004

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) (NK) (Anaes.)

Fee: $233.35 Benefit: 75% = $175.05 85% = $198.35

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

56847

56847 - Additional Information

Item Start Date:
01-Mar-1999
Description Start Date:
01-May-2006
Schedule Fee Start Date:
01-Nov-2004

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 prior to intravenous contrast injection, when undertaken, not including a study performed to exclude coronary artery calcification or image the coronary arteries (R) (NK) (Anaes.)

Fee: $283.85 Benefit: 75% = $212.90 85% = $241.30

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57001

57001 - Additional Information

Item Start Date:
01-Nov-1996
Description Start Date:
01-May-2006
Schedule Fee Start Date:
01-Nov-2004

BRAIN, CHEST AND UPPER ABDOMEN


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) (K) (Anaes.)

Fee: $466.65 Benefit: 75% = $350.00 85% = $396.70

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57007

57007 - Additional Information

Item Start Date:
01-Nov-1996
Description Start Date:
01-May-2006
Schedule Fee Start Date:
01-Nov-2004

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 prior to intravenous contrast injection, when undertaken, not including a study performed to exclude coronary artery calcification or image the coronary arteries (R) (K) (Anaes.)

Fee: $567.75 Benefit: 75% = $425.85 85% = $487.55

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57041

57041 - Additional Information

Item Start Date:
01-Mar-1999
Description Start Date:
01-May-2006
Schedule Fee Start Date:
01-Nov-2004

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) (NK) (Anaes.)

Fee: $233.40 Benefit: 75% = $175.05 85% = $198.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57047

57047 - Additional Information

Item Start Date:
01-Mar-1999
Description Start Date:
01-May-2006
Schedule Fee Start Date:
01-Nov-2004

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 prior to intravenous contrast injection, when undertaken, not including a study performed to exclude coronary artery calcification or image the coronary arteries (R) (NK) (Anaes.)

Fee: $283.90 Benefit: 75% = $212.95 85% = $241.35

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57201

57201 - Additional Information

Item Start Date:
01-Nov-1996
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

PELVIMETRY


COMPUTED TOMOGRAPHY - PELVIMETRY (R) (K) (Anaes.)

Fee: $155.20 Benefit: 75% = $116.40 85% = $131.95

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57247

57247 - Additional Information

Item Start Date:
01-Mar-1999
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - PELVIMETRY (R) (NK) (Anaes.)

Fee: $77.55 Benefit: 75% = $58.20 85% = $65.95

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57341

57341 - Additional Information

Item Start Date:
01-Nov-1996
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

INTERVENTIONAL TECHNIQUES


COMPUTED TOMOGRAPHY, in conjunction with a surgical procedure using interventional techniques, not being a service associated with a service to which another item in this table applies (R) (K) (Anaes.)

Fee: $470.00 Benefit: 75% = $352.50 85% = $399.50

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57345

57345 - Additional Information

Item Start Date:
01-Mar-1999
Description Start Date:
01-Mar-1999
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY, in conjunction with a surgical procedure using interventional techniques, not being a service associated with a service to which another item in this table applies (R) (NK) (Anaes.)

Fee: $241.60 Benefit: 75% = $181.20 85% = $205.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57350

57350 - Additional Information

Item Start Date:
01-Nov-1996
Description Start Date:
01-May-2006
Schedule Fee Start Date:
01-Nov-2004

SPIRAL ANGIOGRAPHY


COMPUTED TOMOGRAPHY - spiral angiography with intravenous contrast medium, including any scans performed before intravenous contrast injection - 1 or more spiral data acquisitions, including image editing, and maximum intensity projections or 3 dimensional surface shaded display, with hardcopy recording of multiple projections, where:

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

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

(c)    the service has not been performed on the same patient within the previous 12 months; and

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

Fee: $510.00 Benefit: 75% = $382.50 85% = $433.50

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57351

57351 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-May-2006
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - spiral angiography with intravenous contrast medium, including any scans performed before intravenous contrast injection - 1 or more spiral data acquisitions, including image editing, and maximum intensity projections or 3 dimensional surface shaded display, with hardcopy recording of multiple projections, where:

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

(b)    the service is performed for the exclusion of acute or recurrent pulmonary embolism; acute symptomatic arterial occlusion; post operative complication of arterial surgery; acute ruptured aneurysm; or acute dissection of the aorta, carotid or vertebral artery; and

(c)    the services to which 57350 or 57355 apply have been performed on the same patient within the previous 12 months; and

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

Fee: $510.00 Benefit: 75% = $382.50 85% = $433.50

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57355

57355 - Additional Information

Item Start Date:
01-Mar-1999
Description Start Date:
01-May-2006
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - spiral angiography with intravenous contrast medium, including any scans performed before intravenous contrast injection - 1 or more spiral data acquisitions, including image editing, and maximum intensity projections or 3 dimensional surface shaded display, with hardcopy recording of multiple projections, where:

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

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

(c)    the service has not been performed on the same patient within the previous 12 months; and

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

Fee: $264.15 Benefit: 75% = $198.15 85% = $224.55

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57356

57356 - Additional Information

Item Start Date:
01-Nov-2001
Description Start Date:
01-May-2006
Schedule Fee Start Date:
01-Nov-2004

COMPUTED TOMOGRAPHY - spiral angiography with intravenous contrast medium, including any scans performed before intravenous contrast injection - 1 or more spiral data acquisitions, including image editing, and maximum intensity projections or 3 dimensional surface shaded display, with hardcopy recording of multiple projections, where:

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

b)    the service is performed for the exclusion of acute or recurrent pulmonary embolism; acute symptomatic arterial

    occlusion; post operative complication of arterial surgery; or acute ruptured aneurysm; acute dissection of the aorta,

    carotid or vertebral artery; and

(c)    the services to which 57350 or 57355 apply have been performed on the same patient within the previous 12 months; and

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

Fee: $264.15 Benefit: 75% = $198.15 85% = $224.55

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57360

57360 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

COMPUTED TOMOGRAPHY OF THE CORONARY ARTERIES performed on a minimum of a 64 slice (or equivalent) scanner, where the request is made by a specialist or consultant physician, and:

a)    the patient has stable symptoms consistent with coronary ischaemia, is at low to intermediate risk of coronary artery disease and would have been considered for coronary angiography; or

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

c)    the patient will be undergoing non-coronary cardiac surgery (R) (K)

(Anaes.)

Fee: $700.00 Benefit: 75% = $525.00 85% = $619.80

(See para IN.0.12, IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

57361

57361 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

COMPUTED TOMOGRAPHY OF THE CORONARY ARTERIES performed on a minimum of a 64 slice (or equivalent) scanner, where the request is made by a specialist or consultant physician, and:

a)    the patient has stable symptoms consistent with coronary ischaemia, is at low to intermediate risk of coronary artery disease and would have been considered for coronary angiography; or

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

c)    the patient will be undergoing non-coronary cardiac surgery (R) (NK)

(Anaes.)

Fee: $350.00 Benefit: 75% = $262.50 85% = $297.50

(See para IN.0.12, IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58700

58700 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Dec-1991
Schedule Fee Start Date:
01-Nov-2004

PLAIN RENAL ONLY (R)

Fee: $46.05 Benefit: 75% = $34.55 85% = $39.15

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58702

58702 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

PLAIN RENAL ONLY (R) (NK)

Fee: $23.05 Benefit: 75% = $17.30 85% = $19.60

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58706

58706 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

INTRAVENOUS PYELOGRAPHY, with or without preliminary plain films and with or without tomography - (R)

Fee: $157.90 Benefit: 75% = $118.45 85% = $134.25

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58708

58708 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

INTRAVENOUS PYELOGRAPHY, with or without preliminary plain films and with or without tomography - (R) (NK)

Fee: $78.95 Benefit: 75% = $59.25 85% = $67.15

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58715

58715 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

ANTEGRADE OR RETROGRADE PYELOGRAPHY, with or without preliminary plain films and with preparation and contrast injection - 1 side - (R)

Fee: $151.55 Benefit: 75% = $113.70 85% = $128.85

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58717

58717 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

ANTEGRADE OR RETROGRADE PYELOGRAPHY, with or without preliminary plain films and with preparation and contrast injection - 1 side - (R) (NK)

Fee: $75.80 Benefit: 75% = $56.85 85% = $64.45

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58718

58718 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

RETROGRADE CYSTOGRAPHY OR RETROGRADE URETHROGRAPHY with or without preliminary plain films and with preparation and contrast injection - (R)

(Anaes.)

Fee: $126.10 Benefit: 75% = $94.60 85% = $107.20

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58720

58720 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

RETROGRADE CYSTOGRAPHY OR RETROGRADE URETHROGRAPHY with or without preliminary plain films and with preparation and contrast injection - (R) (NK)

(Anaes.)

Fee: $63.05 Benefit: 75% = $47.30 85% = $53.60

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58721

58721 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

RETROGRADE MICTURATING CYSTOURETHROGRAPHY, with preparation and contrast injection - (R)

(Anaes.)

Fee: $138.25 Benefit: 75% = $103.70 85% = $117.55

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58723

58723 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

RETROGRADE MICTURATING CYSTOURETHROGRAPHY, with preparation and contrast injection - (R) (NK)

(Anaes.)

Fee: $69.15 Benefit: 75% = $51.90 85% = $58.80

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58900

58900 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Jul-2016
Schedule Fee Start Date:
01-Nov-2004

PLAIN ABDOMINAL ONLY, not being a service associated with a service to which item 58909, 58912 or 58915 applies (NR)

Fee: $35.70 Benefit: 75% = $26.80 85% = $30.35

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58902

58902 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2016
Schedule Fee Start Date:
01-Jul-2011

PLAIN ABDOMINAL ONLY, not being a service associated with a service to which item 58909, 58911, 58912, 58914, 58915 or 58917 applies (NR) (NK)

Fee: $17.85 Benefit: 75% = $13.40 85% = $15.20

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58903

58903 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Jul-2016
Schedule Fee Start Date:
01-Nov-2004

PLAIN ABDOMINAL ONLY, not being a service associated with a service to which item 58909, 58912 or 58915 applies (R)

Fee: $47.60 Benefit: 75% = $35.70 85% = $40.50

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58905

58905 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2016
Schedule Fee Start Date:
01-Jul-2011

PLAIN ABDOMINAL ONLY, not being a service associated with a service to which item 58909, 58911, 58912, 58914, 58915 or 58917 applies (R) (NK)

Fee: $23.80 Benefit: 75% = $17.85 85% = $20.25

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58909

58909 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

BARIUM or other opaque meal of 1 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 or 57942 or 57945 applies - (R)

Fee: $89.95 Benefit: 75% = $67.50 85% = $76.50

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58911

58911 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

BARIUM or other opaque meal of 1 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, 57945, 57950, 57953 or 57956 applies - (R) (NK)

Fee: $45.00 Benefit: 75% = $33.75 85% = $38.25

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58912

58912 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Dec-1991
Schedule Fee Start Date:
01-Nov-2004

BARIUM or other opaque meal OF OESOPHAGUS, STOMACH, DUODENUM AND FOLLOW THROUGH TO COLON, with or without screening of chest, with or without preliminary plain film (R)

Fee: $110.25 Benefit: 75% = $82.70 85% = $93.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58914

58914 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

BARIUM or other opaque meal OF OESOPHAGUS, STOMACH, DUODENUM AND FOLLOW THROUGH TO COLON, with or without screening of chest, with or without preliminary plain film (R) (NK)

Fee: $55.15 Benefit: 75% = $41.40 85% = $46.90

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58915

58915 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Dec-1991
Schedule Fee Start Date:
01-Nov-2004

BARIUM or other opaque meal, SMALL BOWEL SERIES ONLY, with or without preliminary plain film (R)

Fee: $78.95 Benefit: 75% = $59.25 85% = $67.15

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58916

58916 - Additional Information

Item Start Date:
01-Nov-1997
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

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.)

Fee: $138.50 Benefit: 75% = $103.90 85% = $117.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58917

58917 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

BARIUM or other opaque meal, SMALL BOWEL SERIES ONLY, with or without preliminary plain film (R) (NK)

Fee: $39.50 Benefit: 75% = $29.65 85% = $33.60

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58920

58920 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

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) (NK)

(Anaes.)

Fee: $69.25 Benefit: 75% = $51.95 85% = $58.90

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58921

58921 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

OPAQUE ENEMA, with or without air contrast study and with or without preliminary plain films - (R)

Fee: $135.25 Benefit: 75% = $101.45 85% = $115.00

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58923

58923 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

OPAQUE ENEMA, with or without air contrast study and with or without preliminary plain films - (R) (NK)

Fee: $67.65 Benefit: 75% = $50.75 85% = $57.55

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58927

58927 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

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)

Fee: $76.45 Benefit: 75% = $57.35 85% = $65.00

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58929

58929 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

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) (NK)

Fee: $38.25 Benefit: 75% = $28.70 85% = $32.55

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58933

58933 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

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

Fee: $205.60 Benefit: 75% = $154.20 85% = $174.80

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58935

58935 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

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

Fee: $102.80 Benefit: 75% = $77.10 85% = $87.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58936

58936 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Nov-2004

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

Fee: $195.95 Benefit: 75% = $147.00 85% = $166.60

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58938

58938 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

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

Fee: $98.00 Benefit: 75% = $73.50 85% = $83.30

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58939

58939 - Additional Information

Item Start Date:
01-Nov-1996
Description Start Date:
19-Feb-1997
Schedule Fee Start Date:
01-Nov-2004

DEFAECOGRAM (R)

Fee: $139.30 Benefit: 75% = $104.50 85% = $118.45

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

58941

58941 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

DEFAECOGRAM (R) (NK)

Fee: $69.65 Benefit: 75% = $52.25 85% = $59.25

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63271

63271 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

NOTE: Benefits are payable for each service included by Subgroup 10 on three occasions only in any 12 month period


MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of cervical spine and brachial plexus for:


- tumour (R) (Contrast)

(Anaes.)

Fee: $492.80 Benefit: 75% = $369.60 85% = $418.90

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63274

63274 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- trauma (R) (Contrast)

(Anaes.)

Fee: $492.80 Benefit: 75% = $369.60 85% = $418.90

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63277

63277 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- cervical radiculopathy (R) (Contrast)

(Anaes.)

Fee: $492.80 Benefit: 75% = $369.60 85% = $418.90

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63280

63280 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- previous surgery (R) (Contrast)

(Anaes.)

Fee: $492.80 Benefit: 75% = $369.60 85% = $418.90

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63282

63282 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

NOTE: Benefits are payable for each service included by Subgroup 10 on three occasions only in any 12 month period


MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of cervical spine and brachial plexus for:


- tumour (R) (NK) (Contrast)

(Anaes.)

Fee: $246.40 Benefit: 75% = $184.80 85% = $209.45

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63283

63283 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- trauma (R) (NK) (Contrast)

(Anaes.)

Fee: $246.40 Benefit: 75% = $184.80 85% = $209.45

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63284

63284 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- cervical radiculopathy (R) (NK) (Contrast)

(Anaes.)

Fee: $246.40 Benefit: 75% = $184.80 85% = $209.45

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63285

63285 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- previous surgery (R) (NK) (Contrast)

(Anaes.)

Fee: $246.40 Benefit: 75% = $184.80 85% = $209.45

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63440

63440 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of person under the age of 16 for:


- pelvic or abdominal mass (R) (Contrast)

(Anaes.)

Fee: $403.20 Benefit: 75% = $302.40 85% = $342.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63443

63443 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- mediastinal mass (R) (Contrast)

(Anaes.)

Fee: $403.20 Benefit: 75% = $302.40 85% = $342.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63446

63446 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- congenital uterine or anorectal abnormality (R) (Contrast)

(Anaes.)

Fee: $403.20 Benefit: 75% = $302.40 85% = $342.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63447

63447 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of person under the age of 16 for:


- pelvic or abdominal mass (R) (NK) (Contrast)

(Anaes.)

Fee: $201.60 Benefit: 75% = $151.20 85% = $171.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63448

63448 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- mediastinal mass (R) (NK) (Contrast)

(Anaes.)

Fee: $201.60 Benefit: 75% = $151.20 85% = $171.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63449

63449 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- congenital uterine or anorectal abnormality (R) (NK) (Contrast)

(Anaes.)

Fee: $201.60 Benefit: 75% = $151.20 85% = $171.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63470

63470 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Nov-2010
Schedule Fee Start Date:
01-Aug-2004

NOTE: Benefits are payable for a service under items 63470 and 63473 on one occasion only.


MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where:

(a)    the patient is referred by a specialist or by a consultant physician and

(b)    the request for scan identifies that (i) a histological diagnosis of carcinoma of the cervix has been made and (ii) the patient has been diagnosed with cervical cancer at FIGO stage 1B or greater


Scan of:


- Pelvis for the staging of histologically diagnosed cervical cancer at FIGO stages 1B or greater (R) (Contrast)

(Anaes.)

Fee: $403.20 Benefit: 75% = $302.40 85% = $342.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63473

63473 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- Pelvis and upper abdomen, in a single examination, for the staging of histologically diagnosed cervical cancer at FIGO stages 1B or greater (R) (Contrast)

(Anaes.)

Fee: $627.20 Benefit: 75% = $470.40 85% = $547.00

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63476

63476 - Additional Information

Item Start Date:
01-Jul-2009
Description Start Date:
01-Nov-2010
Schedule Fee Start Date:
01-Jul-2009

NOTE: benefits are payable for a service under item 63476 on one occasion only.

MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician and where:  

(a)     a phased array body coil is used, and

(b)     the request for scan identifies that the indication is for the initial staging of rectal cancer (including cancer of the rectosigmoid and anorectum).



Scan of:


- Pelvis for the initial staging of rectal cancer (R) (contrast)

(Anaes.)

Fee: $403.20 Benefit: 75% = $302.40 85% = $342.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63479

63479 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

NOTE: Benefits are payable for a service included by Subgroup 20 on one occasion only.

MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where:

(a)    the patient is referred by a specialist or by a consultant physician and

(b)    the request for scan identifies that (i) a histological diagnosis of carcinoma of the cervix has been made and (ii) the patient has been diagnosed with cervical cancer at FIGO stage 1B or greater


Scan of:


- Pelvis for the staging of histologically diagnosed cervical cancer at FIGO stages 1B or greater (R) (NK) (Contrast)

(Anaes.)

Fee: $201.60 Benefit: 75% = $151.20 85% = $171.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63481

63481 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- Pelvis and upper abdomen, in a single examination, for the staging of histologically diagnosed cervical cancer at FIGO stages 1B or greater (R) (NK) (Contrast)

(Anaes.)

Fee: $313.60 Benefit: 75% = $235.20 85% = $266.60

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63484

63484 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

NOTE: benefits are payable for a service included by Subgroup 20 on one occasion only.

MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician and where:  

(a)     a phased array body coil is used, and

(b)     the request for scan identifies that the indication is for the initial staging of rectal cancer (including cancer of the rectosigmoid and anorectum).



Scan of:


- Pelvis for the initial staging of rectal cancer (R) (NK) (contrast)

(Anaes.)

Fee: $201.60 Benefit: 75% = $151.20 85% = $171.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63482

63482 - Additional Information

Item Start Date:
01-Jan-2006
Description Start Date:
01-Nov-2012
Schedule Fee Start Date:
01-Jan-2006

NOTE: Benefits are only payable for each service included by Subgroup 21 on three occasions only in any 12 month period

MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of pancreas and biliary tree for:

- suspected biliary or pancreatic pathology (R)

(Anaes.)

Fee: $403.20 Benefit: 75% = $302.40 85% = $342.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63486

63486 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

NOTE: Benefits are only payable for each service included by Subgroup 21 on three occasions only in any 12 month period


MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of pancreas and biliary tree for:


- suspected biliary or pancreatic pathology (R) (NK)

(Anaes.)

Fee: $201.60 Benefit: 75% = $151.20 85% = $171.40

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63151

63151 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of one region or two contiguous regions of the spine for:


- infection (R) (Contrast)

(Anaes.)

Fee: $358.40 Benefit: 75% = $268.80 85% = $304.65

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63154

63154 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- tumour (R) (Contrast)

(Anaes.)

Fee: $358.40 Benefit: 75% = $268.80 85% = $304.65

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63157

63157 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of one region or two contiguous regions of the spine for:


- infection (R) (NK) (Contrast)

(Anaes.)

Fee: $179.20 Benefit: 75% = $134.40 85% = $152.35

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63158

63158 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- tumour (R) (NK) (Contrast)

(Anaes.)

Fee: $179.20 Benefit: 75% = $134.40 85% = $152.35

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63161

63161 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

NOTE: Benefits are payable for each service included by Subgroup 7 on three occasions only in any 12 month period


MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of one region or two contiguous regions of the spine for:


- demyelinating (R) (Contrast)

(Anaes.)

Fee: $358.40 Benefit: 75% = $268.80 85% = $304.65

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63164

63164 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- congenital malformation of the spinal cord or the cauda equina or the meninges (R) (Contrast)

(Anaes.)

Fee: $358.40 Benefit: 75% = $268.80 85% = $304.65

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63167

63167 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

myelopathy (R) (Contrast)

(Anaes.)

Fee: $358.40 Benefit: 75% = $268.80 85% = $304.65

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63170

63170 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- syrinx (congenital or acquired) (R) (Contrast)

(Anaes.)

Fee: $358.40 Benefit: 75% = $268.80 85% = $304.65

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63173

63173 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- cervical radiculopathy (R) (Contrast)

(Anaes.)

Fee: $358.40 Benefit: 75% = $268.80 85% = $304.65

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63176

63176 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- sciatica (R) (Contrast)

(Anaes.)

Fee: $358.40 Benefit: 75% = $268.80 85% = $304.65

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63179

63179 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- spinal canal stenosis (R) (Contrast)

(Anaes.)

Fee: $358.40 Benefit: 75% = $268.80 85% = $304.65

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63182

63182 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- previous spinal surgery (R) (Contrast)

(Anaes.)

Fee: $358.40 Benefit: 75% = $268.80 85% = $304.65

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63185

63185 - Additional Information

Item Start Date:
01-Aug-2004
Description Start Date:
01-Aug-2004
Schedule Fee Start Date:
01-Aug-2004

- trauma (R)

(Anaes.)

Fee: $358.40 Benefit: 75% = $268.80 85% = $304.65

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63186

63186 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

NOTE: Benefits are payable for each service included by Subgroup 7 on three occasions only in any 12 month period


MAGNETIC RESONANCE IMAGING performed under the professional supervision of an eligible provider at an eligible location where the patient is referred by a specialist or by a consultant physician - scan of one region or two contiguous regions of the spine for:


- demyelinating (R) (NK) (Contrast)

(Anaes.)

Fee: $179.20 Benefit: 75% = $134.40 85% = $152.35

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63187

63187 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- congenital malformation of the spinal cord or the cauda equina or the meninges (R) (NK) (Contrast)

(Anaes.)

Fee: $179.20 Benefit: 75% = $134.40 85% = $152.35

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63188

63188 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- myelopathy (R) (NK) (Contrast)

(Anaes.)

Fee: $179.20 Benefit: 75% = $134.40 85% = $152.35

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63189

63189 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- syrinx (congenital or acquired) (R) (NK) (Contrast)

(Anaes.)

Fee: $179.20 Benefit: 75% = $134.40 85% = $152.35

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63190

63190 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- cervical radiculopathy (R) (NK) (Contrast)

(Anaes.)

Fee: $179.20 Benefit: 75% = $134.40 85% = $152.35

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63191

63191 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- sciatica (R) (NK) (Contrast)

(Anaes.)

Fee: $179.20 Benefit: 75% = $134.40 85% = $152.35

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63192

63192 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- spinal canal stenosis (R) (NK) (Contrast)

(Anaes.)

Fee: $179.20 Benefit: 75% = $134.40 85% = $152.35

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63193

63193 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- previous spinal surgery (R) (NK) (Contrast)

(Anaes.)

Fee: $179.20 Benefit: 75% = $134.40 85% = $152.35

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

63194

63194 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

- trauma (R) (NK)

(Anaes.)

Fee: $179.20 Benefit: 75% = $134.40 85% = $152.35

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55700

55700 - Additional Information

Item Start Date:
01-Feb-2000
Description Start Date:
01-Nov-2007
Schedule Fee Start Date:
01-Feb-2000

PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, ultrasound scan of, by any or all approaches, if:

(a)    the patient is referred by a medical practitioner or participating midwife; and

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

(c)    the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and

(d) if the patient is referred by a medical practitioner -- the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

(e) if the patient is referred by a participating midwife - the referring midwife does not have a business or financial arrangement with the providing practitioner; and

(f)    1 or more of the following conditions are present:

    (i)    hyperemesis gravidarum;

    (ii)    diabetes mellitus;

    (iii)    hypertension;

    (iv)    toxaemia of pregnancy;

    (v)    liver or renal disease;

    (vi)    autoimmune disease;

    (vii)    cardiac disease;

    (viii)    alloimmunisation;

    (ix)    maternal infection;

    (x)    inflammatory bowel disease;

    (xi)    bowel stoma;

    (xii)    abdominal wall scarring;

    (xiii)    previous spinal or pelvic trauma or disease;

    (xiv)    drug dependency;

    (xv)    thrombophilia;

    (xvi)    significant maternal obesity;

    (xvii)    advanced maternal age;

    (xviii)    abdominal pain or mass;

    (xix)    uncertain dates;

    (xx)    high risk pregnancy;

    (xxi)    previous post dates delivery;

    (xxii)    previous caesarean section;

    (xxiii)    poor obstetric history;

    (xxiv)    suspicion of ectopic pregnancy;

    (xxv)    risk of miscarriage;

    (xxvi)    diminished symptoms of pregnancy;

    (xxvii)    suspected or known cervical incompetence;

    (xxviii)    suspected or known uterine abnormality;

    (xxix)    pregnancy after assisted reproduction;

    (xxx)    risk of fetal abnormality (R)


Footnote: For nuchal translucency measurements performed when the pregnancy is dated by a crown rump length of 45 to 84mm, refer to item number 55707 (R). Fee is payable only for item 55700 or item 55707, not both items.

Fee: $60.00 Benefit: 75% = $45.00 85% = $51.00

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55701

55701 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, ultrasound scan of, by any or all approaches, where:

(a)    the patient is referred by a medical practitioner; and

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

(c)    the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and

(d)    the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

(e)    one or more of the following conditions are present:

    (i)    hyperemesis gravidarum;

    (ii)    diabetes mellitus;

    (iii)    hypertension;

    (iv)    toxaemia of pregnancy;

    (v)    liver or renal disease;

    (vi)    autoimmune disease;

    (vii)    cardiac disease;

    (viii)    alloimmunisation;

    (ix)    maternal infection;

    (x)    inflammatory bowel disease;

    (xi)    bowel stoma;

    (xii)    abdominal wall scarring;

    (xiii)    previous spinal or pelvic trauma or disease;

    (xiv)    drug dependency;

    (xv)    thrombophilia;

    (xvi)    significant maternal obesity;

    (xvii)    advanced maternal age;

    (xviii)    abdominal pain or mass;

    (xix)    uncertain dates;

    (xx)    high risk pregnancy;

    (xxi)    previous post dates delivery;

    (xxii)    previous caesarean section;

    (xxiii)    poor obstetric history;

    (xxiv)    suspicion of ectopic pregnancy;

    (xxv)    risk of miscarriage;

    (xxvi)    diminished symptoms of pregnancy;

    (xxvii)    suspected or known cervical incompetence;

    (xxviii)    suspected or known uterine abnormality;

    (xxix)    pregnancy after assisted reproduction;

    (xxx)    risk of fetal abnormality (R)


Footnote: For nuchal translucency measurements performed when the pregnancy is dated by a crown rump length of 45 to 84mm, refer to item number 55707 or 55714 (R) (NK). Fee is payable only for item 55700 or 55701, or, or item 55707 or 55714, not both items

Fee: $30.00 Benefit: 75% = $22.50 85% = $25.50

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55702

55702 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, ultrasound scan of, by any or all approaches, where:

(a)    the patient is not referred by a medical practitioner; and

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

(c)    the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and

(d)    one or more of the following conditions are present:

    (i)    hyperemesis gravidarum;

    (ii)    diabetes mellitus;

    (iii)    hypertension;

    (iv)    toxaemia of pregnancy;

    (v)    liver or renal disease;

    (vi)    autoimmune disease;

    (vii)    cardiac disease;

    (viii)    alloimmunisation;

    (ix)    maternal infection;

    (x)    inflammatory bowel disease;

    (xi)    bowel stoma;

    (xii)    abdominal wall scarring;

    (xiii)    previous spinal or pelvic trauma or disease;

    (xiv)    drug dependency;

    (xv)    thrombophilia;

    (xvi)    significant maternal obesity;

    (xvii)    advanced maternal age;

    (xviii)    abdominal pain or mass;

    (xix)    uncertain dates;

    (xx)    high risk pregnancy;

    (xxi)    previous post dates delivery;

    (xxii)    previous caesarean section;

    (xxiii)    poor obstetric history;

    (xxiv)    suspicion of ectopic pregnancy;

    (xxv)    risk of miscarriage;

    (xxvi)    diminished symptoms of pregnancy;

    (xxvii)    suspected or known cervical incompetence;

    (xxviii)    suspected or known uterine abnormality;

    (xxix)    pregnancy after assisted reproduction;

    (xxx)    risk of fetal abnormality (NR)


Footnote: For nuchal translucency measurements performed when the pregnancy is dated by a crown rump length of 45 to 84mm, refer to item number 55708 or 55716 (R) (NK). Fee is payable only for item 55702 or 55703, or, item 55707 or 55714, not both items

Fee: $17.50 Benefit: 75% = $13.15 85% = $14.90

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55703

55703 - Additional Information

Item Start Date:
01-Feb-2000
Description Start Date:
01-Nov-2007
Schedule Fee Start Date:
01-Feb-2000

PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, ultrasound scan of, by any or all approaches, where:

(a)    the patient is not referred by a medical practitioner; and

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

(c)    the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and

(d)    one or more of the following conditions are present:

    (i)    hyperemesis gravidarum;

    (ii)    diabetes mellitus;

    (iii)    hypertension;

    (iv)    toxaemia of pregnancy;

    (v)    liver or renal disease;

    (vi)    autoimmune disease;

    (vii)    cardiac disease;

    (viii)    alloimmunisation;

    (ix)    maternal infection;

    (x)    inflammatory bowel disease;

    (xi)    bowel stoma;

    (xii)    abdominal wall scarring;

    (xiii)    previous spinal or pelvic trauma or disease;

    (xiv)    drug dependency;

    (xv)    thrombophilia;

    (xvi)    significant maternal obesity;

    (xvii)    advanced maternal age;

    (xviii)    abdominal pain or mass;

    (xix)    uncertain dates;

    (xx)    high risk pregnancy;

    (xxi)    previous post dates delivery;

    (xxii)    previous caesarean section;

    (xxiii)    poor obstetric history;

    (xxiv)    suspicion of ectopic pregnancy;

    (xxv)    risk of miscarriage;

    (xxvi)    diminished symptoms of pregnancy;

    (xxvii)    suspected or known cervical incompetence;

    (xxviii)    suspected or known uterine abnormality;

    (xxix)    pregnancy after assisted reproduction;

    (xxx)    risk of fetal abnormality (NR)


Footnote: For nuchal translucency measurements performed when the pregnancy is dated by a crown rump length of 45 to 84mm, refer to item number 55708 (R). Fee is payable only for item 55703 or item 55707, not both items.

Fee: $35.00 Benefit: 75% = $26.25 85% = $29.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55704

55704 - Additional Information

Item Start Date:
01-Feb-2000
Description Start Date:
01-Nov-2007
Schedule Fee Start Date:
01-Feb-2000

PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, if:

(a)    the patient is referred by a medical practitioner or participating midwife; and

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

(c)    the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and

(d) if the patient is referred by a medical practitioner -- the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

(e) if the patient is referred by a participating midwife -- the referring midwife does not have a business or financial arrangement with the providing practitioner; and

(f) one or more of the following conditions are present:

    (i)    hyperemesis gravidarum;

    (ii)    diabetes mellitus;

    (iii)    hypertension;

    (iv)    toxaemia of pregnancy;

    (v)    liver or renal disease;

    (vi)    autoimmune disease;

    (vii)    cardiac disease;

    (viii)    alloimmunisation;

    (ix)    maternal infection;

    (x)    inflammatory bowel disease;

    (xi)    bowel stoma;

    (xii)    abdominal wall scarring;

    (xiii)    previous spinal or pelvic trauma or disease;

    (xiv)    drug dependency;

    (xv)    thrombophilia;

    (xvi)    significant maternal obesity;

    (xvii)    advanced maternal age;

    (xviii)    abdominal pain or mass;

    (xix)    uncertain dates;

    (xx)    high risk pregnancy;

    (xxi)    previous post dates delivery;

    (xxii)    previous caesarean section;

    (xxiii)    poor obstetric history;

    (xxiv)    suspicion of ectopic pregnancy;

    (xxv)    risk of miscarriage;

    (xxvi)    diminished symptoms of pregnancy;

    (xxvii)    suspected or known cervical incompetence;

    (xxviii)    suspected or known uterine abnormality;

    (xxix)    pregnancy after assisted reproduction;

    (xxx)    risk of fetal abnormality (R)


Footnote: For nuchal translucency measurements performed when the pregnancy is dated by a crown rump length of 45 to 84mm, refer to item number 55707 (R). Fee is payable only for item 55704 or item 55707, not both items.

Fee: $70.00 Benefit: 75% = $52.50 85% = $59.50

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55705

55705 - Additional Information

Item Start Date:
01-Feb-2000
Description Start Date:
01-Nov-2007
Schedule Fee Start Date:
01-Feb-2000

PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, where:

(a)    the patient is not referred by a medical practitioner; and

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

(c)    the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and

(d)    one or more of the following conditions are present:

    (i)    hyperemesis gravidarum

    (ii)    diabetes mellitus;

    (iii)    hypertension;

    (iv)    toxaemia of pregnancy;

    (v)    liver or renal disease;

    (vi)    autoimmune disease;

    (vii)    cardiac disease;

    (viii)    alloimmunisation;

    (ix)    maternal infection;

    (x)    inflammatory bowel disease;

    (xi)    bowel stoma;

    (xii)    abdominal wall scarring;

    (xiii)    previous spinal or pelvic trauma or disease;

    (xiv)    drug dependency;

    (xv)    thrombophilia;

    (xvi)    significant maternal obesity;

    (xvii)    advanced maternal age;

    (xviii)    abdominal pain or mass;

    (xix)    uncertain dates;

    (xx)    high risk pregnancy;

    (xxi)    previous post dates delivery;

    (xxii)    previous caesarean section;

    (xxiii)    poor obstetric history;

    (xxiv)    suspicion of ectopic pregnancy;

    (xxv)    risk of miscarriage;

    (xxvi)    diminished symptoms of pregnancy;

    (xxvii)    suspected or known cervical incompetence;

    (xxviii)    suspected or known uterine abnormality;

    (xxix)    pregnancy after assisted reproduction;

    (xxx)    risk of fetal abnormality (NR)


Footnote: For nuchal translucency measurements performed when the pregnancy is dated by a crown rump length of 45 to 84mm, refer to item number 55708 (R). Fee is payable only for item 55705 or item 55708, not both items.

Fee: $35.00 Benefit: 75% = $26.25 85% = $29.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55706

55706 - Additional Information

Item Start Date:
01-Feb-2000
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Feb-2000

PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan (not exceeding 1 service in any 1 pregnancy) of, by any or all approaches, with measurement of all parameters for dating purposes, if:

(a)    the patient is referred by a medical practitioner or participating midwife; and

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

(c)    the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and

(d) if the patient is referred by a medical practitioner - the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

(e) if the patient is referred by a participating midwife - the referring midwife does not have a business or financial arrangement with the providing practitioner; and

(f)    the service is not performed in the same pregnancy as item 55709 (R)

Fee: $100.00 Benefit: 75% = $75.00 85% = $85.00

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55707

55707 - Additional Information

Item Start Date:
01-Nov-2005
Description Start Date:
01-Nov-2007
Schedule Fee Start Date:
01-Nov-2005

PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan (not exceeding 1 service in any 1 pregnancy) of, by any or all approaches, if;

(a)    the patient is referred by a medical practitioner or participating midwife; and

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

(c)    the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and

(d) if the patient is referred by a medical practitioner - the referring medical practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and

(e) if the patient is referred by a participating midwife - the referring midwife does not have a business or financial arrangement with the providing practitioner; and

(f)    at least 1 condition mentioned in paragraph (f) of item 55704 is present; and

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

(h)    the service is not performed with item 55700, 55703, 55704 or 55705 on the same patient within 24 hours (R)

Fee: $70.00 Benefit: 75% = $52.50 85% = $59.50

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55708

55708 - Additional Information

Item Start Date:
01-Nov-2005
Description Start Date:
01-Nov-2007
Schedule Fee Start Date:
01-Nov-2005

PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan (not exceeding 1 service in any 1 pregnancy) of, by any or all approaches, where;

(a)    the patient is not referred by a medical practitioner; and

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

(c)    the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and

(d)    one or more of the conditions in subparagraphs (e) (i) to (xxx) of item 55704 are present; and

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

(f)    the service is not performed in conjunction with item 55700, 55703, 55704 or 55705 on the same patient within 24 hours (NR)

Fee: $35.00 Benefit: 75% = $26.25 85% = $29.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55709

55709 - Additional Information

Item Start Date:
01-Feb-2000
Description Start Date:
01-Feb-2000
Schedule Fee Start Date:
01-Feb-2000

PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan (not exceeding 1 service in any 1 pregnancy) of, by any or all approaches, with measurement of all parameters for dating purposes, where:

(a)    the patient is not referred by a medical practitioner; and

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

(c)    the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and

(d)    the service is not performed in the same pregnancy as item 55706 (NR)

Fee: $38.00 Benefit: 75% = $28.50 85% = $32.30

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55710

55710 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, where:

(a)    the patient is referred by a medical practitioner; and

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

(c)    the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and

(d)    the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member;

    and

(e)    one or more of the following conditions are present:

    (i)    hyperemesis gravidarum;

    (ii)    diabetes mellitus;

    (iii)    hypertension;

    (iv)    toxaemia of pregnancy;

    (v)    liver or renal disease;

    (vi)    autoimmune disease;

    (vii)    cardiac disease;

    (viii)    alloimmunisation;

    (ix)    maternal infection;

    (x)    inflammatory bowel disease;

    (xi)    bowel stoma;

    (xii)    abdominal wall scarring;

    (xiii)    previous spinal or pelvic trauma or disease;

    (xiv)    drug dependency;

    (xv)    thrombophilia;

    (xvi)    significant maternal obesity;

    (xvii)    advanced maternal age;

    (xviii)    abdominal pain or mass;

    (xix)    uncertain dates;

    (xx)    high risk pregnancy;

    (xxi)    previous post dates delivery;

    (xxii)    previous caesarean section;

    (xxiii)    poor obstetric history;

    (xxiv)    suspicion of ectopic pregnancy;

    (xxv)    risk of miscarriage;

    (xxvi)    diminished symptoms of pregnancy;

    (xxvii)    suspected or known cervical incompetence;

    (xxviii)    suspected or known uterine abnormality;

    (xxix)    pregnancy after assisted reproduction;

    (xxx)    risk of fetal abnormality (R)


Footnote: For nuchal translucency measurements performed when the pregnancy is dated by a crown rump length of 45 to 84mm, refer to item 55704 or 55707 (R) (NK). Fee is payable only for item 55704 or 55710, or, item 55707 or 55714, not both items

Fee: $35.00 Benefit: 75% = $26.25 85% = $29.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55711

55711 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, where:

(a)    the patient is not referred by a medical practitioner; and

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

(c)    the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and

(d)    one or more of the following conditions are present:

    (i)    hyperemesis gravidarum

    (ii)    diabetes mellitus;

    (iii)    hypertension;

    (iv)    toxaemia of pregnancy;

    (v)    liver or renal disease;

    (vi)    autoimmune disease;

    (vii)    cardiac disease;

    (viii)    alloimmunisation;

    (ix)    maternal infection;

    (x)    inflammatory bowel disease;

    (xi)    bowel stoma;

    (xii)    abdominal wall scarring;

    (xiii)    previous spinal or pelvic trauma or disease;

    (xiv)    drug dependency;

    (xv)    thrombophilia;

    (xvi)    significant maternal obesity;

    (xvii)    advanced maternal age;

    (xviii)    abdominal pain or mass;

    (xix)    uncertain dates;

    (xx)    high risk pregnancy;

    (xxi)    previous post dates delivery;

    (xxii)    previous caesarean section;

    (xxiii)    poor obstetric history;

    (xxiv)    suspicion of ectopic pregnancy;

    (xxv)    risk of miscarriage;

    (xxvi)    diminished symptoms of pregnancy;

    (xxvii)    suspected or known cervical incompetence;

    (xxviii)    suspected or known uterine abnormality;

    (xxix)    pregnancy after assisted reproduction;

    (xxx)    risk of fetal abnormality (NR)


Footnote: For nuchal translucency measurements performed when the pregnancy is dated by a crown rump length of 45 to 84mm, refer to item 55708 or 55716 (R) (NK). Fee is payable only for item 55705 or 55711, or,  item 55708 or 55716, not both items

Fee: $17.50 Benefit: 75% = $13.15 85% = $14.90

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55712

55712 - Additional Information

Item Start Date:
01-Feb-2000
Description Start Date:
01-Nov-2001
Schedule Fee Start Date:
01-Feb-2000

PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, where:

(a)    the patient is referred by a medical practitioner who is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists or who has a Diploma of Obstetrics or 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 has obstetric privileges at a non-metropolitan hospital; and

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

(c)    the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and

(d)    the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member;

    and

(e)    further examination is clinically indicated in the same pregnancy to which item 55706 or 55709 applies (R)

Fee: $115.00 Benefit: 75% = $86.25 85% = $97.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55713

55713 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan (not exceeding 1 service in any 1 pregnancy) of, by any or all approaches, with measurement of all parameters for dating purposes, where:

(a)    the patient is referred by a medical practitioner; and

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

(c)    the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and

(d)    the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member;    and

(e)    the service is not performed in the same pregnancy as item 55709 or 55717 (R) (NK)

Fee: $50.00 Benefit: 75% = $37.50 85% = $42.50

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES

55714

55714 - Additional Information

Item Start Date:
01-Jul-2011
Description Start Date:
01-Jul-2011
Schedule Fee Start Date:
01-Jul-2011

PELVIS OR ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan (not exceeding 1 service in any 1 pregnancy) of, by any or all approaches, where;

(a)    the patient is referred by a medical practitioner; and

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

(c)    the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and

(d)    the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member;    and

(e)    one or more of the conditions mentioned in subparagraphs (e) (i) to (xxx) of item 55704 or 55710 are present; and

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

(g)    the service is not performed with item 55700, 55701, 55702, 55703, 55704, 55705, 55710 or 55711 on the same patient within 24 hours (R) (NK)

Fee: $35.00 Benefit: 75% = $26.25 85% = $29.75

(See para IN.0.19 of explanatory notes to this Category)

Category 5 - DIAGNOSTIC IMAGING SERVICES