Medicare Benefits Schedule - Note DN.1.22

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Category 2 - DIAGNOSTIC PROCEDURES AND INVESTIGATIONS

DN.1.22

Skin Prick Testing (items 12000-12005)

Skin prick testing and Intradermal testing should always be performed in a medical setting with the ready availability of medical practitioners competent to treat systemic allergic reactions, and appropriate resuscitation equipment. Because intradermal testing carries a higher risk of anaphylaxis it should only be performed in a hospital setting (or equivalent) by either a specialist or consultant physician with proficiency and experience in all aspects of skin testing for allergy.

Item 12003 should only be used by appropriately trained doctors such as allergist immunologists or equivalently trained medical practitioners. An alternative to Skin Prick Testing (SPT) is serum specific IgE food allergen testing. Serum specific IgE (ssIgE) allergy blood testing to food panels is not recommended.

Item 12004 should only be used by appropriately trained doctors such as allergist immunologists or equivalently trained medical practitioners.

Item 12005 should only be used by appropriately trained doctors such as allergist immunologists, anaesthetists or equivalently trained medical practitioners.

Related Items: 12000 12001 12002 12003 12004 12005


Related Items

Category 2 - DIAGNOSTIC PROCEDURES AND INVESTIGATIONS

12000

12000 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Nov-2018
Schedule Fee Updated:
01-Nov-2023

Skin prick testing for aeroallergens by a specialist or consultant physician in the practice of the specialist or consultant physician’s specialty, including all allergens tested on the same day, not being a service associated with a service to which item 12001, 12002, 12005, 12012, 12017, 12021, 12022 or 12024 applies

Fee: $42.85 Benefit: 75% = $32.15 85% = $36.45

(See para DN.1.22 of explanatory notes to this Category)

Category 2 - DIAGNOSTIC PROCEDURES AND INVESTIGATIONS

12001

12001 - Additional Information

Item Start Date:
01-Nov-2018
Description Updated:
01-Nov-2018
Schedule Fee Updated:
01-Nov-2023

Skin prick testing for aeroallergens, including all allergens tested on the same day, not being a service associated with a service to which item 12000, 12002, 12005, 12012, 12017, 12021, 12022 or 12024 applies.

Applicable only once in any 12 month period

Fee: $42.85 Benefit: 75% = $32.15 85% = $36.45

(See para DN.1.22 of explanatory notes to this Category)

Category 2 - DIAGNOSTIC PROCEDURES AND INVESTIGATIONS

12002

12002 - Additional Information

Item Start Date:
01-Nov-2018
Description Updated:
01-Nov-2018
Schedule Fee Updated:
01-Nov-2023

Repeat skin prick testing of a patient for aeroallergens, including all allergens tested on the same day, if:

(a) further testing for aeroallergens is indicated in the same 12 month period to which item 12001 applies to a service for the patient; and

(b) the service is not associated with a service to which item 12000, 12001, 12005, 12012, 12017, 12021, 12022 or 12024 applies

Applicable only once in any 12 month period

Fee: $42.85 Benefit: 75% = $32.15 85% = $36.45

(See para DN.1.22 of explanatory notes to this Category)

Category 2 - DIAGNOSTIC PROCEDURES AND INVESTIGATIONS

12003

12003 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Nov-2018
Schedule Fee Updated:
01-Nov-2023

Skin prick testing for food and latex allergens, including all allergens tested on the same day, not being a service associated with a service to which item 12012, 12017, 12021, 12022 or 12024 applies

Fee: $42.85 Benefit: 75% = $32.15 85% = $36.45

(See para DN.1.22 of explanatory notes to this Category)

Category 2 - DIAGNOSTIC PROCEDURES AND INVESTIGATIONS

12004

12004 - Additional Information

Item Start Date:
01-Nov-2018
Description Updated:
01-Nov-2018
Schedule Fee Updated:
01-Nov-2023

Skin testing for medication allergens (antibiotics or non general anaesthetics agents) and venoms (including prick testing and intradermal testing with a number of dilutions), including all allergens tested on the same day, not being a service associated with a service to which item 12012, 12017, 12021, 12022 or 12024 applies

Fee: $64.80 Benefit: 75% = $48.60 85% = $55.10

(See para DN.1.22 of explanatory notes to this Category)

Category 2 - DIAGNOSTIC PROCEDURES AND INVESTIGATIONS

12005

12005 - Additional Information

Item Start Date:
01-Nov-2018
Description Updated:
01-Nov-2018
Schedule Fee Updated:
01-Nov-2023

Skin testing:

(a) performed by or on behalf of a specialist or consultant physician in the practice of the specialist or consultant physician’s specialty; and

(b) for agents used in the perioperative period (including prick testing and intradermal testing with a number of dilutions), to investigate anaphylaxis in a patient with a history of prior anaphylactic reaction or cardiovascular collapse associated with the administration of an anaesthetic; and

(c) including all allergens tested on the same day; and

(d) not being a service associated with a service to which item 12000, 12001, 12002, 12003, 12012, 12017, 12021, 12022 or 12024 applies

Fee: $87.15 Benefit: 75% = $65.40 85% = $74.10

(See para DN.1.22 of explanatory notes to this Category)


Legend

  • Assist - Addition/Deletion of (Assist.)
  • Amend - Amended Description
  • Anaes - Anaesthetic Values Amended
  • Emsn - EMSN Change
  • Fee - Fee Amended
  • Renum - Item Number Change (renumbered)
  • New - New Item
  • NewMin - New Item (previous Ministerial Determination)
  • Qfe - QFE Change